Hemorrhoids

Definition

Hemorrhoids are swollen veins in the anus or lower part of the rectum.

Alternative Names

Rectal lump; Piles; Lump in the rectum; Rectal bleeding - hemorrhoids; Blood in the stool - hemorrhoids

Causes

Hemorrhoids are very common. They result from increased pressure on the anus. This can occur during pregnancy or childbirth, and due to constipation. The pressure causes the normal anal veins and tissue to swell. This tissue can bleed, often during bowel movements.

Hemorrhoids may be caused by:

Hemorrhoids may be inside or outside the body.

Symptoms

Hemorrhoids are most often not painful, but if a blood clot forms, they can be very painful.

Common symptoms include:

Exams and Tests

Most of the time, a health care provider can diagnose hemorrhoids by simply looking at the rectal area. External hemorrhoids can often be detected this way.

Tests that may help diagnose the problem include:

Treatment

Treatments for hemorrhoids include:

Things you can do to reduce itching include:

Sitz baths can help you to feel better. Sit in warm water for 10 to 15 minutes.

If your hemorrhoids do not get better with home treatments, you may need some type of office treatment to shrink the hemorrhoids.

If office treatment is not enough, some type of surgery may be necessary, such as removal of the hemorrhoids (hemorrhoidectomy). These procedures are generally used for people with severe bleeding or prolapse who have not responded to other therapy.

Possible Complications

The blood in the hemorrhoid may form clots. This can cause tissue around it to die. Surgery is sometimes needed to remove hemorrhoids with clots.

Rarely, severe bleeding may also occur. Iron deficiency anemia can result from long-term blood loss.

When to Contact a Medical Professional

Contact your provider if:

Get medical help right away if:

Prevention

Constipation, straining during bowel movements, and sitting on the toilet too long raise your risk for hemorrhoids. To prevent constipation and hemorrhoids, you should:

References

Bass LM, Wershil BK. Anatomy, histology, embryology, and developmental anomalies of the small and large intestine. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 98.

Cameron J. Anorectal. In: Cameron J, ed. Current Surgical Therapy. 14th ed. Philadelphia, PA: Elsevier; 2023:chap 5.

Zainea GG, Pfenninger JL. Office treatment of hemorrhoids. In: Fowler GC, ed. Pfenninger and Fowler's Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 87.



Review Date: 9/9/2023
Reviewed By: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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