Hemorrhoids (also called piles) are inflamed, swollen blood vessels located in and around the anus and lower rectum. These vessels can stretch under pressure, like varicose veins in the legs. Hemorrhoids are either inside the anus (internal) or under the skin around the anus (external). About 50% of the adult population of the United States, both men and women, have hemorrhoids.
Hemorrhoids aren’t usually dangerous or life-threatening. They aren’t contagious.
Causes include increased pressure and swelling from straining to move the bowel and conditions such as pregnancy and chronic constipation or diarrhea. Heredity and aging are other factors.
Many people have hemorrhoids but not all have symptoms. Pain or tenderness can occur during bowel movements. The most common symptom of internal hemorrhoids is bright red blood covering stools (bowel movements), on toilet paper, or in the toilet. Internal hemorrhoids may poke through to outside the body and become irritated and painful. These are protruding hemorrhoids. Symptoms of external hemorrhoids include painful swelling or hard lump near the anus. Straining, rubbing, or cleaning around the anus may cause irritation with bleeding and itching. Draining mucus may cause itching.
The health care provider may suspect hemorrhoids from the symptoms and will make a diagnosis by doing a physical examination. Hemorrhoids can be painless, and the health care provider may find them on routine physical examinations.
Soft bowel movements are important for preventing and treating hemorrhoids. Eating a high-fiber diet and drinking plenty of fluids are important. Measures to reduce symptoms include warm tub or sitz baths several times a day. Ice packs can help reduce swelling. Cream or suppositories can be applied to the affected area. If hemorrhoids are very inflamed, the health care provider may prescribe creams or ointments to decrease inflammation. Daily use of stool softeners such as docusate during flare-ups helps. Most people get better in about 2 weeks if they follow the doctor’s suggestions.
Some hemorrhoids are treated surgically to remove or reduce the size of hemorrhoids. These methods include rubber band ligation, sclerotherapy, electric or laser heat (laser coagulation) or infrared light (infrared photocoagulation), and hemorrhoidectomy. For ligation, a rubber band around the bottom of the hemorrhoid cuts off circulation, and the hemorrhoid goes away. Sclerotherapy uses a chemical to shrink hemorrhoids. For heat and light methods, special tools are used to burn hemorrhoids. Hemorrhoidectomy is surgery to remove hemorrhoids permanently.
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