What are hemorrhoids | What Causes Hemorrhoids

Hemorrhoids are swollen and inflamed veins around the anus or in the lower rectum. The rectum is the last part of the large intestine leading to the anus. The anus is the opening at the end of the digestive tract where bowel contents leave the body.

External hemorrhoids are located under the skin around the anus. Internal hemorrhoids develop in the lower rectum. Internal hemorrhoids may protrude, or prolapse, through the anus causing some discomfort and in some cases, bleeding. Most prolapsed hemorrhoids shrink back inside the rectum on their own. Severely prolapsed hemorrhoids may protrude permanently and require treatment.

Anatomy of the lower rectum and anus showing the muscle sphincters. The internal anal sphincter is made of smooth muscle. The external anal sphincter is made up of skeletal muscle

Anatomy of the lower rectum and anus showing the muscle sphincters.

Diagram the anal anatomy. internal and external hemorrhoids. Human anatomy

Diagram of the anal anatomy. Internal and external hemorrhoids.


How do i know if i have hemorrhoids?

In many cases you are prompted by the early signs and symptoms to take notice and like many of us, begin researching the problem in an attempt to do a self-diagnosis prior to seeking medical advice.

The most common symptom of internal hemorrhoids is bright red blood on stool, on toilet paper, or in the toilet bowl after a bowel movement. Internal hemorrhoids that are not prolapsed are usually not painful. Prolapsed hemorrhoids often cause pain, discomfort, and anal itching.

Blood clots may form in external hemorrhoids. A blood clot in a vein is called a thrombosis. Thrombosed external hemorrhoids cause bleeding, painful swelling, or a hard lump around the anus. When the blood clot dissolves, extra skin is left behind. This skin can become irritated or itch. Excessive straining, rubbing, or cleaning around the anus may make symptoms, such as itching and irritation, worse.

Hemorrhoids are not dangerous or life threatening. Symptoms usually go away within a few days and can be treated, and the discomfort relieved by implementing simple remedies. Some people with hemorrhoids may never have symptoms.

What causes hemorrhoids?

Factors that may cause swelling in the anal and rectal veins include:

  • Chronic constipation or diarrhea
  • Straining during bowel movements
  • Carrying or lifting heavy loads
  • Lack of fiber in the diet
  • Low intake of fluids
  • Sitting for long periods at a time
  • Weakening of connective tissue in the rectum and anus that occurs with age

Pregnancy can also cause hemorrhoids by increasing pressure in the abdomen, which may enlarge the veins in the lower rectum and anus. For most women, hemorrhoids caused by pregnancy disappear after childbirth.


How are hemorrhoids diagnosed?

If you go and see a medical professional, generally he/she will examine the anus and rectum to determine whether the patient has hemorrhoids. This examination will be a physical exam to initially look for visible hemorrhoids. A digital rectal exam with a gloved, lubricated finger and/or an anoscope (a hollow, lighted tube for viewing the lower few inches of the rectum) provides a more thorough internal diagnosis.

How are hemorrhoids treated?

When suffering from hemorrhoids, sitting, lying down or even standing can cause discomfort and in many cases, when this discomfort persists, the best treatment for hemorrhoids can simply be a matter of relieving the symptoms by finding a remedy or combination of remedies that provide the best results until healing has taken place. Some look to medicines and topical creams, others find a more natural approach can be just as effective and suits them better. Now while medicines, both topical and internal, offer one particular form of relief, something as simple as adjusting one’s seating can provide ample results as well, without the influence of chemicals. And in some cases symptoms can initially be treated with increased dietary fiber and adequate fluid intake.

The main approaches for treatment and assisting recovery can be broken down as follows:


Could my symptoms be something else?

Hemorrhoids are common and usually not too serious. They can often be treated with home remedies, and you may not even need to be seen by a doctor. But symptoms typical of hemorrhoids, especially rectal bleeding, may also be caused by other diseases, some of them serious, like colon cancer. So it is important to have all the information before conducting a self-diagnosis. Here are other causes for hemorrhoid symptoms that you should be made aware of:

  • Colon and rectal cancer. Rectal and colon cancer are rare before age 40. Colon cancer symptoms may include persistent bleeding, a change in bowel habits or bowel movement shape, lower abdominal pain, and unexpected weight loss.
  • Anal fissures. Anal fissures are small tears, like paper cuts, in the anal canal that can act very much like hemorrhoids. Anal fissures can cause pain, burning, and bleeding. They can occur at any age and are usually caused by constipation. Anal fissures usually clear up with home treatments similar to those used for hemorrhoids.2
  • Inflammatory bowel disease (IBD). This condition, which Hall says includes ulcerative colitis and Crohn's disease, can cause rectal bleeding and discomfort. Both types of IBD are long-term diseases that usually begin in young adults, he says. Symptoms may include cramps, diarrhea, weight loss, and fever.2
  • Pruritis ani. "This condition is frequently mistaken for hemorrhoids because it causes itching and burning in the rectal area," explains Hall. "It is actually a type of localized dermatitis." Pruritis ani causes an intense urge to scratch. It may result from too much moisture or a food sensitivity. Treatment involves keeping the area dry, avoiding scrubbing, and using a prescription ointment or cream.2
  • Genital warts. Genital warts are one of the many sexually transmitted diseases (STDs) that can grow in the anal area and cause symptoms of bleeding and discomfort. Genital warts are caused by human papilloma virus (HPV), and they should always be treated because they will continue to grow and increase the chances of getting rectal cancer. Other STDs, including chlamydia and gonorrhea, can also occur in the anal area and cause symptoms of irritation and bleeding.2


You should seek treatment for hemorrhoid symptoms if:

  • You have rectal bleeding for the first time
  • You have heavy rectal bleeding
  • You have rectal bleeding that is not responding to home care
  • You have other hemorrhoid symptoms, such as pain, pressure, itching, and burning, that do not respond to home care after a few days
  • You have hemorrhoid symptoms along with other symptoms such as fever, weight loss, abdominal pain, or a change in bowel habits2

Medical disclaimer: The information, including but not limited to, text, graphics, images and other material contained on this website are for educational and informational purposes only and should not be construed as medical advice. Always seek the advice of your physician or other qualified health care provider regarding a medical condition or treatment.