Dr. Elizabeth McConnell - Board Certified Colorectal Surgeon

McConnell Colorectal Center

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Colonoscopy, Surgical Procedures, Colorectal Diseases, and Anal Diseases

Hemorrhoids

What are hemorrhoids?

Hemorrhoids are found inside the anus and/or under the skin around the anus. Straining to move stool may cause Hemorrhoids. Hemorrhoids occur when the veins around the anus or lower rectum are swollen and inflamed.

Straining or irritation from passing stool can injure a hemorrhoid's delicate surface and cause it to bleed. Due to internal anal membranes lacking pain-sensitive nerve fibers, the internal hemorrhoids typically do not cause discomfort but you might experience a feeling of fullness in your rectum following a bowel movement. Sometimes straining pushes internal hemorrhoids through the anal opening. If a hemorrhoid remains displaced it can cause pain and irritation. Blood may pool in an external hemorrhoid and form a clot causing severe pain, swelling and inflammation.

You can't see or feel internal hemorrhoids. External hemorrhoids are usually painful.

Pregnancy, aging, chronic constipation or diarrhea and anal intercourse may cause Hemorrhoids.

What are signs that you have hemorrhoids?

In most instances, Hemorrhoids are not dangerous. In fact, most symptoms of hemorrhoids are gone within a few days. Some anorectal conditions have similar symptoms and are incorrectly referred to as hemorrhoids. These other anorectal conditions include fissures, fistulae, abscesses, or irritation and itching.

A protruding hemorrhoid is an internal hemorrhoid that protrudes through the anus outside the body and becomes both irritated and painful. Some people have hemorrhoids even though they do not experience any symptoms of hemorrhoids. The most common symptom of internal hemorrhoids is bright red blood covering the stool, on toilet paper, or in the toilet bowl.

External hemorrhoids may have the following symptoms: painful swelling or a hard lump around the anus which is the result of a blood clot forming. This external hemorrhoid condition is called thrombosed external hemorrhoid.

Excessive straining, rubbing, or cleaning around the anus may cause irritation with itching and/or bleeding. Itching may also be caused by draining mucus.

When irritated, external hemorrhoids can itch or bleed.

Are hemorrhoids very common?

Men and women both may have hemorrhoids, this is a common condition in both men and women. By age 50 half of the population has hemorrhoids. Hemorrhoids are also common among pregnant women because the fetus puts pressure on the abdomen. Hormonal changes in pregnant women may also cause hemorrhoidal vessels to enlarge. These hemorrhoidal vessels are placed under intense pressure during childbirth. Hemorrhoids caused by pregnancy are a temporary problem with most women.

What is the method used to diagnose hemorrhoids?

The doctor will examine the anus and rectum to look for swollen blood vessels which indicate that hemorrhoids are present. The doctor will also perform a digital rectal exam with a gloved, lubricated finger in order to check for abnormalities. If bleeding from the rectum or blood in the stool occurs, an evaluation and diagnosis by a doctor is very important . Bleeding from the rectum or blood in the stool may also be a symptom of digestive diseases such as colorectal cancer.

An exam with an anoscope, which is a hollow, lighted tube useful for viewing internal hemorrhoids, or a proctoscope, which is useful for examining the entire rectum, will be used by the doctor in order to take a closer examination of the rectum for hemorrhoids.

The doctor may examine the rectum and lower colon with sigmoidoscopy or the doctor may examine the entire colon with colonoscopy in order to rule out other causes of gastrointestinal bleeding. Sigmoidoscopy and colonoscopy are procedures involving the doctor using a lighted, flexible tubes inserted through the rectum in order to view the rectum and lower colon.

How may I medically treat hemorrhoids?

Initially, the goal is to relieve symptoms. A 10-minute warm water tub bath several times a day and use of a hemorrhoidal cream or suppository may be used to relieve symptoms. It is a good idea to re-increase fiber and fluid intake which will result in a softer, bulkier stool.

In order to prevent hemorrhoids from recurring, doctors recommend relieving the pressure and straining of constipation. In turn, a softer stool will make emptying the bowels easier and less straining will lesson hemorrhoid pressure and help to prevent hemorrhoids from protruding.

Fruits, vegetables and whole grains are a great source of fiber. It may also be suggested by your doctor that you use a bulk stool softener or a fiber supplement such as Metamucil or Citrucel.

Hemorrhoids sometimes need to be removed through surgery.

Below is a list of techniques used to remove or reduce the size of internal hemorrhoids:

Rubber band ligation. The doctor will place a rubber band around the base of the hemorrhoid. The band will cut off circulation to the hemorrhoid causing it to wither away soon after.

Sclerotherapy. In order to shrink the hemorrhoid, a chemical solution is injected around the blood vessel.

Infrared coagulation. A device burns the hemorrhoidal tissue.

Hemorrhoidectomy. Severe hemorrhoids may be removed through surgery.

What can I do to prevent hemorrhoids?

Diet (increasing your fiber intake) and exercise are the best ways to prevent hemorrhoids. A soft stool will decrease pressure and straining.