How common are hemorrhoids?

You may be surprised to learn that hemorrhoids are a normal part of our anatomy. We have both internal and external hemorrhoids, located inside the anal canal and around the anal opening, respectively. The internal hemorrhoids are a part of the blood supply to the anus and are made up of small arterial branches. External hemorrhoids are veins.

We are not aware of our hemorrhoids when they are in their normal state. They cause no symptoms. But sometimes we can develop problems because of our internal hemorrhoids. This is known as "internal hemorrhoidal disease." Such symptoms can occur occasionally (flare ups) or may be chronic (long-term).

External hemorrhoids cause symptoms when a blood clot suddenly forms in one of the veins at the anus opening; this is known as a "thrombosed external hemorrhoid.” This blood clot results in a firm external lump that may cause anal pain and, at times, bleeding between bowel movements.

Both internal and external hemorrhoidal problems are common. There are treatment options.

What are the causes of hemorrhoid problems?

Factors that can lead to the development of hemorrhoid problems include:

  • Straining during bowel movements or heavy lifting or vigorous activity.
  • Hard or watery bowel movements.
  • Sitting on the toilet for a long time (for example, while reading or playing video games).
  • A low-fiber diet.
  • Pregnancy and vaginal deliveries.
  • Aging.

What are the symptoms of internal hemorrhoidal disease?

The symptoms of internal hemorrhoidal disease include:

  • Rectal bleeding, usually bright red, during and occasionally between bowel movements.
  • Anal pain, especially during or after bowel movements.
  • Anal itching or burning.
  • Anal area is hard to clean.
  • Bulging (prolapse) of the internal hemorrhoids during bowel movements. The hemorrhoids may go back in on their own, or can be pushed back inside the anus by hand.
  • Drainage.

Last reviewed by a Cleveland Clinic medical professional on 05/18/2016.


  • National Institute of Diabetes and Digestive and Kidney Diseases. Hemorrhoids. Accessed 6/25/2020.
  • American Society of Colon and Rectal Surgeons. Hemorrhoids. Accessed 5/18/2016.
  • American Academy of Family Physicians. Hemorrhoids. Accessed 5/18/2016.

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