Hemorrhoids

Medically reviewed by: Gary H. Hoffman, MD

Hemorrhoids are swollen veins that enlarge and develop in the lower portion of the rectum or anus. This is a common condition that results from increased pressure on the veins in the anorectal region. The swollen veins can cause pain, especially when you are sitting.

Hemorrhoids may be caused by straining during bowel movements, but may also result from constipation, prolonged sedentary periods, anal infections and certain liver diseases. Women who are pregnant or have recently given birth are at an increased risk for developing hemorrhoids, as are those who are overweight or obese.

Hemorrhoids may develop either inside or outside of the anorectum, and are classified by their location.

  • Internal hemorrhoids develop inside of the anus, at the end of the rectum.
  • External hemorrhoids develop at the end of the anal canal, and may protrude outside of the anus.

Symptoms of Hemorrhoids

Internal hemorrhoids may cause a minor amounts of pain during bowel movements, but often do not cause severe discomfort. External hemorrhoids are most often associated with typical hemorrhoid symptoms, including:

  • Intense pain
  • Anal itching
  • Bleeding
  • Lumps or protrusions
  • Anal leakage and soiling

An external hemorrhoid may be visible, appearing as a bright red lump near the anus. Internal hemorrhoids may protrude outside of the anal opening and become visible. When this occurs, the condition is referred to as a prolapsed hemorrhoid. A prolapsed hemorrhoid may return to the inside of the anus on its own, or can be gently pushed into place by the patient.

Complications of Hemorrhoids

Blood clots may develop within the swollen veins, causing the surrounding tissue to become inflamed. If a blood clot forms, the hemorrhoid appears blue, or deep purple. Surgery is often needed to remove the hemorrhoid and clot.

Though rare, severe bleeding may occur as the result of hemorrhoids that could lead to iron deficiency anemia or a decreased number of circulating red blood cells.

If you are suffering from hemorrhoids, it is important that you speak with your doctor about the treatment options that are available to relieve the pain or other symptoms. Medical and surgical treatment options are available depending upon the location and severity of the hemorrhoids.

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