Hemorrhoids

You may not know much about them if you’ve never experienced one yourself, but hemorrhoids are a common issue. In fact, everybody has them, but we don’t tend to call them hemorrhoids until they become symptomatic.

Whether you think you may be suffering from hemorrhoids or simply want to be more informed about this issue, we have some helpful information for you. Hemorrhoids can be an unpleasant problem, but understanding what you’re dealing with and how to prevent and treat the issue can help you find some much-needed relief.

What Are Hemorrhoids?

Hemorrhoids are cushions of tissue,located in the lower rectum, that contain blood vessels, muscle and elastic fibers. Hemorrhoids contribute to our resting continence, meaning they assist the body in controlling the expulsion of stools. When you’re not experiencing itching, burning or discomfort from hemorrhoids, you probably don’t think about them at all, but they’re always there.

As with other tissue in your body, hemorrhoids can swell or become inflamed. This tends to occur when the connective tissues in a hemorrhoid weaken, allowing the hemorrhoid to slip down into the anal canal.

When hemorrhoids become swollen or inflamed, they may be referred to as piles, though are often still called “hemorrhoids”.

We will refer to inflamed hemorrhoids as both piles and hemorrhoids according to the common usage.

Experiencing inflamed hemorrhoids is a common issue that affects about half of adults by the time they reach 50. While many people get hemorrhoids in older adulthood, anyone can experience this problem.

Signs and Symptoms of Hemorrhoids

The symptoms of hemorrhoids can differ depending on whether a person has internal or external hemorrhoids.

You may be suffering from hemorrhoids if you’re experiencing any of these symptoms:

1. Pain

Pain in the rectum or anus is often the first sign that you may have external hemorrhoids or an associated condition, such as an anal fissure. Piles can cause significant pain when the tissue is inflamed and swollen due to the relatively high number of nerves in the area. You may notice the pain is worse during a bowel movement* since the stool passing through puts pressure on the hemorrhoids.

*If you only experience pain during bowel movements, be sure to investigate possible other causes. These causes may be as minor as anal fissures or as serious as colon cancer.

2. Blood

If you notice a small amount of blood on the toilet paper after a bowel movement or see blood in your stool, this may be a sign of hemorrhoids. This blood will typically be bright red in color. This indicates that the blood hasn’t traveled far outside its normal pathways and is a good indication of piles or anal fissures somewhere in the lower anal cavity.

Bleeding can also be an indication of more serious conditions. For example, excessive amounts of bright red blood in the stool may indicate colitis, diverticulitis or colon cancer. Dark red blood in the stool, known as occult bleeding, may also be an indication of colon cancer. If you’re not sure what’s causing your bleeding, you should check with your doctor to determine whether further screening is appropriate. If you suspect you may have colon cancer, early detection is key to treating it effectively.

3. Rectal Itching

An itchy feeling in the rectum is one of the most common and irritating hemorrhoid symptoms. Itching or burning from hemorrhoids tends to be the worst just after a bowel movement. Itching can be caused by mucus discharge that comes from prolapsed hemorrhoids. This mucus irritates the skin and can cause even greater irritation when mixed with stool.

It may be tempting to clean the area to provide temporary relief, but adding moisture to the area or using cleansers that alter the pH can sometimes make matters worse. Additionally, you should avoid scratching the location, as this could cause you to break the skin. Broken skin in the rectum puts you at risk of developing an infection.

4. Swelling or Prolapse

By definition, piles are swollen hemorrhoids. This means many hemorrhoid sufferers experience swelling in the anal area that they can feel. This swelling is caused by rubbing and irritation of the prolapsing tissue. Keep in mind that if you feel a lump on the rectum and have a fever, you could have an abscess. If you don’t have a fever, it’s more likely that your swelling is from a hemorrhoid.

In some instances, hemorrhoids will prolapse, meaning they come down through the anal canal and protrude outside the rectum. This tends to happen when piles have become more severe and advanced. Straining to move stools can cause a hemorrhoid to prolapse.

Types of Hemorrhoids

Medical professionals classify hemorrhoids mainly according to whether they are internal or external. As you’ll see, there are further classifications within these two categories.

Internal Hemorrhoids

Internal hemorrhoids exist inside the rectum, out of sight. Because there are no nerve endings in the rectum, these hemorrhoids are typically painless. The most common symptom of internal hemorrhoids is bleeding. You may see small amounts of bright red blood on your toilet paper or inside the toilet bowl. Internal hemorrhoids can also cause itching or a feeling of fullness following a bowel movement. Hemorrhoids that bleed but remain concealed in the rectum are classified as Grade I hemorrhoids.

While internal hemorrhoids typically go unseen, they can also push through the anal opening. These are known as prolapsing or prolapsed hemorrhoids. When prolapse occurs, internal hemorrhoids can be classified using a grading scale:

  • Grade I: Hemorrhoids that bleed but remain concealed in the rectum are classified as Grade I hemorrhoids. If the hemorrhoid prolapses, it belongs to one of the following grades.
  • Grade II: In some cases, the prolapsed tissue will reduce on its own, meaning it will retract back into the anal canal spontaneously. These hemorrhoids are classified as Grade II.
  • Grade III: Grade III hemorrhoids protrude outside the rectum and remain that way until they are pushed back into place manually.
  • Grade IV: Prolapsed hemorrhoids that will not reduce when you try to push them back in are classified as Grade IV.

Prolapsed hemorrhoids can lead to the development of excess skin, called skin tags. In most cases, treating internal hemorrhoids will relieve the external symptoms. You may also want to have the skin tag removed, but this is not necessary for recovery.

External Hemorrhoids

External hemorrhoids often occur as bulges or lumps around the anus. Unlike internal hemorrhoids, you can feel these from the outside. Some people may mistake a prolapsed internal hemorrhoid for an external hemorrhoid. The difference is that external hemorrhoids form on or around the anus rather than descending down the rectum. Another way to tell the difference is that external hemorrhoids do not bleed, therefore if you are experiencing bleeding as a symptom and have ruled out anything more serious – you likely have internal hemorrhoids

People can also mistake external skin tags or irritation caused by internal hemorrhoids for an external hemorrhoid. In fact, most patients who complain about external issues are also suffering from internal hemorrhoids. This means addressing the internal hemorrhoids can provide external relief.

Because of the sensitive nerve fibers in this area, external hemorrhoids are often painful, especially when sitting. They also may bleed and itch. Pain can become even more severe if a blood clot forms in the hemorrhoid. Hemorrhoids containing blood clots are called thrombosed hemorrhoids. These can be internal, but they are more often external. These hemorrhoids are not especially dangerous, but they can be particularly uncomfortable.

Causes of Hemorrhoids

Hemorrhoids result from an increase in pressure in the veins of the rectum, typically from too much straining. Many people underestimate how easily hemorrhoids can develop. The following circumstances could all potentially lead to piles:

  • Constipation: Constipation can cause hemorrhoids when a person strains excessively to pass a bowel movement, putting pressure on the veins in the anus. A diet low in fiber and high in fat can be one cause of constipation, though it can also stem from other conditions such as Irritable Bowel Syndrome. Not drinking enough water can also lead to constipation by limiting the amount of fluid in the intestines, leading to hardening of the stool.
  • Chronic diarrhea: On the opposite end of the spectrum, having chronic problems with diarrhea can also create pressure that causes hemorrhoids. Diet and conditions such as Irritable Bowel Syndrome are just a couple causes of diarrhea. When piles already exist, diarrhea can worsen their swelling and irritation.
  • Pregnancy and childbirth: Pregnant women are at an increased risk of experiencing hemorrhoids due to the pressure exerted by the growing fetus. Pregnant women are also likely to experience constipation. Straining while giving birth also causes hemorrhoids to develop in some cases.
  • Obesity: People suffering from obesity may also be at an increased risk of developing hemorrhoids. This is due in part to the pressure on the pelvic region from extra abdominal weight. If obesity results from a poor diet, this may also cause constipation, which, as we’ve seen, is a common cause of hemorrhoids.
  • Prolonged sitting: Sitting for long periods can place pressure on the veins in the rectum and anus, which can cause hemorrhoids to develop. This may be a problem for people who sit for extended periods at a desk or sit on the toilet for long periods due to constipation.
  • Heavy lifting: You may be aware that straining on the toilet can cause hemorrhoids, but other types of physical exertion can also lead to piles. For instance, straining while lifting heavy objects can increase pressure enough that veins swell and hemorrhoids occur.
  • Age: In some cases, there isn’t a clear event or circumstance that leads to a hemorrhoid. It could simply be a part of aging. As we age, the tissues supporting the veins can weaken or stretch, which causes hemorrhoids to develop.

Hemorrhoid Prevention

Understanding the causes of hemorrhoids can also give some insight into how to prevent them. While we can’t always prevent hemorrhoids, especially if age is a factor, there are some ways you can lessen the likelihood that you’ll experience this problem.

If you’ve experienced painful piles in the past, you’ll be glad to know there are steps you can take to help with prevention:

1. Stay Hydrated

Staying hydrated is important if you want to maintain good health and prevent constipation. The amount of water you need depends on factors like your activity level, but according to experts, the average man should have about 3.7 liters of water every day, and the average woman should have about 2.7 liters. These totals include all the fluids we take in, which partly come from food. A simpler guide that works well for most people is to drink eight glasses of water every day.

2. Eat a Healthy, High-Fiber Diet

Eating a healthy diet rich in fiber is also a good way to prevent constipation and improve your overall health. Unfortunately, most Americans consume less than half of the recommended amounts of fiber each day. Avoid high-fat, low-fiber foods and instead look for fruits, vegetables and grains that are naturally high in soluble fiber. You may also want to take a fiber supplement if you struggle to get enough fiber or frequently suffer from constipation.

3. Strategically Time Bathroom Trips

When you feel the urge to go to the bathroom, try not to put it off. Waiting too long could cause the stool to harden, making it harder to pass. If you want to avoid straining, pay attention to your body’s natural urges. If you’re struggling with having a bowel movement, don’t strain too hard or spend too long on the toilet. If you can’t have a bowel movement within two minutes, come back later and try again.

4. Stay Physically Active

As we’ve seen, sitting for long periods can put undue pressure on the rectum, so try to move around whenever you can. If you work an office job, take breaks to stand up or try using a sit-stand desk so you’re not sitting for hours at a time. Maintaining a more active lifestyle overall through exercise can also help you maintain a healthy weight, which lessens your risk of experiencing hemorrhoids.

Hemorrhoid Treatment Options

Considering the pain and discomfort associated with external hemorrhoids, it is no wonder that people seek ways to address the problem. Some treatment options for hemorrhoids are only aimed at providing temporary relief, while others intend to address the problem long term.

Temporary Relief

Some options you can try at home to soothe the itching and pain caused by hemorrhoids include:

  • Topical ointments: You can find some over-the-counter creams and ointments at your pharmacy that can help relieve pain and itching from external hemorrhoids.
  • Warm baths: Soaking the area in warm water can also be soothing and provide some relief if you have external hemorrhoids. Adding Epsom salts to a sitz bath is a good way to deliver even more relief.
  • Pain relievers: Over-the-counter pain relievers like ibuprofen, aspirin or acetaminophen can relieve pain temporarily. Just make sure you take the appropriate amount according to the directions or your doctor’s recommendation.
  • Hot and cold compresses: Applying heat or cold can soothe the area. Only apply compresses for around 10 minutes at a time. A cold compress can also reduce swelling.

Beyond these temporary measures, long-term solutions can also address the problem more thoroughly. It is best to try non-invasive options first and save surgery as a last resort.

More Permanent Treatments

Some non-invasive ways of addressing hemorrhoids are:

  • Sclerotherapy: As with varicose veins, sclerotherapy can also treat piles, though it’s typically best for Grade I or II hemorrhoids only. A doctor injects a chemical solution that damages the vein, causing it to shrink. Typically, a person will need to undergo a series of sclerotherapy treatments to get the desired results.
  • Coagulation: Coagulation is another minimally invasive option. It works best for small internal hemorrhoids. This procedure involves exposing hemorrhoids to a laser or infrared light, which causes scar tissue to form. This scar tissue cuts off blood flow, causing the hemorrhoid to die, and it prevents swelling in that area.
  • Hemorrhoid banding: One of the most effective treatment options is banding, especially for internal hemorrhoids. A doctor placesa rubber band around the swollen tissue, which cuts off blood flow to the pile. This causes the tissue to die and detach from the body, leaving behind scar tissue which redirects blood flow and helps prevent future prolapse. The CRH O’Regan System for hemorrhoid banding makes this procedure more comfortable by holding the affected vein in place with gentle manual suction, eliminating the need for forceps.

Find a Local Physician Who Utilizes the CRH O’Regan System

If you want to treat your piles to find long-term relief, consider hemorrhoid banding with the CRH O’Regan System. This system allows for a more comfortable, painless procedure and can help you get the results you desire. You don’t need to fast or otherwise prep for your procedure, and there is no recovery time when you’re done.

You can quickly get back to daily life and enjoy relief from pain, swelling and other symptoms of hemorrhoids. If you’re interested in this procedure, find a physician’s office near you that offers the CRH O’Regan Banding System.

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Heal Your Hemorrhoids

Remove hemorrhoids gently and quickly. Learn about CRH O'Regan, or take action now:

Find a physician near you.

Quick Facts

3000 + Physicians Nationwide 1,000,000 Patients Trained 99% Effective Non-Surgical Solution One Minute Procedure No Prep, No Sedation, No Downtime Return to Work the Same Day

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