What are hemorrhoids?
The term hemorrhoids refers to a condition in which the veins
around the anus or lower rectum are swollen and inflamed.
Hemorrhoids may result from straining to move stool. Other
contributing factors include pregnancy, aging, chronic constipation or diarrhea,
and anal intercourse.
Hemorrhoids are either inside the anus (internal) or under the
skin around the anus (external).
What are the symptoms of
Many anorectal problems, including fissures, fistulae,
abscesses, or irritation and itching (pruritus ani), have similar symptoms and
are incorrectly referred to as hemorrhoids.
Hemorrhoids usually are not dangerous or life threatening. In
most cases, hemorrhoidal symptoms will go away within a few days.
Although many people have hemorrhoids, not all experience
symptoms. The most common symptom of internal hemorrhoids is bright red blood
covering the stool, on toilet paper, or in the toilet bowl. However, an internal
hemorrhoid may protrude through the anus outside the body, becoming irritated
and painful. This is known as a protruding hemorrhoid.
Symptoms of external hemorrhoids may include painful swelling
or a hard lump around the anus that results when a blood clot forms. This
condition is known as a thrombosed external hemorrhoid.
In addition, excessive straining, rubbing, or cleaning around
the anus may cause irritation with bleeding and/or itching, which may produce a
vicious cycle of symptoms. Draining mucus may also cause itching.
How common are hemorrhoids?
Hemorrhoids are very common in both men and women. About half
of the population have hemorrhoids by age 50. Hemorrhoids are also common among
pregnant women. The pressure of the fetus in the abdomen, as well as hormonal
changes, cause the hemorrhoidal vessels to enlarge. These vessels are also
placed under severe pressure during childbirth. For most women, however,
hemorrhoids caused by pregnancy are a temporary problem.
How are hemorrhoids diagnosed?
A thorough evaluation and proper diagnosis by the doctor is
important any time bleeding from the rectum or blood in the stool occurs.
Bleeding may also be a symptom of other digestive diseases, including colorectal
The doctor will examine the anus and rectum to look for
swollen blood vessels that indicate hemorrhoids and will also perform a digital
rectal exam with a gloved, lubricated finger to feel for abnormalities.
Closer evaluation of the rectum for hemorrhoids requires an
exam with an anoscope, a hollow, lighted tube useful for viewing internal
hemorrhoids, or a proctoscope, useful for more completely examining the entire
To rule out other causes of gastrointestinal bleeding, the
doctor may examine the rectum and lower colon (sigmoid) with sigmoidoscopy or
the entire colon with colonoscopy. Sigmoidoscopy and colonoscopy are diagnostic
procedures that also involve the use of lighted, flexible tubes inserted through
What is the treatment?
Medical treatment of hemorrhoids is aimed initially at
relieving symptoms. Measures to reduce symptoms include
tub baths several times a day in plain, warm
water for about 10 minutes
application of a hemorroidal cream or
suppository to the affected area for a limited time
Illustration reprinted with
permission from the American Society of Colon and Rectal Surgeons.
Artist: Russell K. Pearl, M.D.
Preventing the recurrence of hemorrhoids will require
relieving the pressure and straining of constipation. Doctors will often
recommend increasing fiber and fluids in the diet. Eating the right amount of
fiber and drinking six to eight glasses of fluid (not alcohol) result in softer,
bulkier stools. A softer stool makes emptying the bowels easier and lessens the
pressure on hemorrhoids caused by straining. Eliminating straining also helps
prevent the hemorrhoids from protruding.
Good sources of fiber are fruits, vegetables, and whole
grains. In addition, doctors may suggest a bulk stool softener or a fiber
supplement such as psyllium (Metamucil) or methylcellulose (Citrucel).
In some cases, hemorrhoids must be treated endoscopically or
surgically. These methods are used to shrink and destroy the hemorrhoidal
tissue. The doctor will perform the procedure during an office or hospital
A number of methods may be used to remove or reduce the size
of internal hemorrhoids. These techniques include
Rubber band ligation.
A rubber band is placed around the base of the hemorrhoid inside the rectum.
The band cuts off circulation, and the hemorrhoid withers away within a few
A chemical solution is injected around the blood vessel to shrink the
A special device is used to burn hemorrhoidal tissue.
Occasionally, extensive or severe internal or external hemorrhoids may
require removal by surgery known as hemorrhoidectomy.
How are hemorrhoids prevented?
The best way to prevent hemorrhoids is to keep stools soft so
they pass easily, thus decreasing pressure and straining, and to empty bowels as
soon as possible after the urge occurs. Exercise, including walking, and
increased fiber in the diet help reduce constipation and straining by producing
stools that are softer and easier to pass.
The U.S. Government does not endorse or favor any specific
commercial product or company. Trade, proprietary, or company names appearing in
this document are used only because they are considered necessary in the context
of the information provided. If a product is not mentioned, the omission does
not mean or imply that the product is unsatisfactory.
National Institutes of Health (NIH)
Nutritional and Herbal Therapy for
- Fiber, especially insoluble fiber, is
extremely important in creating regular bowel movements and easy
elimination. Some sources include wheat bran and psyllium husks.
- Drink plenty of water, 6-8 glasses a day, especially if
you have increased your fiber intake.
- Vitamin C is good for the integrity of your veins.
It helps keep their tone.
- Flavonoids and anthocyanins strengthen
veins. Some sources of flavonoids include lemons, limes, apples, tomatoes,
onions and carrots. Some sources of anthocyanins include dark, red berries,
blueberries, cherries, grapes and red cabbage.
- According to the
Tao of Nutrition, one natural food remedy for hemorrhoids is
eating a banana on an empty stomach everyday. For bleeding hemorrhoids, eat
three bananas daily. Another food remedy is eating steamed dried persimmons.
- A Chinese herbal ointment,
Ching Wan Hung is excellent for shrinking
hemorrhoids and relieving symptoms.
Tao of Nutrition, by Maoshing Ni, Ph.D., C.A., and Cathy McNease,