Hemorrhoids are swollen veins around the anus or lower part of the rectum. They are common. They affect more than 50% of people over the age of 50. Sometimes they bother people and sometimes they don’t. They can be inside or outside. They do not lead to cancer.

What is it?

Hemorrhoids are swollen veins around the anus or lower part of the rectum.

What are the types of hemorrhoids?

  • Internal or external. Internal hemorrhoids are inside the rectum. You cannot see them. They usually do not hurt but may bleed. External ones are under the skin around the anus. You can see them and feel them. They can hurt and bleed.

internal hemorrhoids

  • Symptomatic or asymptomatic. Hemorrhoids may be present without causing symptoms. Symptoms are painless bleeding, pain or discomfort around the anus, lump around the anus, itchiness, and irritation.
  • Reducible or non-reducible. Reducible hemorrhoids can go inside the rectum on their own or by pushing them in. Non-reducible ones do not go into the rectum even when pushed in.
  • Thrombosed or non-Thrombosed. A Thrombosed hemorrhoid is an external hemorrhoid with blood clot inside. The blot clot makes them look blue, purple or black. They are very painful and may require an incision and drainage.

What causes it?

  • Genetics. It appears that people with family history of hemorrhoids are more likely to have them.
  • Straining. Any activity that causes straining can lead to hemorrhoids. These include constipation, cough, heavy lifting, prolonged standing or sitting, pregnancy, obesity.

What are the symptoms?

  • Painless bleeding. This is usually bright red blood.
  • Pain or discomfort around the anus.
  • Lump around the anus.
  • Itchiness and anal irritation.

How can I prevent hemorrhoids?

  • Avoid straining.
  • Fiber.
  • Adequate hydration.
  • Exercise.

What is the treatment?

  • Fiber. To avoid constipation and ensure regular bowel movements.
  • Sitz bath. This is done by sitting on 3 inches or more of warm water for 10- 15minutes, two to three times a day. Epsom salt may be added to the water.
  • Cream and suppositories. There are several creams and suppositories available over the counter to treat this condition. Some of them contain hydrocortisone, a steroid medication. They can relieve itchiness and anal irritation.
  • Medical procedures and surgery: These are done by a physician, usually a gastroenterologist or colorectal surgeon.
  1. Sclerotherapy.  This is done by injecting a chemical into the blood vessel of the hemorrhoid to shrink it.
  2. Coagulation or cauterization. An electric probe, laser beam, or infrared light is used to burn the hemorrhoids.
  3. Rubber band ligation.  A small rubber band is placed over the internal hemorrhoid to cut off blood flow. rubber band on hemorrhoids
  4. Staples.  The hemorrhoid is stapled to cut off blood supply and shrink it.
  5. Hemorrhoidectomy.  A knife is used to cut off the hemorrhoids. This is usually the last resort if all else fails.

When should you see a doctor?

  • If you have symptoms.
  • If the symptoms persists despite treatment.
  • If the symptoms are getting worse.


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