What is hemorrhoids?

Hemorrhoids are swollen veins in the anal canal. This common problem can be painful, but it's usually not serious. Veins can swell inside the anal canal to form internal hemorrhoids. Or they can swell near the opening of the anus to form external hemorrhoids. You can have both types at the same time.

Hemorrhoids may cause:

• Rectal bleeding. You may see bright red blood on the toilet paper or in the toilet after a bowel movement. You may see blood on the stool.
• Itching. Hemorrhoids often seep mucus. It can irritate the skin and cause itching.
• Discomfort. You may still feel the urge to pass stool right after having a bowel movement.
• Pain.
  • When a vein within an external hemorrhoid gets irritated, blood may clot under the skin, forming a hard, bluish lump. This is known as a thrombosed, or clotted, hemorrhoid. Thrombosed hemorrhoids can be very painful.
  • Large internal hemorrhoids that bulge from the anus may be painful if they're squeezed by the anal muscles. They may be very painful if the blood supply to the hemorrhoid is cut off.

Your doctor can tell if you have hemorrhoids by asking about your past health and doing a physical exam.

You may not need many tests at first if your doctor thinks that your rectal bleeding is caused by hemorrhoids. Your doctor may just examine your rectum with a gloved finger. Or your doctor may use a short, lighted scope to look inside the rectum.

Rectal bleeding can be a sign of a more serious problem, such as colon, rectal, or anal cancer. So if the first exam doesn't show a clear cause of your problems, your doctor may do tests to check for other causes of bleeding. The doctor may use a lighted scope to look at the lower third of your colon. This is called sigmoidoscopy. Or your doctor may use another kind of scope to look at the entire colon. This is called colonoscopy.

For most external hemorrhoids, home treatment is all you need. The same home treatment can be used for most internal hemorrhoids.

• Slowly add fiber to your meals. Eat foods that have lots of fiber, such as fruits, vegetables, and whole grains.
• Use an over-the-counter ointment for a limited time to stop itching. You also may use a stool softener.
• Try suppositories. They can help relieve irritation and lubricate the anal canal during bowel movements.
• Drink plenty of water.
• Get some exercise every day.

If your internal hemorrhoids are severe, you may need other treatment. The doctor may tie off the hemorrhoids with rubber bands or create scar tissue around the hemorrhoids. These treatments reduce the blood supply to the hemorrhoids so they shrink or go away.

Surgery to remove hemorrhoids may be done if other treatments don't work. It may be done to remove large internal or external hemorrhoids that are uncomfortable or painful.

• Sit in a few inches of warm water (sitz bath) 3 times a day and after bowel movements. The warm water helps with pain and itching.
• Put ice on your anal area several times a day for 10 minutes at a time. Put a thin cloth between the ice and your skin. Follow this by placing a warm, wet towel on the area for another 10 to 20 minutes.
• Take pain medicines exactly as directed.
  • If the doctor gave you a prescription medicine for pain, take it as prescribed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• Keep the anal area clean, but be gentle. Use water and a fragrance-free soap, or use baby wipes or medicated pads such as Tucks.
• Wear cotton underwear and loose clothing to decrease moisture in the anal area.
• Eat more fiber. Include foods such as whole-grain breads and cereals, raw vegetables, raw and dried fruits, and beans.
• Drink plenty of fluids. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
• Use a stool softener that contains bran or psyllium. You can save money by buying bran or psyllium (available in bulk at most health food stores) and sprinkling it on foods or stirring it into fruit juice. Or you can use a product such as Metamucil or Hydrocil.
• Practice healthy bowel habits.
  • Go to the bathroom as soon as you have the urge.
  • Avoid straining to pass stools. Relax and give yourself time to let things happen naturally.
  • Do not hold your breath while passing stools.
  • Do not read while sitting on the toilet. Get off the toilet as soon as you have finished.
• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.