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Learn about hemorrhoids
Hemorrhoids, also sometimes called piles, are a common problem. According to Mayo Clinic, nearly three out of four adults experience hemorrhoids at some point in their lives.
Hemorrhoids can develop inside the lower rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids). Swollen veins can cause mild pain, anal itching, and bleeding.
Internal hemorrhoids
Internal hemorrhoids occur inside the rectum. Most of the time, you cannot see or feel an internal hemorrhoid, and they rarely cause pain or discomfort. However, irritation when passing stool may cause painless bleeding. Prolapsed internal hemorrhoids can cause pain and irritation.
External hemorrhoids
External hemorrhoids involve swollen veins underneath the skin around the anus. External hemorrhoids can be itchy and painful, and they may fill with blood that can clot, called thrombosed hemorrhoids. Like internal hemorrhoids, external hemorrhoids can prolapse.
Hemorrhoid causes
The veins around the anus tend to stretch under pressure, leading to bulging or swelling. Any sort of straining that increases the pressure on your body's lower extremities can cause swollen anal and rectal veins.
Hemorrhoids may occur due to:
Increased pelvic pressure from weight gain, especially during pregnancy
Straining to lift heavy objects or weightlifting
Straining during bowel movements due to constipation
Sitting for long periods, for example on office chairs or toilets
Eating a low-fiber diet
Hemorrhoid symptoms
Internal hemorrhoids rarely cause pain (and typically cannot be felt) until the internal hemorrhoid prolapses. As a result, many people with internal hemorrhoids do not know that they have hemorrhoids due to the lack of symptoms.
If you have symptoms of internal hemorrhoids, you may notice bright red blood on toilet paper, in stool, or in the toilet bowl. These are signs of rectal bleeding.
The symptoms of external hemorrhoids include:
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Anal itching
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Hard lumps near the anus that feel sore or tender
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Pain or aching in the anus, especially when you sit
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Rectal bleeding
How to treat hemorrhoids
Most hemorrhoids go away on their own without treatment. Most symptoms, including mild pain and bleeding, may last one week. Fortunately, at-home treatment options can provide pain relief. Some common at-home hemorrhoid treatments include:
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Drinking plenty of water throughout the day to help reduce constipation.
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Eating more fiber or taking a fiber supplement. Try to eat at least 20–35 grams of fiber daily.
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Using gentle stool softeners such as Miralax (polyethylene glycol powder)
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Soaking in a warm bath (sitz bath) for 10–20 minutes a day.
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Using toilet paper with lotion or flushable wet wipes to clean the area
If your symptoms do not improve beyond two weeks or more, your healthcare may recommend a medical procedure to treat your hemorrhoid, such as:
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Rubber band ligation: During rubber band ligation, a small rubber band is placed around the base of the hemorrhoid and cuts off blood supply to the swollen vein.
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Electrocoagulation: An electric current stops blood flow to the hemorrhoid.
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Hemorrhoid stapling: A stapling instrument removes an internal hemorrhoid. Hemorrhoid stapling can also pull prolapsed hemorrhoids back inside the anus.
Hemorrhoid medication
Prescription-strength steroid creams
Your doctor may prescribe prescription steroid creams to relieve itching and pain, such as:
Over-the-counter options
In addition, you may take OTC pain relievers, such as acetaminophen and ibuprofen, to relieve hemorrhoid pain.
How to prevent hemorrhoids
Hemorrhoids become more common with age, but simple lifestyle changes can help prevent hard stools and constipation:
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Avoid sitting too long or pushing too hard on the toilet.
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Go to the bathroom when the urge hits.
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Stay hydrated throughout the day.
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Eat high-fiber foods.
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Stay physically active.
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Take laxatives and stool softeners only as recommended by your doctor.
When to see a doctor for hemorrhoids
If you notice blood on toilet paper or bleeding during bowel movements, or if your hemorrhoids do not improve after a week of at-home treatment, talk to your doctor.
Do not assume that bleeding is due to a swollen vein, especially if you are also experiencing changes in bowel movements or stool. Bleeding can occur due to other conditions, including rectal cancer and colon cancer. Seek emergency medical treatment if you:
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Notice large amounts of rectal bleeding
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Feel lightheaded, dizzy, or faint
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Experience nausea or vomiting
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Feel severe pain
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Develop a fever or chills
Related conditions to hemorrhoids
Gastrointestinal disorders can also cause rectal bleeding and other symptoms of hemorrhoids. Some of these disorders can be life-threatening and require medical treatment. It is important to talk to your health care professional if you're experiencing symptoms.
IBS (irritable bowel syndrome)
Crohn's disease & Ulcerative Colitis
Crohn's disease and Ulcerative Colitis are lifelong conditions that cannot be cured. However, medical treatments can help control symptoms and prevent flares.
Colorectal cancer
Because symptoms usually do not arise until the cancer has advanced, it is important to schedule regular screenings.
Hemorrhoid treatment FAQs
What are hemorrhoids?
What is the best hemorrhoid treatment?
How much does hemorrhoid treatment cost?
How long do hemorrhoids take to heal?
What is the treatment for a thrombosed external hemorrhoid?
During the procedure, your doctor will make a small cut in the blood clot to drain it. You will receive local anesthesia to numb the affected area.
This procedure works best within three days after the hemorrhoid appears. Although it works quickly, blood clots may return after surgery.
What over the counter medicine is available for hemorrhoids (piles)?
Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil) can help manage pain and discomfort. Witch hazel pads or wipes can provide a soothing, astringent effect that helps reduce irritation and itching. Constipation can worsen hemorrhoids, so stool softeners like Colace (docusate) can ease bowel movements and reduce straining.
For long-term relief, it's important to talk to a doctor. A doctor can diagnose the type and severity of your hemorrhoids and recommend the most effective treatment plan. This might include prescription medications or minimally invasive procedures for severe cases. Your doctor will also help identify any underlying issues that are contributing to your hemorrhoids.
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Hemorrhoid treatment resources
Sources:
PlushCare is dedicated to providing you with accurate and trustworthy health information.
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Cleveland Clinic. Hemorrhoids. Accessed on May 25, 2022. https://my.clevelandclinic.org/health/diseases/15120-hemorrhoids
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Harvard Health. Hemorrhoids and what to do about them. Accessed on May 25, 2022. https://www.health.harvard.edu/diseases-and-conditions/hemorrhoids_and_what_to_do_about_them
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Mayo Clinic. Hemorrhoids. Accessed on May 25, 2022. https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268#:~:text=Hemorrhoids%20are%20swollen%20veins%20in,rectum%2C%20similar%20to%20varicose%20veins.
PlushCare content is reviewed by MDs, PhDs, NPs, nutritionists, and other healthcare professionals. Learn more about our editorial standards and meet the medical team. The PlushCare site or any linked materials are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment.