The type of hemorrhoid you have depends on where it occurs.
- (Body) Internal hemorrhoids involve the veins inside your rectum. Internal hemorrhoids usually don’t hurt but they may bleed painlessly.
- Prolapsed hemorrhoids may stretch down until they bulge outside your anus. A prolapsed hemorrhoid may go back inside your rectum on its own, or you can gently push it back inside.
- External hemorrhoids involve the veins outside the anus. They can be itchy or painful and can sometimes crack and bleed.
If you have a hemorrhoid, you may feel a tender lump on the edge of your anus. You may also see blood on the toilet paper or in the toilet after a bowel movement.
Prevention
The best way to prevent hemorrhoids is to keep your stools soft, so they pass easily. To prevent hemorrhoids and reduce symptoms of hemorrhoids, follow these tips:
- Eat high-fiber foods: Eat more fruits, vegetables and whole grains. Doing so softens the stool and increases its bulk, which will help you avoid the straining that can cause hemorrhoids or worsen symptoms from existing hemorrhoids. Add fiber to your diet slowly to avoid problems with gas.
- Drink plenty of fluids: Drink six to eight glasses of water and other liquids (not alcohol) each day to help keep stools soft.
- Consider fiber supplements: Most people don’t get enough of the recommended amount of fiber — 25 grams a day for women and 38 grams a day for men — in their diet. Studies have shown that over-the-counter fiber supplements, such as Metamucil and Citrucel, improve overall symptoms and bleeding from hemorrhoids. If you use fiber supplements, be sure to drink at least eight glasses of water or other fluids every day. Otherwise, the supplements can cause constipation or make constipation worse.
- Don’t strain: Straining and holding your breath when trying to pass a stool creates greater pressure in the veins in the lower rectum.
- Go as soon as you feel the urge: If you wait to pass a bowel movement and the urge goes away, your stool could become dry and be harder to pass.
- Exercise: Stay active to help prevent constipation and to reduce pressure on veins, which can occur with long periods of standing or sitting. Exercise can also help you lose excess weight that may be contributing to your hemorrhoids.
- Avoid long periods of sitting: Sitting too long, particularly on the toilet, can increase the pressure on the veins in the anus.
Risk Factors
People whose parents had hemorrhoids may be more likely to get them. Pregnant women often get hemorrhoids because of the strain from carrying the baby and from giving birth. Being very overweight or standing or lifting too much can make hemorrhoids worse.
Causes
Hemorrhoids are caused by increased pressure in the veins of your anus or rectum. One of the main causes is straining when you’re trying to have a bowel movement. This may happen if you’re constipated or if you have diarrhea. It may also happen if you sit on the toilet too long. Hemorrhoids can also be caused by obesity, heavy lifting or any other activity that caused you to strain.
Symptoms
Signs and symptoms of hemorrhoids may include:
- Painless bleeding during bowel movements — you might notice small amounts of bright red blood on your toilet tissue or in the toilet bowl
- Itching or irritation in your anal region
- Pain or discomfort
- Swelling around your anus
- A lump near your anus, which may be sensitive or painful
- Leakage of feces
Hemorrhoid symptoms usually depend on the location. Internal hemorrhoids lie inside the rectum. You usually can’t see or feel these hemorrhoids, and they usually don’t cause discomfort. External hemorrhoids are under the skin around your anus. When irritated, external hemorrhoids can itch or bleed.
Diagnosis
See your doctor if you notice bleeding to make sure the cause is hemorrhoids and not some other problem. Bleeding from your rectum or anus or bloody stools may be a sign of something more serious such as cancer.
Treatment
Simple diet and lifestyle changes often reduce the swelling of hemorrhoids and relieve hemorrhoid symptoms. Eating a high-fiber diet can make stools softer and easier to pass, reducing the pressure on hemorrhoids caused by straining. Doctors may also suggest taking a bulk stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel).
Other changes that may help relieve hemorrhoid symptoms include
- drinking six to eight 8-ounce glasses of water or other nonalcoholic fluids each day
- sitting in a tub of warm water for 10 minutes several times a day
- exercising to prevent constipation
- not straining during bowel movements
Over-the-counter creams and suppositories may temporarily relieve the pain and itching of hemorrhoids. These treatments should only be used for a short time because long-term use can damage the skin.
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