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. We’re all born with hemorrhoids, but at baseline, they don’t bother us. It’s only when they become swollen and enlarged that they produce irritating symptoms.
Anyone can get symptomatic hemorrhoids, even teenagers. (Because hemorrhoids take a while to develop, they’re uncommon in children.) You may be more at risk if you:
Are overweight or obese.
Are pregnant.
Eat a low- fiber diet.
Have chronic constipation or diarrheal.
Regularly lift heavy objects.
Spend a lot of time sitting on the toilet.
Strain while having bowel movements.
What are the types of hemorrhoids?
Hemorrhoids can happen inside or outside the rectum. The type depends on where the swollen vein develops. Types include:
External: 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.
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Internal: 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.
Prolapsed: Both internal and external hemorrhoids can prolapse, meaning they stretch and bulge outside of the anus. These hemorrhoids may bleed or cause pain.
Tests
Digital rectal exam: Your provider inserts a gloved, lubricated finger into the rectum to feel for swollen veins.
Anoscopy: Your provider uses an anoscope (lighted tube) to view the lining of the anus and rectum.
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Sigmoidoscopy: 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
Rubber band ligation: A small rubber band placed around the base of a hemorrhoid cuts off blood supply to the vein.
Electrocoagulation: 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.
Sclerotherapy: A chemical injected into the swollen vein destroys hemorrhoid tissue.
Surgical treatments include:
Hemorrhoidectomy: 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.
Prevention
Drink plenty of water throughout the day. • Drink plenty of water throughout the day.
Eat more high-fiber foods (fresh fruits, vegetables and whole grains) or take supplements. Generally, women should aim for 25 grams of fiber per day, while men should get 35 grams of fiber.
Stay physically active. Being on the move keeps bowels moving.
Take laxatives or use enemas only as recommended by your healthcare provider.
