Alternative names: Piles
Hemorrhoids are caused by swollen veins in and around the anus and lower rectum. This swelling can happen either inside or outside of the anus, and can be painful. Hemorrhoids are a very common problem. Almost half of the population has suffered from hemorrhoids by the time they reach age 50.
An internal hemorrhoid, or swelling that takes place in the veins inside of the anus, can be detected by bright red blood on toilet paper, on a bowel movement, or in the toilet bowl. In some cases, an internal hemorrhoid can prolapse, or push outside of the anus, during a bowel movement. This causes marked irritation and pain.
An external hemorrhoid, or swelling that takes place in the veins outside and around the anus, can cause painful swelling, bleeding, and itching. Sometimes a lump of tender skin will form around the anus.
Hemorrhoids are caused by pressure on the veins around and inside the anus and lower rectum. This pressure can result from:
- Straining, or pushing hard, during bowel movements
- Long-term constipation or diarrhea
- Anal intercourse
Because bleeding from the rectum, or blood in a bowel movement, can indicate a serious digestive disease, your doctor will want to examine the anus and rectum to look for the signs of hemorrhoids and rule out any other causes. He or she may perform a digital rectal exam with a gloved, lubricated finger. Your doctor also may want to do a more intensive examination, using one of these tools:
- An anoscope, a hollow, lighted tube for viewing inside the anus
- Flexible sigmoidoscopy uses a thin, flexible tube - about two feet long - to examine the lower intestine and the rectum. The tube has a tiny video camera and a light mounted at its tip. The video camera transmits images to a television monitor, which allows your doctor to see inside your body. The procedure takes about three minutes, and causes only slight discomfort.
- In a colonoscopy, a doctor uses a thin, flexible tube to examine the entire large intestine. The tube has a tiny video camera and a light mounted at its tip. The video camera transmits images to a television monitor, which allows your doctor to see inside your body. This will take about an hour, and you will be given medication to make you relaxed and drowsy.
Mild cases of hemorrhoids can be eased by eating more fiber??as found in fruits, vegetables, bread, and cereal??and drinking plenty of fluids. Short baths taken in plain water, and over-the-counter hemorrhoidal creams can also help, as can making an effort not to strain during bowel movements. The pain and swelling of most mild hemorrhoid cases will decrease in less than a week with these measures.
Severe cases of hemorrhoids can be treated with several methods, including:
- Ligation is often done on internal hemorrhoids that prolapse outside of the anus during bowel movements. A small rubber band is used to cut off the blood supply to the hemorrhoid, which will fall off within a few days. This method can cause some pain and bleeding.
- Sclerotherapy injects a chemical around the blood vessel to shrink an internal hemorrhoid
- Infrared coagulation burns away hemorrhoidal tissue
- If other methods do not work, a doctor might perform a hemorroidectomy to remove an internal or external hemorrhoid by surgery. This is done under general anesthesia, which means that you will be asleep and will feel no pain from the procedure. You may need to stay in the hospital after the operation, and plan for time away from normal activities.