Hemorrhoids are swollen, enlarged veins that form inside and outside the anus and rectum. They can be painful, uncomfortable and cause rectal bleeding. Hemorrhoids are also called piles.

Causes of Hemorrhoids

  • Straining puts pressure on veins in the anus or rectum, causing hemorrhoids.

  • You might think of them as varicose veins that affect your bottom.

  • Any sort of straining that increases pressure on your belly or lower extremities can cause anal and rectal veins to become swollen and inflamed.

Hemorrhoids may develop due to:

  • Pelvic pressure from weight gain, especially during pregnancy.

  • Pushing hard to have a bowel movement (poop) because of constipation.

  • Straining to lift heavy objects or weightlifting.

Symptoms of Hemorrhoids

Internal hemorrhoids rarely cause pain (and typically can’t be felt) unless they prolapse. Many people with internal hemorrhoids don’t know they have them because they don’t have symptoms.

If you have symptoms of internal hemorrhoids, you might see blood on toilet paper, in stool or the toilet bowl. These are signs of rectal bleeding.

Signs of external hemorrhoids include:

  • Itchy anus.

  • Hard lumps near the anus that feel sore or tender.

  • Pain or ache in the anus, especially when you sit.

  • Rectal bleeding.

Prolapsed hemorrhoids can be painful and uncomfortable. You may be able to feel them bulging outside the anus and gently push them back inside.

Types of Hemorrhoids


Swollen veins form underneath the skin around the anus. Your anus is the canal where poop comes out. External hemorrhoids can be itchy and painful. Occasionally, they bleed. Sometimes they fill with blood that can clot. This is not dangerous, but can result in pain and swelling.


Swollen veins form inside the rectum. Your rectum is the part of the digestive system that connects the colon (large intestine) to the anus. Internal hemorrhoids may bleed, but they usually aren’t painful.


Both internal and external hemorrhoids can prolapse, meaning they stretch and bulge outside of the anus. These hemorrhoids may bleed or cause pain.

Diagnosis of Hemorrhoids

Digital rectal exam

Your provider inserts a gloved, lubricated finger into the rectum to feel for swollen veins.


Your provider uses an anoscope (lighted tube) to view the lining of the anus and rectum.


Your provider uses a sigmoidoscope (lighted tube with a camera) to view inside the lower (sigmoid) part of the colon and rectum. Procedure types include flexible sigmoidoscopy and rigid sigmoidoscopy (proctoscopy).

Treatment of Hemorrhoids

You should see your healthcare provider if symptoms get worse or interfere with your daily life or sleep. Also seek help if signs don’t improve after a week of at-home treatments.

Your provider may treat hemorrhoids with:

Rubber band ligation

A small rubber band placed around the base of a hemorrhoid cuts off blood supply to the vein.


An electric current stops blood flow to a hemorrhoid.

Infrared coagulation

A small probe inserted into the rectum transmits heat to get rid of the hemorrhoid.


A chemical injected into the swollen vein destroys hemorrhoid tissue.

Surgical treatments include:


Surgery removes large external hemorrhoids or prolapsed internal ones.

Hemorrhoid stapling

A stapling instrument removes an internal hemorrhoid. Or it pulls a prolapsed internal hemorrhoid back inside the anus and holds it there.

At home treatment for Hemorrhoids

  • Apply over-the-counter medications containing lidocaine, witch hazel or hydrocortisone to the affected area.

  • Drink more water.

  • Increase fiber intake through diet and supplements. Try to obtain at least 20-35 grams of daily fiber intake

  • Soak in a warm bath (sitz bath) for 10 to 20 minutes a day.

  • Soften stool by taking laxatives.

  • Take nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation.

  • Use toilet paper with lotion or flushable wet wipes to gently pat and clean your bottom after pooping. You can also use a tissue or washcloth moistened with water.

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