Learn About Hemorrhoids

What is the definition of Hemorrhoids?

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

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What are the alternative names for Hemorrhoids?

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

What are the causes of Hemorrhoids?

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:

  • Straining during bowel movements
  • Constipation
  • Sitting for long periods of time, especially on the toilet
  • Certain diseases, such as cirrhosis

Hemorrhoids may be inside or outside the body.

  • Internal hemorrhoids occur just inside the anus, at the beginning of the rectum. When they are large, they may fall outside (prolapse). The most common problem with internal hemorrhoids is bleeding during bowel movements.
  • External hemorrhoids occur outside the anus. They can result in difficulty cleaning the area after a bowel movement. If a blood clot forms in an external hemorrhoid, it can be very painful (thrombosed external hemorrhoid).
What are the symptoms of Hemorrhoids?

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

Common symptoms include:

  • Painless bright red blood from the rectum
  • Anal itching
  • Anal ache or pain, especially while sitting
  • Pain during bowel movements
  • One or more hard tender lumps near the anus
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What are the current treatments for Hemorrhoids?

Treatments for hemorrhoids include:

  • Over-the-counter corticosteroid (for example, cortisone) creams to help reduce pain and swelling
  • Hemorrhoid creams with lidocaine to help reduce pain
  • Stool softeners to help reduce straining and constipation

Things you can do to reduce itching include:

  • Apply witch hazel to the area with a cotton swab.
  • Wear cotton underwear.
  • Avoid toilet tissue with perfumes or colors. Use baby wipes instead.
  • Try not to scratch the area.

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.

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What are the possible complications of Hemorrhoids?

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 should I contact a medical professional for Hemorrhoids?

Contact your provider if:

  • Hemorrhoid symptoms do not improve with home treatment.
  • You have rectal bleeding. Your provider may want to check for other, more serious causes of the bleeding.

Get medical help right away if:

  • You lose a lot of blood
  • You are bleeding and feel dizzy, lightheaded, or faint
How do I prevent Hemorrhoids?

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

  • Drink plenty of fluids.
  • Eat a high-fiber diet of fruits, vegetables, and whole grains.
  • Consider using fiber supplements.
  • Use stool softeners to prevent straining.
Hemorrhoids
Hemorrhoid surgery  - series
What are the latest Hemorrhoids Clinical Trials?
Intra-operative Use of Ketamine for Post-Operative Analgesia in Patients Undergoing Hemorrhoidectomy: A Prospective, Randomized Controlled Trial.
Summary: This is a prospective, randomized study of ketamine versus no ketamine in approximately 100 patients undergoing hemorrhoidectomy for Grade III or IV hemorrhoids. The participants will be blinded to which treatment arm they are assigned, because participants will be under anesthesia when the ketamine is administered. The investigators will know whether the participant receives ketamine or not.
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A Prospective Assessment of Surgical Treatments in Hemorrhoidal Disease: Real-life Practice and Early Outcome in Terms of Patient-reported Symptoms and Quality of Life
Summary: This study aims to evaluate the effect of surgical treatments on the quality of life in hemorrhoidal disease. All available treatment methods will be included in this 1-year cohort which is going to collect data from a big metropol.
What are the Latest Advances for Hemorrhoids?
Modified rubber band ligation for treatment of grade II/III hemorrhoids: clinical efficacy and safety evaluation-a retrospective study.
Summary: Modified rubber band ligation for treatment of grade II/III hemorrhoids: clinical efficacy and safety evaluation-a retrospective study.
Comprehensive literature review of the applications of surgical laser in benign anal conditions.
Summary: Comprehensive literature review of the applications of surgical laser in benign anal conditions.
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Preventing hemorrhoids during pregnancy: a multicenter, randomized clinical trial.
Summary: Preventing hemorrhoids during pregnancy: a multicenter, randomized clinical trial.
Who are the sources who wrote this article ?

Published Date: September 19, 2021
Published By: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

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.

Obokhare I, Amajoyi R. Management of hemorrhoids. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:289-295.

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.