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Hemorrhoids, also known as piles, are swollen veins in the lower part of the anus and rectum. When the walls of these vessels are stretched, they become irritated.

Although hemorrhoids can be unpleasant and painful, they are easily treated and very preventable. As hemorrhoids generally get worse over time, doctors suggest that they should be treated as soon as they appear.

Fast facts on hemorrhoids

Here are some key points about hemorrhoids. More detail and supporting information is in the main article.

  • Women are more likely to get hemorrhoids while pregnant.
  • The likelihood of developing hemorrhoids increases as a person ages.
  • Hemorrhoids occur when the veins surrounding the anus are engorged or enlarged.
  • Sometimes, medicines and surgery are needed to treat hemorrhoids.

In the majority of cases, simple measures will alleviate symptoms while hemorrhoids get better without treatment. However, medicines and even surgery may sometimes be needed.

Home treatments

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Specialist ultrasonic device for hemorrhoid surgery.

Symptoms can be relieved in the following ways. However, they will not eliminate the hemorrhoids:

  • Topical creams and ointments: Over the counter (OTC) creams or suppositories, which contain hydrocortisone, are available to buy online. There are also pads which contain witch hazel, or a numbing agent that can be applied to the skin.
  • Ice packs and cold compresses: Applying these to the affected area may help with the swelling.
  • A sitz bath using warm water: A sitz bath is placed over the toilet. Some pharmacies sell them, and they may relieve the burning or itching symptoms.
  • Moist towelettes: Dry toilet paper may aggravate the problem.
  • Analgesics: Some painkillers, such as aspirin, ibuprofen, and acetaminophen may alleviate the pain and discomfort.

Medicines

Most hemorrhoid medicines are OTC. These include ointments, pads, or suppositories.

Active ingredients as hydrocortisone and witch hazel are known to relieve itching and pain. Consult with a doctor if these medicines do not show results after a week of treatment.

Nonsurgical treatment options

The most common type of nonsurgical hemorrhoid removal technique is rubber band ligation.

This is an outpatient procedure for internal hemorrhoids, where an elastic band is placed on the base of the hemorrhoid to cut off blood supply. The hemorrhoid will either shrink or fall off.

Another procedure is sclerotherapy, where a solution is injected into an internal hemorrhoid. This produces a scar that cuts off blood supply to the hemorrhoid.

Infrared photocoagulation and electrocoagulation are two other options.

Surgical options

Surgery may involve a complete removal of the hemorrhoids, known as a hemorrhoidectomy.

It may also involve stapling, where a prolapsed hemorrhoid is tacked back into place. These procedures are performed under general anesthesia, and most people can go home on the same day as the surgery.

Enlargement of the veins around the anus causes hemorrhoids.

They can occur for the following reasons:

  • Pregnancy: They occur more commonly in pregnant women because, as the uterus enlarges, it presses on the vein in the colon, causing it to bulge.
  • Aging: Hemorrhoids are most common among adults aged 45 to 65 years. This does not mean, however, that young people and children do not get them.
  • Diarrhea: Hemorrhoids can occur after cases of chronic diarrhea.
  • Chronic constipation: Straining to move stool puts additional pressure on the walls of the blood vessels.
  • Sitting for too long: Staying in a seated position for long periods of time can cause hemorrhoids, especially on the toilet.
  • Heavy lifting: Repeatedly lifting heavy objects can lead to hemorrhoids.
  • Anal intercourse: This can cause new hemorrhoids or worsen existing ones.
  • Obesity: Diet-related obesity can cause hemorrhoids.
  • Genetics: Some people inherit a tendency to develop hemorrhoids.

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Hemorrhoids can be either internal or external.

Symptoms of hemorrhoids often include:

  • painless bleeding
  • itching or irritation in the anal area
  • discomfort, pain, or soreness in the same area
  • lumps and swelling in the anal region
  • leaking feces

Symptoms can be unpleasant or alarming, but they are usually not a cause for concern.

Hemorrhoids can be either internal or external.

Internal hemorrhoids

Internal hemorrhoids are deep inside the rectum and not visible from outside. They are normally painless. Often, the first sign that internal hemorrhoids are present is rectal bleeding.

Straining can sometimes push an internal hemorrhoid so that it protrudes through the anus. This is called a protruding or prolapsed hemorrhoid and can be painful.

External hemorrhoids

External hemorrhoids are under the skin around the anus and are therefore visible. Because there are more sensitive nerves in this part of the body, they are normally more painful. Straining when passing a stool may cause them to bleed.

Diagnosis

Anyone experiencing the symptoms outlined above should contact a doctor. Bear in mind that other things, including colorectal and anal cancers, can cause rectal bleeding.

A doctor can carry out a physical examination and perform other tests to determine whether or not hemorrhoids are present. These tests may include a digital rectal exam. This is a manual inspection by the doctor using a gloved, lubricated finger.

If symptoms include significant amounts of bleeding, dizziness, and a fainting sensation, the individual should seek emergency care immediately.

The risk of developing hemorrhoids is greatly reduced when stools are kept soft. This can be helped in the following ways:

  • Nutrition: Eating plenty of foods rich in fiber, such as fruits and vegetables, as well as whole grains, means stools will nearly always be soft. Similarly, drinking plenty of fluids helps keep stools soft. OTC fiber supplements also ease constipation.
  • Avoiding over-straining: When using the toilet, try not to strain. This creates pressure in the veins in the lower rectum.
  • Going to the toilet when needed: People should not wait if they need to use the toilet. The longer the wait, the drier the stools will be.
  • Physical activity: Sitting or standing still for long periods puts pressure on the veins. Physical activity also helps stool move through the bowel, so bowel movements are more regular.
  • Maintaining a healthy body weight: Being overweight significantly raises the risk of having hemorrhoids.

Hemorrhoids are often treated successfully and without complications, especially if treatment starts early. However, the following rare complications can arise:

  • Strangulated hemorrhoid: If the blood supply to the hemorrhoid is cut off, it may become strangulated. This can cause significant pain.
  • Anemia: Significant, chronic blood loss from hemorrhoids can lead to anemia. This occurs when there are not enough red blood cells in a person's circulation.
  • Blood clots: Sometimes, blood may clot in the anus, which can be painful. The area will swell and become inflamed.