Introduction
Hemorrhoids are veins in the rectum or anus that become swollen and painful. Sometimes they go away by themselves, but in other cases they can cause lingering pain, itching, and bleeding. There are two types of hemorrhoids: those that are just inside the anus or lower rectum (internal) and those that are outside the opening to the anus (external). You can have both at the same time. Internal hemorrhoids usually do not cause pain or discomfort, while external hemorrhoids often do. However, internal hemorrhoids can protrude outside the anus (prolapsed hemorrhoid) and become painful. In some cases, a blot clot (thrombosis) may form in the vein, making the hemorrhoid more painful. In severe cases, these hemorrhoids require surgery.
Signs and Symptoms
Symptoms of hemorrhoids include:
- Anal itching
- Anal 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
Causes
Hemorrhoids are a type of varicose vein that tends to occur as we get older; about 75% of Americans have hemorrhoids at some point. Being constipated or passing large, hard stools may contribute to developing hemorrhoids. In many cases, however, there is no obvious cause. The increased pressure during pregnancy may also cause hemorrhoids. Contributing factors include the following:
- Some medical conditions (such as cirrhosis -- end stage liver disease)
- Pregnancy
- Sitting for a long period of time (especially sitting on the toilet)
- Obesity
- Chronic diarrhea
- Chronic constipation and straining
- Diet low in fiber or fluids
