Hemorrhoids — sometimes called piles — are swollen veins that develop on the inside and outside of your anus and rectum. All people have hemorrhoids, but not all hemorrhoids cause symptoms.
On this page:
What Are Hemorrhoids?
Hemorrhoids — sometimes called piles — are swollen veins that develop on the inside and outside of your anus and rectum. All people have hemorrhoids, but not all hemorrhoids cause symptoms.
If hemorrhoids cause symptoms, they are usually mild and can be treated at home. However, some types of hemorrhoids can cause severe pain and require medical treatment.
What are the types of hemorrhoids?
There are two main types of hemorrhoids, including:
- External hemorrhoid — Occurs underneath the skin around your anus and can cause itching, pain, and bleeding.
- Internal hemorrhoid — Occurs inside your rectum and may cause bleeding.
How common are hemorrhoids?
Hemorrhoids are very common. According to the National Institutes of Health (NIH), hemorrhoids affect about 1 in 20 people in the U.S. and about half of adults over the age of 50.
What causes hemorrhoids?
Hemorrhoids happen when there is pressure on the veins in your anus or rectum.
Why do you get hemorrhoids?
Hemorrhoids can be caused by:
- Constipation.
- Lifting heavy objects, including weightlifting.
- Obesity.
- Pregnancy.
- Sitting on the toilet for long periods of time.
- Straining during bowel movements.
Hemorrhoid risk factors
Hemorrhoids are more likely to occur in older people because the tissues that support the veins in your rectum and anus stretch and weaken as you age.
You may be at higher risk for hemorrhoids if you:
- Are over 50.
- Are overweight or obese.
- Are pregnant.
- Have chronic constipation.
- Routinely lift heavy objects.
Complications of hemorrhoids
Complications of hemorrhoids include:
- Prolapsed hemorrhoid — Both internal and external hemorrhoids can prolapse. This happens when they become large and bulge outside your anus, causing bleeding and pain.
- Strangulated hemorrhoid — A medical emergency that occurs when blood flow to a prolapsed hemorrhoid is cut off.
- Thrombosed hemorrhoid — A complication of hemorrhoids that occurs when a blood clot forms inside a hemorrhoid, causing severe pain and swelling.
How can I prevent hemorrhoids?
You may be able to lower your risk of hemorrhoids by:
- Avoiding constipation and straining.
- Drinking plenty of water.
- Eating a diet rich in fiber.
- Exercising regularly.
What Are the Signs and Symptoms of Hemorrhoids?
Although some hemorrhoids do not cause any symptoms, the ones that do may cause:
- A sensitive or painful lump near your anus.
- Bleeding during bowel movements, usually without pain.
- Itching, swelling, or irritation around your anus.
- Pain or discomfort around your anus.
Thrombosed hemorrhoids, which occur when a blood clot forms inside the hemorrhoid, can be extremely painful.
Is a hemorrhoid serious?
Although hemorrhoids are very common and rarely dangerous, they can affect your quality of life and cause significant discomfort.
When should I see a doctor about my hemorrhoid symptoms?
If your hemorrhoids are causing bothersome symptoms that do not respond to at-home care, you should schedule an appointment with a colon and rectal care specialist.
You should seek immediate medical attention if you experience rectal bleeding along with lightheadedness, dizziness, or faintness.
How Do You Diagnose Hemorrhoids?
Most cases of hemorrhoids can be diagnosed based on your symptoms and a physical exam.
What to expect during your visit
If your doctor suspects hemorrhoids, they will:
- Ask about your symptoms.
- Perform an exam or order other tests.
- Review your health history and medications.
Tests to diagnose hemorrhoids
Your doctor may perform a test called a digital rectal exam to diagnose hemorrhoids. During the exam, your doctor will use a gloved, lubricated finger to feel for hemorrhoids inside your rectum.
If needed, other tests may include:
- Anoscopy — Uses a lighted tube called an anoscope to look inside your anus and rectum.
- Sigmoidoscopy — Uses a lighted tube with a camera to look at your lower colon and rectum.
Anoscopy and sigmoidoscopy are outpatient (same-day) procedures that do not require anesthesia.
Hemorrhoids prognosis
Most cases of hemorrhoids improve with a few days of at-home treatment. If your hemorrhoids are painful or bothersome, minimally invasive surgical procedures are successful at relieving symptoms.
How Do You Treat Hemorrhoids?
The goals of hemorrhoid treatment are to relieve symptoms and prevent complications. Hemorrhoid treatment options may include:
Nonsurgical treatment for hemorrhoids
Nonsurgical treatment may include:
- Dietary planning — Your doctor may recommend that you include more water and high-fiber foods in your diet to limit constipation and straining, which can reduce your risk of developing hemorrhoids.
- Medications — For mild cases of hemorrhoids, your doctor may recommend treatment using creams, suppositories, ointments, or medicated pads.
Will a hemorrhoid go away on its own?
Hemorrhoids may go away on their own, especially if they are small. However, a doctor may need to treat large or hemorrhoids that cause complications.
Procedures to treat hemorrhoids
Our board-certified colon and rectal surgeons use less-painful techniques to treat hemorrhoids effectively.
Minimally invasive procedures to treat hemorrhoids often can be performed in our office and include:
- External hemorrhoid thrombectomy — An external hemorrhoid thrombectomy treats a painful blood clot called a thrombosis that can form in an external hemorrhoid. Your doctor will make a small incision in the hemorrhoid to remove the clot.
- Hemorrhoid banding — Hemorrhoid banding, also called rubber band ligation, involves placing tiny rubber bands around a hemorrhoid to cut off the blood flow. The lack of blood flow causes the hemorrhoid to shrink and fall off.
- Hemorrhoid injections — Hemorrhoid injections involve injecting liquid into the hemorrhoid to stop bleeding and prevent swelling.
- Thermal coagulation — Thermal coagulation involves using a light source to create a small burn on the surface of the hemorrhoid, which stops the bleeding and causes it to shrink.
Surgical procedures to treat hemorrhoids
Surgical techniques to treat hemorrhoids include:
- Hemorrhoidectomy — Hemorrhoidectomy is a procedure to remove a hemorrhoid. You may receive local anesthesia with sedation or general anesthesia, depending on the surgical technique used.
- Stapled hemorrhoidopexy — This procedure cuts off blood flow to an internal hemorrhoid using staples.
Why Choose UPMC for Hemorrhoid Care?
When you choose UPMC for hemorrhoid care, you will receive:
- Access to board-certified specialists — Our colon and rectal care specialists are experienced in caring for all types of hemorrhoids.
- Expert diagnosis and personalized care — Our team will develop a customized treatment plan to reduce your symptoms and improve your quality of life.
- A full range of treatment options — We use the latest nonsurgical, minimally invasive, and surgical techniques to provide comprehensive care.
