Differentiating Between The Two
The symptoms of a fissure and a hemorrhoid can be similar. Either can cause pain, itching and bleeding. However, if you are in pain and don’t feel an external lump, the condition is more likely to be a fissure. If you notice that you are leaking mucus from your anus, the problem is probably a hemorrhoid.
The best way to settle the question of anal fissures vs. hemorrhoids is to see a doctor, who will perform an examination using anoscopy. This involves looking at the area with a special tool.
You might also be referred to a specialist to perform an internal examination. The procedure, called sigmoidoscopy, examines both your rectum and part of your colon with a lighted instrument.
Your symptoms could also be the result of a more serious condition, such as an infection, an abscess or cancer. Before trying to self-treat, have a doctor rule out these other possibilities.
Symptoms Of Enlarged Hemorrhoids
Symptoms, Causes & Home remedies of Hemorrhoids
When you have enlarged hemorrhoids, the symptoms may involve1,3:
- Itching and irritation around the anus
- Burning sensation at the anus
- Mucus discharge
- Severe pain
- Bleeding without pain you may see some bright red blood spots on the toilet tissue or even on the toilet bowl
- Having a sensation that your bowel isnt like empty
- Swelling around the anus
- Have moist, pink pumps forming on edges of the anus or bulging out, these may also assume a purple or bluish look4.
Effective Treatment Of External Hemorrhoid Symptoms
If you have external hemorrhoidal symptoms, the CRH System can likely help. Most of these external symptoms actually come from the internal hemorrhoids. For those patients whose symptoms include external hemorrhoidal swelling banding of the internal hemorrhoids is typically an effective treatment! Patients will often see a significant decrease in the size of their external hemorrhoids after treatment, along with decreased swelling with straining and bowel movements! Surgery is needed only in the most severe cases in fact, around 90% of patients with external complaints are helped with internal banding.
Some patients with external symptoms will be found to have an anal fissure in addition to their hemorrhoids. These fissures, or tears of the lining of the anus, can cause significant pain and bleeding. Typically patients with anal fissures are given topical medication for this problem, while the CRH System is able to treat the patients associated hemorrhoids.
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What Causes Internal And External Hemorrhoids And Simple Ways To Treat Them
Hemorrhoids are usually caused by increased pressure due to pregnancy, being overweight, or straining during bowel movements. By midlife, hemorrhoids often become an ongoing complaint. By age 50, about half the population has experienced one or more of the classic symptoms, which include rectal pain, itching, bleeding, and possibly prolapse . Although hemorrhoids are rarely dangerous, they can be a recurrent and painful intrusion. Fortunately, there’s a lot we can do about hemorrhoids.
Can Hemorrhoids Be Prevented Or Avoided
Just about everyone has hemorrhoids at some time. But some things may make you more likely to get them. People whose parents had hemorrhoids may be more likely to get them. Pregnant women often get hemorrhoids because of the strain from carrying the baby and from giving birth. Being very overweight or standing or lifting too much can make hemorrhoids worse.
Can Natural Home Remedies Treat And Prevent Hemorrhoids
Regardless of the size or swelling of a hemorrhoid, no treatment is required if symptoms do not exist. Prevention is perhaps the most effective treatment. Diet and adequate hydration are very important to maintain normal bowel movements. Hemorrhoid symptoms can occur with the passage of hard stool and constipation, as well as diarrhea and frequent bowel movements. People with constipation may require a high-fiber diet, adequate hydration, and stool softeners. Those with too frequent bowel movements may require antidiarrheal medications and diet adjustments. These preventive measures decrease the amount of straining that is required to have a bowel movement, thus decreasing the pressure within the blood vessels to prevent swelling. The internal hemorrhoid always stays protruded or prolapsed and is at risk for thrombosis or strangulation should the anal muscles go into spasm.
Grade 1 hemorrhoids are treated symptomatically. There can be some spasm of the anal muscles. Warm sitz baths, sitting in a warm tub for 20 minutes, two or three times a day may be helpful. Avoiding spicy food may also prevent anal itching. Over-the-counter medications may be helpful.
How Diet Contributes To Hemorrhoids
The kind of food you take impacts your susceptibility to get hemorrhoids. If you take a diet that has high fiber, it is less likely that you will have hemorrhoids, however, if you are accustomed to taking a diet consisting of processed foods, then you face a higher risk of getting hemorrhoids.
Having a low-fiber diet may lead to constipation, which in turn may make you get hemorrhoids because constipation makes you strain on the toilet and aggravates the hemorrhoids because of hard stool. The hard stool arising due to constipation further irritates the veins making them inflamed and even painful.3
One of the signs and symptoms of hemorrhoids is bleeding that isnt accompanied by pain . You may see some bright red blood on toilet paper, on the stool surface, or dripping into the toilet. The bright red blood shows that the bleeding is occurring in the lower gut and hasnt been digested or has not passed through the stomach and intestines. If it had passed through stomach and intestines, it would appear in stool as black, tarry stool .
Hemorrhoid bleeding resolves by itself without needing treatment, however, if you have bleeding occurring when you have a bowel movement, it is important that you check with a doctor. Hemorrhoids are the commonest cause of bleeding when having bowel movement, however, it can also be a sign of other serious conditions such as:3
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How Can I Treat My Hemorrhoids
You can most often treat your hemorrhoids at home by
- taking a stool softener or a fiber supplement such as psyllium or methylcellulose
- drinking water or other nonalcoholic liquids each day as recommended by your health care professional
- not straining during bowel movements
- not sitting on the toilet for long periods of time
- taking over-the-counter pain relievers such as acetaminophen, ibuprofen, naproxen, or aspirin
- sitting in a tub of warm water, called a sitz bath, several times a day to help relieve pain
Applying over-the-counter hemorrhoid creams or ointments or using suppositoriesa medicine you insert into your rectummay relieve mild pain, swelling, and itching of external hemorrhoids. Most often, doctors recommend using over-the-counter products for 1 week. You should follow up with your doctor if the products
- do not relieve your symptoms after 1 week
- cause side effects such dry skin around your anus or a rash
Most prolapsed internal hemorrhoids go away without at-home treatment. However, severely prolapsed or bleeding internal hemorrhoids may need medical treatment.
How Do You Treat External Hemorrhoids Diagnosis
External hemorrhoids appear as bumps and/or dark areas surrounding the anus. If the lump is tender, it suggests that the hemorrhoid is thrombosed. Any lump needs to be carefully followed, however, and should not be assumed to be a hemorrhoid since there are rare cancers of the anal area that may masquerade as hemorrhoids.
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What Should I Eat If I Have Hemorrhoids Diet
Individuals with hemorrhoids should soften their stools by increasing the fiber in their diets.
Fiber is found in numerous foods, including
- fresh and dried fruits,
- whole grains, and
In general, 20 to 30 grams of fiber per day is recommended, whereas the average American diet contains less than 15 grams of fiber. Fiber supplements, like psyllium, methylcellulose, and calcium polycarbophil, also may be used to increase the intake of fiber.
Stool softeners and increased drinking of liquids also may be recommended, as well as bulk-forming laxatives. Nevertheless, the benefits of fiber, liquids, and stool softeners have not been well-tested with respect to hemorrhoidal control in scientific studies.
How Do Hemorrhoids Go Away
There are a number of over-the-counter treatment options that can help the itching, pain, and discomfort. First, you should talk to your doctor if you think you are experiencing hemorrhoid symptoms. They may recommend some of the following:
- A stool softener can help reduce straining. This can help prevent hemorrhoids and makes it less painful to pass stool when you have them.
- Laxatives are helpful if you are not having regular bowel movements.
- Topical medications can reduce the discomfort and pain, and help shrink the hemorrhoids.
- You can also soak daily in a warm bath or a sitz bath .
It can take anywhere from a few days to over a week for the swelling to go down and the symptoms to go away. If your symptoms do not get better with these treatments, your doctor may suggest an in-office procedure to remove your hemorrhoids. These procedures are usually done using a local anesthetic, but depending on the procedure may cause some pain and discomfort following the procedure.
A common misconception is that once you have hemorrhoids they never go away. In fact, they can go away! Explore all the options, which focus on avoiding constipation and hard bowel movements. If youre having pain, topical treatment can be given as well. If nothing helps, there are small procedural options that a gastroenterologist or a surgeon can offer to treat your hemorrhoids. Dr. Kumar
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Medical Procedures For Hemorrhoids That Wont Go Away
If hemorrhoids don’t go away with home treatments, medical procedures may be necessary.
If you visit your doctor with painful external hemorrhoids those located around the outside of the anus that are visible from the outside your doctor may offer to excise them during the office visit. You will be given a shot with a local anesthetic to numb the area before the procedure.
Doctor’s office procedures for internal hemorrhoids those located inside the rectum may include:
Rubber Band Ligation This is the most commonly performed hemorrhoid procedure in the United States. In this procedure, which can be used for grades 1, 2, and 3 internal hemorrhoids , the doctor places a small rubber band around the base of the hemorrhoid, which can be done when your doctor performs an anoscopy examination to better visualize the hemorrhoids. The rubber band cuts off the hemorrhoid’s blood supply.
The procedure typically causes the hemorrhoid to shrink and fall off within about a week, though several short visits to your doctor may be necessary to completely get rid of the hemorrhoid. Minor bleeding and a feeling of pressure may occur, but this can usually be alleviated with OTC pain relievers. This procedure is not associated with significant recovery time.
When Hemorrhoid Surgery May Be Necessary
Very few people fewer than 10 percent of all adults who see a doctor because of symptomatic hemorrhoids will require a surgical operation.
Surgery to remove hemorrhoids is called a hemorrhoidectomy.
Your doctor may recommend a hemorrhoidectomy if:
- You have large external hemorrhoids
- You have both internal and external hemorrhoids
- An internal hemorrhoid has prolapsed
In a hemorrhoidectomy, the doctor makes a small incision to remove the hemorrhoid and surrounding tissue before closing the wound with stitches.
A hemorrhoidectomy is performed in an operating room and can be done under general anesthesia, in which you are unconscious and unable to feel pain.
It can also be done with a spinal anesthetic block while you are awake , or with a combination of relaxing and sedating drugs given intravenously and a local anesthetic injected around the anus.
Hemorrhoidectomy is associated with postoperative pain, but the procedure is successful for 95 percent of cases.
More recently, another option aimed at avoiding the postoperative pain of a hemorrhoidectomy has become available, called a stapled hemorrhoidopexy. A circular stapling device pulls the hemorrhoidal tissue upward and to its normal position, stapling it in place. The staples eventually fall out over time.
There are many options for the treatment of hemorrhoids. Its best to discuss the benefits and risks of each of these with your doctor in order to come up with the treatment plan that is best for your particular case.
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What Causes External Hemorrhoids
The most common cause of external hemorrhoids is repeated straining while having a bowel movement. Hemorrhoids develop when the veins of the rectum or anus become dilated or enlarged and can be either internal or external. External hemorrhoids are usually found beneath the skin that surrounds the anus.
There is a range of symptoms that can affect a person with hemorrhoids. Symptoms tend to vary depending on the severity of your hemorrhoids. Some of the symptoms that you may have include the following:
You may notice bleeding when using the bathroom. This includes seeing blood on toilet paper or in the toilet. Lumps around the anus may feel as if they are swollen.
These symptoms may also occur because of other conditions. But if you experience these symptoms, you should schedule an exam with your doctor.
How Can I Treat Hemorrhoids At Home
Hemorrhoids often go away on their own without treatment. Symptoms like pain and bleeding may last one week or slightly longer. In the meantime, you can take these steps to ease symptoms:
- Apply over-the-counter medications containing lidocaine, witch hazel or hydrocortisone to the affected area.
- Drink more water.
- Increase fiber intake through diet and supplements. Try to obtain at least 20-35 grams of daily fiber intake
- Soak in a warm bath for 10 to 20 minutes a day.
- Soften stool by taking laxatives.
- Take nonsteroidal anti-inflammatory drugs for pain and inflammation.
- Use toilet paper with lotion or flushable wet wipes to gently pat and clean your bottom after pooping. You can also use a tissue or washcloth moistened with water.
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Improving Your Diet And Lifestyle
What Are The Treatments For Hemorrhoids
If at-home treatments for hemorrhoids don’t help you, you may need a medical procedure. There are several different procedures that your provider can do in the office. These procedures use different techniques to cause scar tissue to form in the hemorrhoids. This cuts off the blood supply, which usually shrinks the hemorrhoids. In severe cases, you may need surgery.
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Home Remedies For Hemorrhoids
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Who Is At Risk For Hemorrhoids
Hemorrhoids are one of the most common gastrointestinal illnesses. They affect both males and females of all races, in all age groups. But there are some factors that can put you at higher risk including:
- GeneticsA family history of hemorrhoids puts you at higher risk. Doctors will often ask whether family members suffer from hemorrhoids in order to identify a genetic tendency.
- AgingThe risk of hemorrhoids increases with age. While children and young adults do experience hemorrhoids, they are most common in adults 45-65 years old.
- ObesityBody weight can contribute to the risk of hemorrhoids since heavier weight can cause additional strain on the body and contribute to a more sedentary lifestyle.
- NutritionA poor diet that lacks fiber often leads to constipation and straining during bowel movements.
- PregnancyThe weight of carrying a baby during pregnancy can put increased pressure on the pelvic area. Thankfully, these will often resolve completely after delivery of the baby.
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What Questions Should I Ask My Doctor
You may want to ask your healthcare provider:
- Why did I get hemorrhoids?
- What is the best treatment for me?
- What lifestyle changes can I make to keep from getting hemorrhoids again?
- When will symptoms improve?
- Should I look out for signs of complications?
A note from Cleveland Clinic
An estimated 15 million Americans have sought treatments for hemorrhoids at some point in their lives. But many more suffer needlessly. Dont be too embarrassed to talk to your healthcare provider about your symptoms. If hemorrhoids cause pain or discomfort, your provider has treatments that can help. You can also take steps to keep hemorrhoids from coming back.
Last reviewed by a Cleveland Clinic medical professional on 01/18/2021.