- Internal 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 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 shown to reduce hemorrhoid symptoms.
- Fluids—drinking plenty of non-alcoholic fluids will help soften stools
- Rubber band ligation—a rubber band is 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—electricity, laser, or infrared light is used to shrink the hemorrhoidal tissue
- Eat a high fiber diet.
- Exercise regularly.
- 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/. Updated October 2012. Accessed May 30, 2013.
Hemorrhoids. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated March 21, 2013. Accessed May 30, 2013.
Hemorrhoids. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/hemorrhoids/index.aspx . Updated April 30, 2012. Accessed May 30, 2013.
Jayaraman S, Colquhoun PH, Malthaner RA. Stapled versus conventional surgery for hemorrhoids. Cochrane Database Syst Rev . 2006;(4):CD005393.
- Reviewer: Peter Lucas, MD; Michael Woods, MD
- Review Date: 05/2013 -
- Update Date: 05/30/2013 -