by Amy Scholten, MPH
Hemorrhoids are swollen blood vessels in and around the anus and lower rectum. They stretch under pressure and are similar to varicose veins in the legs. Hemorrhoids are either internal or external.
The exact cause of hemorrhoids is unknown. The major contributing factor appears to be too much pressure on the veins in the rectum. If the pressure continues, the veins become enlarged and protrude.
Risk Factors TOP
A risk factor is something that increases your chance of getting a disease or condition. Risk factors include:
In most cases, symptoms will go away within several days. Although many people have hemorrhoids, not all experience symptoms.
Common symptoms include:
The doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor will examine the anus and rectum to look for swollen blood vessels and perform a digital rectal exam. This is done by inserting a gloved, lubricated finger into the rectum to feel for abnormalities. Sometimes, it is necessary to do the exam with the use of an endoscope that allows visualizing the rectal canal and other parts of the colon.
Bleeding from the rectum or blood in the stool can be a symptom of other diseases involving gastrointestinal tract or colon/rectal cancer. It is important to see a doctor if you have any rectal bleeding.
Initial medical treatment of hemorrhoids is aimed at relieving symptoms. Measures to reduce symptoms include:
If these treatments provide insufficient relief, one of several nonsurgical procedures may be used to shrink or destroy the hemorrhoidal tissue. These procedures, which are generally performed in a doctor’s office, include:
If nonsurgical procedures are either not an option or fail to resolve the problem, surgical management is the final option:
If you are diagnosed with hemorrhoids, follow your doctor's instructions.
American Society of Colon and Rectal Surgeons
National Digestive Diseases Information Clearinghouse
The Canadian Association of Gastroenterology
The College of Family Physicians of Canada
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Altomare DF, Rinaldi M, La Torre F, et al. Red hot chili pepper and hemorrhoids: the explosion of a myth: results of a prospective, randomized, placebo-controlled, crossover trial. Dis Colon Rectum. 2006;49:1018-1023.
Hemorrhoids. American Society of Colon and Rectal Surgeons website. Available at: http://www.fascrs.org/patients/conditions/hemorrhoids/. Published Janurary 2008. Accessed July 1, 2009.
Hemorrhoids. DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated June 2009. Accessed July 1, 2009
Hemorrhoids. National Institutes of Health, National Institute of Diabetes, Digestive, and Kidney Diseases website. Available at: http://digestive.n... . Published November 2004. Accessed July 1, 2009.
Jayaraman S, Colquhoun PH, Malthaner RA. Stapled versus conventional surgery for hemorrhoids. Cochrane Database Syst Rev . 2006;(4):CD005393.
Last reviewed September 2012 by Peter Lucas, MD
Last Updated: 09/30/2012