Hemorrhoids

Hemorrhoids may cause:

• Rectal bleeding. You may see bright red blood on the toilet paper or in the toilet after a bowel movement. You may see blood on the stool.
• Itching. Hemorrhoids often seep mucus. It can irritate the skin and cause itching.
• Discomfort. You may still feel the urge to pass stool right after having a bowel movement.
• Pain.
  • When a vein within an external hemorrhoid gets irritated, blood may clot under the skin, forming a hard, bluish lump. This is known as a thrombosed, or clotted, hemorrhoid. Thrombosed hemorrhoids can be very painful.
  • Large internal hemorrhoids that bulge from the anus may be painful if they're squeezed by the anal muscles. They may be very painful if the blood supply to the hemorrhoid is cut off.

Hemorrhoids are usually caused by too much pressure on the veins in the pelvic and rectal area. If you sit on the toilet a long time or strain to have a bowel movement, the extra pressure causes the veins in this tissue to swell and stretch. The result is hemorrhoids.

Things that can lead to hemorrhoids include:

• Diarrhea, constipation, or rushing to complete a bowel movement. These may lead to straining and can put more pressure on veins in the anal canal.
• Pregnancy and labor. This is because of greater pressure on the blood vessels in the pelvic area. Straining to push the baby out during labor can make hemorrhoids worse.
• Being overweight. This may put more pressure on the pelvic veins.
• Medical conditions, such as severe liver disease.

Things that make hemorrhoids worse include:

• Sitting or standing for a long time. This may cause blood to pool in the anal area and put more pressure on the veins.
• Frequent heavy lifting or holding your breath when lifting heavy objects. This can suddenly put more pressure on blood vessels.

Your doctor can tell if you have hemorrhoids by asking about your past health and doing a physical exam.

You may not need many tests at first if your doctor thinks that your rectal bleeding is caused by hemorrhoids. Your doctor may just examine your rectum with a gloved finger. Or your doctor may use a short, lighted scope to look inside the rectum.

Rectal bleeding can be a sign of a more serious problem, such as colon, rectal, or anal cancer. So if the first exam doesn't show a clear cause of your problems, your doctor may do tests to check for other causes of bleeding. The doctor may use a lighted scope to look at the lower third of your colon. This is called sigmoidoscopy. Or your doctor may use another kind of scope to look at the entire colon. This is called colonoscopy.

For most external hemorrhoids, home treatment is all you need. The same home treatment can be used for most internal hemorrhoids.

• Slowly add fiber to your meals. Eat foods that have lots of fiber, such as fruits, vegetables, and whole grains.
• Use an over-the-counter ointment for a limited time to stop itching. You also may use a stool softener.
• Try suppositories. They can help relieve irritation and lubricate the anal canal during bowel movements.
• Drink plenty of water.
• Get some exercise every day.

If your internal hemorrhoids are severe, you may need other treatment. The doctor may tie off the hemorrhoids with rubber bands or create scar tissue around the hemorrhoids. These treatments reduce the blood supply to the hemorrhoids so they shrink or go away.

Surgery to remove hemorrhoids may be done if other treatments don't work. It may be done to remove large internal or external hemorrhoids that are uncomfortable or painful.