- Internal (inside) hemorrhoids develop inside the anus. They are painless and sometimes bleed a lot during bowel movements. They may also protrude during bowel movements. If they protrude from the anal opening and cannot be pushed back, they can cause severe pain.
- External (outside) hemorrhoids develop under the skin around the anus and can easily be felt or seen as a lump. They bleed when broken by straining, rubbing, or scratching.
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Bleeding from the anus that may appear:
- On the stool
- On the toilet paper
- In the toilet bowl
- Anal itching and burning
- Swelling and pain during bowel movements
- Sensitive lumps of various sizes around the anus
- Sitz baths—sitting in plain, warm water 2-3 times a day for about 10 minutes each time
- Ice packs—putting cold packs on the anus for short durations to relieve pain and swelling
- Medication—applying hemorrhoidal creams or suppositories to the affected area
- High-fiber diet—Eating more fresh fruit, raw, or cooked vegetables, and whole grains has been consistently shown to reduce hemorrhoid symptoms including bleeding. If you enjoy spicy foods, you can continue eating them. Studies have shown that they do not worsen hemorrhoidal symptoms.
- Fluids—drinking 6-8 (8-ounce) glasses of nonalcoholic fluids daily to soften stools
- Rubber band ligation—a rubber band placed around the base of the hemorrhoid to cut off circulation and force the hemorrhoid to wither away within a few days
- Sclerotherapy—a chemical solution is injected near the blood vessel to cause scarring and shrinkage of the hemorrhoid
- Coagulation therapy—the use of electricity (direct current electrotherapy), laser, or infrared light (photocoagulation) to shrink the hemorrhoidal tissue
- Hemorrhoidectomy—this surgery involves permanent removal of hemorrhoids by cutting the hemorrhoidal tissue away. Some of the newest surgical treatments involve using stainless steel staples. While many surgeons favor these treatments, there is some evidence that techniques that are more traditional produce more consistent and long-lasting relief.
- Eat a high fiber diet.
- Exercise regularly, especially walking.
- Empty bowels as soon as possible after the urge occurs.
- Avoid the overuse of laxatives.
American Society of Colon and Rectal Surgeons http://www.fascrs.org
National Digestive Diseases Information Clearinghouse http://digestive.niddk.nih.gov
The Canadian Association of Gastroenterology http://www.cag-acg.org
The College of Family Physicians of Canada http://www.cfpc.ca
Alonso-Coello P, Guyatt G, Heels-Ansdell D, et al. Laxatives for the treatment of hemorrhoids. Cochrane Database Syst Rev. 2005;(4):CD004649.
Altomare DF, Rinaldi M, La Torre F, et al. Red hot chili pepper and hemorrhoids: the explosion of a myth: results of a prospective, randomized, placebo-controlled, crossover trial. Dis Colon Rectum. 2006;49:1018-1023.
Hemorrhoids. American Society of Colon and Rectal Surgeons website. Available at: http://www.fascrs.org/patients/conditions/hemorrhoids/. Published Janurary 2008. Accessed July 1, 2009.
Hemorrhoids. DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated June 2009. Accessed July 1, 2009
Hemorrhoids. National Institutes of Health, National Institute of Diabetes, Digestive, and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/hemorrhoids/index.aspx . Published November 2004. Accessed July 1, 2009.
Jayaraman S, Colquhoun PH, Malthaner RA. Stapled versus conventional surgery for hemorrhoids. Cochrane Database Syst Rev . 2006;(4):CD005393.
- Reviewer: Peter Lucas, MD
- Review Date: 09/2012 -
- Update Date: 00/93/2012 -