Hemorrhoids, or piles, are a common issue. These swollen veins inside of your rectum or outside of your anus can cause pain, anal itching and rectal bleeding. Symptoms often improve with at-home treatments, but on occasion, people need medical procedures. Eating more fiber can help prevent hemorrhoids.
Hemorrhoids are swollen, enlarged veins that form inside and outside of your anus and rectum. They can be painful and uncomfortable and cause rectal bleeding. Hemorrhoids are also called piles. We’re all born with hemorrhoids, but at baseline, they don’t bother us. It’s only when they become swollen and enlarged that they produce irritating symptoms.
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An estimated 1 in 20 Americans has symptomatic hemorrhoids. They affect people of all ages, sexes, races and ethnicities. They’re more common as you age, affecting more than half of people over age 50.
Anyone can get symptomatic hemorrhoids, even teenagers. (But because hemorrhoids take a while to develop, they’re uncommon in children.) You may be more at risk if you:
Hemorrhoids can happen inside or outside of your rectum. The type depends on where the swollen vein develops. Types include:
Hemorrhoids and anal fissures cause similar symptoms, such as itching, pain and bleeding. While swollen veins cause hemorrhoids, a tear in the lining of your anus causes an anal fissure. A healthcare provider will do a physical exam and may order tests to find what’s causing your symptoms.
Straining puts pressure on veins in your anus or rectum, causing hemorrhoids. You might think of them as varicose veins that affect your bottom.
Any sort of straining that increases pressure on your belly or lower extremities can cause anal and rectal veins to become swollen and inflamed. Hemorrhoids may develop due to:
Internal hemorrhoids rarely cause pain (and typically can’t be felt) unless they prolapse. Many people with internal hemorrhoids don’t know they have them because they don’t have symptoms.
If you have symptoms of internal hemorrhoids, you might see blood on toilet paper, in your stool or in the toilet bowl. These are signs of rectal bleeding.
Signs of external hemorrhoids include:
Prolapsed hemorrhoids can be painful and uncomfortable. You may be able to feel them bulging outside of your anus and gently push them back inside.
Different gastrointestinal disorders can cause rectal bleeding and other symptoms similar to hemorrhoids. Some of these disorders are life-threatening. For this reason, it’s important to let a healthcare provider know when you’re having symptoms.
Bowel diseases that can cause bleeding include:
A healthcare provider diagnoses hemorrhoids based on symptoms and a physical exam. You may also have:
These tests may be uncomfortable but aren’t painful. They typically take place in a doctor’s office or outpatient center without anesthesia. You go home the same day.
Your provider may perform a colonoscopy to confirm findings from other tests or check for signs of colon cancer. This outpatient procedure requires anesthesia.
Hemorrhoids can be uncomfortable and painful, but they don’t tend to cause serious problems. Rarely, people with hemorrhoids develop:
Hemorrhoids often go away on their own without treatment. Symptoms like pain and bleeding may last one week or slightly longer. In the meantime, you can take these steps to ease symptoms:
You should see your healthcare provider if symptoms get worse or interfere with your daily life or sleep. Also, seek help if signs don’t improve after a week of at-home treatments. Your provider may treat hemorrhoids with:
Surgical treatments include:
Hemorrhoids are common as you get older. These steps can help prevent hard stools and constipation that can lead to hemorrhoids:
Most hemorrhoid symptoms improve within a week with at-home treatments. If hemorrhoids cause extreme pain and discomfort, a medical procedure or even surgery may help.
You should call your healthcare provider if you suspect hemorrhoids and experience:
You may want to ask your healthcare provider:
A note from Cleveland Clinic
An estimated 15 million Americans have sought treatments for hemorrhoids at some point in their lives. But many more are needlessly affected by them. Don’t be too embarrassed to talk to your healthcare provider about your symptoms. If hemorrhoids cause pain or discomfort, your provider has treatments that can help. You can also take steps to keep hemorrhoids from coming back.
Last reviewed by a Cleveland Clinic medical professional on 01/18/2021.
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