Hemorrhoids

Hemorrhoids are swollen veins, similar to varicose veins, in the lowest part of your rectum and anus. Sometimes, the walls of these blood vessels stretch so thin that the veins bulge and get irritated, especially when you poop. You might also hear them called piles.

Hemorrhoids aren't serious, but they can cause unpleasant symptoms. They're one of the most common causes of rectal bleeding. They often go away on their own. Treatments can also help.

Hemorrhoids are very common, especially in older people. About 1 in every 20 people in the U.S. has them. They affect over half of people over 50.

John Hopkins Medicine: “Hemorrhoids.”

Harvard Health Publishing: “Hemorrhoids and what to do about them.”

Medline Plus: “Hemorrhoids – Also called: Piles.”

You might hear about several types of hemorrhoids:

Internal hemorrhoids

These are so far inside your rectum that you can't usually see or feel them. They don't generally hurt because you have few pain-sensing nerves there.

External hemorrhoids

You get these under the skin around your anus, where there are many more pain-sensing nerves.

Prolapsed hemorrhoids

These happen when  an internal hemorrhoid stretches down so far that it bulges outside your anal opening. They usually go back inside your body on their own. Even if they don't, they can often be gently pushed back into place.

Thrombosed hemorrhoids

A blood clot  can turn an external hemorrhoid purple or blue. This is called a thrombosis or a thrombosed hemorrhoid.

Internal hemorrhoids may have no symptoms at all. You might notice blood on your poop, on toilet paper after you wipe, or in the toilet bowl.

Prolapsed hemorrhoid symptoms might include:

External hemorrhoid symptoms may include:

Thrombosed hemorrhoid symptoms may include:

What's the difference between hemorrhoids and anal fissures?

Both conditions can cause pain, bleeding, and itching in the anal area. But while a hemorrhoid results from swollen blood vessels, an anal fissure is a tear or cut in the lining of your anus. Constipation and straining to poop can cause either problem.

Learn more about hemorrhoid symptoms .

What causes hemorrhoids?

Pressure building up in your lower rectum can affect blood flow and make the veins there swell. That may happen because of:

You may get hemorrhoids when you have constipation or diarrhea that doesn't clear up. Coughing, sneezing, and vomiting could make them worse.

A few things can raise your risk of this condition:

You may be more likely to get hemorrhoids if other family members, like your parents, had them.

Older people may be more likely to get them because tissues in the anal area tend to grow weaker as you age.

Pregnancy raises your risk in a couple of ways. The weight of the fetus puts extra pressure on your rectum. You're more prone to constipation , too.

A mostly sedentary lifestyle, or a job in which you have to sit for long stretches, also raises your risk. When you don't move around a lot, blood can pool in your anal area and put pressure on the blood vessels there.

Your doctor will ask about your medical history and symptoms. They'll probably need to do one or both of these exams:

To diagnose internal hemorrhoids or rule out other conditions, you might need a more thorough test, including:

Symptoms usually go away on their own. Your doctor's treatment plan will depend on how serious your symptoms are. Most hemorrhoid treatments and home remedies are safe even when you're pregnant.

Simple lifestyle changes can often relieve mild symptoms within 2-7 days:

Nonsurgical treatments

Over-the-counter creams, pads, and suppositories temporarily ease pain, swelling, and itching. Most contain ingredients like lidocaine, hydrocortisone, or witch hazel.

Don't use an over-the-counter hydrocortisone medication for longer than a week unless your doctor tells you do.

If you have large hemorrhoids, or if other treatments haven't helped, you might need surgery or another procedure to remove or shrink them.

If hemorrhoids are especially large or keep coming back, your doctor might remove them with a sharp tool called a scalpel. This surgery is called hemorrhoidectomy.

Alternative treatments

Witch hazel is a herb you can buy in liquid form at the drugstore. It can temporarily ease symptoms when you use it in a sitz bath or apply it to the affected area. Witch hazel is the active ingredient in some hemorrhoid treatments.

Less is known about the safety and effectiveness of some other herbs that are sometimes used as alternative treatments. They include:

Some people also take supplements containing fiber or probiotics , microorganisms that help promote gut health.

Talk to your doctor before trying any of these.

Read about hemorrhoid treatments.

Rarely, hemorrhoids could lead to problems such as:

To prevent flare-ups, try these steps:

To reduce discomfort, sit on a hemorrhoid cushion or other soft surface rather than a hard chair. Â This can ease swelling of hemorrhoids and prevent new ones.

Over-the-counter pain relievers  like aspirin or acetaminophen can help when your hemorrhoids hurt.

To avoid irritation, take care not to wipe too hard after using the bathroom. Using damp toilet paper can make things easier. Avoid heavily scented wipes.

When should I call my doctor?

Hemorrhoids are rarely dangerous. If the symptoms don't go away in a week or if you have bleeding, see your doctor to make sure you don't have a more serious condition.

What questions should I ask my doctor?

Some questions you might ask during a doctor visit include:

How do they fix hemorrhoids? Hemorrhoids can be treated with lifestyle changes, medications, or medical procedures. Your doctor can recommend a treatment suitable for you.

What happens if you let hemorrhoids go untreated? If they don't go away, or if your symptoms get worse, you'll need treatment to get relief from your symptoms. If you have bleeding from your bottom, see a doctor. This can also be a symptom of other, more serious conditions.

How long do hemorrhoids last? They usually get better in a few days. Some people have repeated cases of hemorrhoids.

Here are some frequently asked questions about this condition:

Who is more likely to get hemorrhoids?

You're more likely to get them if you:

What is the fastest way to heal hemorrhoids?

For most people, sitz baths and a high-fiber diet should do the trick.

How do I prevent hemorrhoids?

The main way to prevent them is to avoid straining when you poop. To prevent constipation , drink plenty of water and eat a lot of fruits, vegetables, and whole grains.

Can I treat hemorrhoids myself?

You can often treat mild cases with lifestyle changes, home remedies like sitz baths, and over-the-counter treatments. But tell your doctor if you don't get better within a week.

Hemorrhoids are a common problem and not usually serious. Lifestyle changes and over-the-counter treatments are often enough to treat them. Make an appointment with your doctor if your symptoms are serious or don't go away after a few days.

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