Information About Hemorrhoids | Gastroenterology


What are hemorrhoids?

Hemorrhoids, also known as piles, are swollen veins in the anus and lower rectum, similar to varicose veins. They develop inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids).

Almost three out of four have hemorrhoids from time to time. There are many causes, but the cause is often unknown. Fortunately, there are effective options for treating hemorrhoids. Most people find relief with home remedies and lifestyle changes.


They are types: Internal or External.

Internal hemorrhoids:  It is deep within the rectum and is not visible from the outside. They are usually painless. Often the first sign is rectal bleeding.

The leak sometimes pushes the internal hemorrhoid outward so that it protrudes through the anus. This is called bulging or enlarged hemorrhoids and it can be painful.

External hemorrhoids: It is found under the skin around the anus and is therefore visible. Because there are more sensitive nerves in this part of the body, they are generally more painful. They can bleed due to leakage when defecating.


If you have external hemorrhoids, you may have:

  • Anal itching
  • One or more light, rough lumps near your anus
  • Anal pain or discomfort, especially when sitting
  • Excessive filtration, massage, or cleaning around your anus can make your symptoms worse. For most people, the symptoms of external hemorrhoids go away within a few days.

If you have internal hemorrhoids, you may have:

  • Rectal bleeding – bright red blood in the stool, toilet paper, or toilet bowl after a bowel movement.
  • Bleeding that has fallen through the anal opening called a prolapse.
  • Most of the time, unexplained internal hemorrhoids are not painful. Enlarged internal hemorrhoids can cause pain and discomfort.


The dilation of the veins around the anus can cause hemorrhoids.

They can occur for the following reasons:

Pregnancy: They are more common in pregnant women because when the uterus dilates, it presses on the vein in the colon, causing it to swell.

Aging: They are more common in adults ages 45 to 65. However, this does not mean that young people and children cannot acquire them.

Diarrhea: These can occur after chronic diarrhea.

Chronic constipation: Leakage to move stool puts extra pressure on the blood vessel walls.

Sitting for a long time: Sitting for a long time can lead to the condition, especially on the toilet.

Heavy lifting: Repeated lifting of heavy objects can lead to hemorrhoids.

Anal intercourse: It can cause new hemorrhoids or make existing ones worse.

Obesity: Dietary reactions can cause.

Genetics: some people inherit the tendency to develop the condition.

Risk factors

If your parents have hemorrhoids, you may have them too. These can also be caused by pregnancy. At our age, these are caused by the stress of sitting too much. And any external hemorrhoids that cause you stress during bowel movements.

If you don’t know the cause your doctor can decide why.


Hemorrhoids can be chronic and painful, but they usually don’t cause problems. In rare cases, thrombosed hemorrhoids can rupture. It can cause more bleeding and pain, but the site of the rupture usually heals on its own. In some cases, a skin tag may form at the site of the healed thrombosed hemorrhoid.

It is very rare, but significant blood loss from chronic hemorrhoids is associated with the development of anemia. Another rare problem is a sore throat, where blood flow to internal hemorrhoids is cut off, causing severe pain. Throat hemorrhoids pose a risk of infection, so it is important to take precautions to prevent this result.

In rare cases, hemorrhoids can cause problems such as:

  • Skin tags: When the lump in the thrombosed hemorrhoid melts, some skin may remain, which can be irritating.
  • Anemia: If you have hemorrhoid that bleeds for a long time, you can lose a lot of blood.
  • Infection: Some external hemorrhoids have infected sores.
  • Throat hemorrhoids: Muscles can block blood flow to enlarged hemorrhoids. It is very painful and requires surgery.


The risk of hemorrhoids is greatly reduced when the stool remains soft. Help in the following ways:

Nutrition: Eating lots of high-fiber foods, such as fruits and vegetables, as well as whole grains, means that the tables are almost always soft. Similarly, drinking plenty of fluids can help keep your stools soft. Over-the-counter fiber supplements also reduce constipation.

Avoid excessive stress: When using the bathroom, try to avoid straining. This creates pressure on the veins in the lower rectum.

Go to the bathroom when needed:  People shouldn’t wait if they need to use the bathroom. If you wait too long, the banks will dry up.

Physical activity: Sitting or standing for a long time puts pressure on the veins. Physical activity also helps move stool through the intestine, so bowel movements are more regular.

Maintain a healthy body weight: Being overweight significantly increases the risk of developing hemorrhoids.


Common symptoms are itching, pain, constipation or a lump, and bleeding. Diagnosis is made by history and physical examination. The story may focus on related symptoms such as constipation, stiff bowel movements, and diarrhea while going to the bathroom. Other questions may be asked about other causes of rectal bleeding, such as tumors, inflammatory bowel disease, and gastrointestinal bleeding.

A physical exam is done to confirm the diagnosis and includes a stool test, where the finger is used to feel for abnormal lumps or masses. Interestingly, internal hemorrhoids are not commonly experienced. Stool examination may be postponed if there is severe pain or swelling. Also, hemorrhoids and constipation can be associated with anal fissures or cracks in the skin around the anus. The associated pain and cramps make the stool test very uncomfortable.

If healthcare professionals are concerned that symptoms, especially rectal bleeding, cannot be explained by hemorrhoids, anoscopy may be considered. Anoscopy is an office procedure where a light tube is inserted to view the anus. A sigmoidoscopy or colonoscopy may be ordered if there is a concern that bleeding may arise from other areas of the colon. These procedures are usually performed by a gastroenterologist or surgeon.

Depending on the situation, blood tests may be ordered. If excessive bleeding occurs, the hemoglobin or red blood cell count can be monitored. If the patient is taking warfarin, the INR (International Normalization Index) or PT (Protime) can be requested to check if the blood “thins”. Note that there are many newer anticoagulants available to “thin” the blood, and their activity cannot be measured by routine blood tests.


Treatment for hemorrhoids is done at home or in the doctor’s office.

Pain relief: To reduce pain, soak in a tub of warm water for at least 10 minutes every day. You can sit in a bottle of warm water to relieve external hemorrhoid pain. If the pain is unbearable, use over-the-counter medicated suppositories, ointments, or creams to relieve the burning and itching. You can find hemorrhoid suppositories online or in stores.

Fiber supplements: If you have constipation, you can also use an over-the-counter fiber supplement to help soften your stool. The two most common substances of this type are psyllium and methylcellulose.

Home remedies: Over-the-counter topical treatments, such as hydrocortisone or hemorrhoid cream, can reduce the discomfort caused by hemorrhoids.

Practice good hygiene by rinsing your anus with warm water every day while showering or bathing. Do not use soap as soap can aggravate the condition. Do not use dry or stiff toilet paper when wiping after a bowel movement.

Applying cold compresses to the anus can reduce inflammation. Pain relievers such as acetaminophen, ibuprofen, or aspirin can also reduce pain or discomfort.

Medical procedures: If home remedies don’t help, your doctor may recommend that you put on a rubber band. In this procedure, the doctor cuts off the circulation of the bleeding by placing a rubber band around it. This causes hemorrhoids to lose circulation, forcing them to contract.

If bonding with rubber bands is not an option for you, your doctor may recommend injection therapy or sclerotherapy. During this procedure, your doctor injects a chemical directly into your bloodstream. This causes the size of the hemorrhoids to decrease.


For those who have hemorrhoids regularly, some diet and lifestyle changes can help with healing and prevention.


  • Eating lots of high-fiber foods softens your stools.
  • Leaking during bowel movements is a common cause, but people can make dietary adjustments to reduce their stress.
  • In general, it is beneficial to include fiber in your diet. The plant fibers in fruits, vegetables, nuts, and grains help collect water in the stool, helping it soften and become easy.
  • Eating soluble fiber such as methylcellulose (Citrucel) or psyllium (Metamucil) reduces constipation.
  • Drinking plenty of water throughout the day helps ensure that the body has enough water for healthy digestion, which also reduces constipation.

What should I eat if I have hemorrhoids? Food

People must soften their stools by increasing the fiber in their diet.

Fiber is found in many foods.

  • Fresh and dried fruits
  • Vegetables
  • Cereals
  • Generally, 20 to 30 grams of fiber per day is recommended, while the average American diet contains less than 15 grams of fiber. Fiber supplements, such as psyllium, methylcellulose, and polycarbophil calcium, can also be used to increase fiber intake.

Drinking more fluids as well as higher doses of laxatives may also be recommended. However, the benefits of fiber, fluid, and stool softening devices for bleeding control have not been well proven in scientific studies.

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