What are Hemorrhoids?

Hemorrhoids, also called rectal lumps or piles, are enlarged veins that occur in the rectum and anus. They can appear inside the lining of the anus, at the outermost area of the rectum (called internal hemorrhoids) or on the anus opening, in which case parts or all of the hemorrhoid might stick out of the body (called external hemorrhoids).

Hemorrhoids are extremely common all around the world, particularly among pregnant women and women who have recently given birth. They are known to cause a lot of severe pain, especially since they develop in an area that is constantly being stimulated and irritated by natural bowel movements and by normal daily activity such as walking or sitting. They can also itch and ache. Doctors usually find hemorrhoids during rectal exams, or patients find them on their own, by simply noticing them as a source of rectal bleeding.

What Causes Hemorrhoids?

Hemorrhoids are caused by a build-up of pressure inside the veins of a patient’s anus. The veins become swollen, hypersensitive and prone to breakage and bleeding. Hemorrhoids can also be caused if a person strains too much to pass stool, which may or may not occur because of an underlying medical condition with constipation as a symptom, such as irritable bowel syndrome or bowel obstruction. Certain infections of the anal and rectal tissue have also been known to cause hemorrhoids.

What Is the Best Hemorrhoid Treatment?

Many over-the-counter creams for hemorrhoids are available in your local pharmacy. These medications claim to reduce swelling and pain, but are not necessarily a cure. Likewise, some patients have experimented with laxatives and other stool softeners to ease pain during bowel movements, as harder or drier stool tends to irritate the hemorrhoids.

Overall, patients with hemorrhoids should avoid wearing clothes that bunch around the rectal area and opt for looser clothes made of light fabrics that breathe, such as cotton underwear. Any household item that may cause the hemorrhoids to be over-stimulated, such as scented lotions or toilet paper, should be replaced with milder products. Scratching the area will not help the condition heal, so patients should seek relief with warm baths instead.

If none of the above treatment options work, there is a heat treatment available called infrared coagulation that will shrink the hemorrhoids. Infrared coagulation is a good option for patients who don’t want to resort to surgery. Otherwise, a surgical process called banding (also known as rubber band litigation or hemorrhoidectomy) can infrequently used for patients for whom other treatment methods have been ineffective.

In some cases patients will mistake all forms of rectal pain as hemorrhoids. While this may be the case, do not assume that rectal pain that you are having is simply a hemorrhoid, as other conditions such as anal fissures (or tears), Crohn’s disease, fistulas and even certain cancers can present similarly.

How Do I Avoid Hemorrhoid Complications?

Call a doctor if you are suffering with hemorrhoids and simple treatment has not worked. If your case is severe and left unattended, the blood collected in the swollen veins could potentially form blood clots that can affect surround tissue and would need to be removed with surgery. Severe bleeding through hemorrhoids can also cause anemia and must be monitored closely with a medical expert.


Reviewed 12/29/2011 by David M. Nolan, M.D.
Diplomate of the American Board of Internal Medicine, 2011
Currently a Fellow of Gastroenterology, at UCI 2011-2014