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Hemorrhoids are painful, swollen veins in the lower portion of the rectum or anus and may be caused by straining during bowel movements, constipation, sitting for long periods of time, anal infections and certain diseases, such as liver cirrhosis.

Hemorrhoids are very common, especially during pregnancy and after childbirth. They result from increased pressure in the veins of the anus. The pressure causes the veins to swell, making them painful, particularly when you are sitting.

Hemorrhoids may be located inside the anus, at the beginning of the rectum (internal hemorrhoids), or they may develop at the anal opening and may hang outside the anus (external hemorrhoids).

For more information or to schedule an appointment with a Virginia Mason gastroenterologist,
call (206) 223-2319.

Symptoms of hemorrhoids

  • Anal itching
  • Anal ache or pain, especially while sitting
  • Bright red blood on toilet tissue, stool, or in the toilet bowl
  • Pain during bowel movements
  • One or more hard tender lumps near the anus

Diagnosis of hemorrhoids

A doctor can often diagnose hemorrhoids simply by examining the rectal area. If necessary, tests that may help diagnose the problem include:

Treatments for hemorrhoids

Fortunately, there are many effective options available to treat hemorrhoids. Most people can get relief from symptoms by making lifestyle changes and using home treatments, like these:

  • Over-the-counter corticosteroid creams to help reduce pain and swelling
  • Hemorrhoid creams with lidocaine to help reduce pain
  • Stool softeners help reduce straining and constipation
  • Witch hazel (applied with cotton swabs) can reduce itching

If your hemorrhoids do not get better with home treatments, and you are experiencing persistent bleeding or pain, your doctor may recommend a procedure called rubber band ligation or a surgical hemorrhoidectomy. 

  • Rubber band ligation: Your doctor places one or two tiny rubber bands around the base of an internal hemorrhoid to cut off its circulation. The hemorrhoid withers and falls off within a week. This procedure is effective for many people but can be uncomfortable and may cause bleeding.
  • Hemorrhoid removal: During a hemorrhoidectomy, your surgeon removes excessive tissue that causes bleeding. The surgery may be done with a local anesthetic combined with sedation, a spinal anesthetic or a general anesthetic. Hemorrhoidectomy is the most effective and complete way to treat severe or recurring hemorrhoids. Complications may include temporary difficulty emptying your bladder and urinary tract infections associated with this problem. Most people experience some pain after the procedure, which medications and soaking in a warm bath can help alleviate.

Complications of hemorrhoids

The blood in the swollen vein may form clots, and the surrounding tissue can die. Surgery is often needed to remove hemorrhoids with clots.

Severe bleeding may also occur. Iron deficiency anemia can result from long-term blood loss. Significant bleeding from hemorrhoids is unusual, however.

Be sure to call your doctor if hemorrhoid symptoms do not improve with home treatment or if you have rectal bleeding. Your doctor may want to check for other, more serious causes of the bleeding.

Call 911 if you lose a lot of blood, or if you are bleeding and feel dizzy, lightheaded or faint.

How to prevent hemorrhoids

To prevent constipation and straining during bowel movements that raise your risk for hemorrhoids, you should:

    • Drink plenty of fluids, at least eight glasses per day
    • Eat a high-fiber diet of fruits, vegetables and whole grains
    • Consider fiber supplements
    • Use stool softeners to prevent straining
    • Avoid sitting on the toilet for long periods of time

Need more information?

Get more information, or schedule an appointment with a Virginia Mason gastroenterologist, by calling (206) 223-2319.