What Do You Do When You Have Hemorrhoids

When To Call Your Doctor

Even if you think it’s from hemorrhoids, you should call your doctor about any rectal bleeding. It’s also a symptom of colon polyps, colitis, Crohn’s disease, diverticulitis, and colorectal cancer. Anal fissures can also cause pain and bleeding. So you’ll want to make sure you get the right diagnosis and treatment.

If your hemorrhoids are very painful or aren’t getting better after you’ve tried treating them yourself, let your doctor know.

Can Hemorrhoids Be Prevented

You can help prevent hemorrhoids by:

• Eating foods that are high in fiber
• Taking a stool softener or a fiber supplement
• Drinking enough fluids every day
• Not straining during bowel movements
• Not sitting on the toilet for long periods of time

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

How Do Healthcare Providers Treat Hemorrhoids

You should see your healthcare provider if symptoms get worse or interfere with your daily life or sleep. Also seek help if signs dont improve after a week of at-home treatments. Your provider may treat hemorrhoids with:

• Rubber band ligation: A small rubber band placed around the base of a hemorrhoid cuts off blood supply to the vein.
• Electrocoagulation: An electric current stops blood flow to a hemorrhoid.
• Infrared coagulation: A small probe inserted into the rectum transmits heat to get rid of the hemorrhoid.
• Sclerotherapy: A chemical injected into the swollen vein destroys hemorrhoid tissue.

Surgical treatments include:

• Hemorrhoidectomy: Surgery removes large external hemorrhoids or prolapsed internal ones.
• Hemorrhoid stapling: A stapling instrument removes an internal hemorrhoid. Or it pulls a prolapsed internal hemorrhoid back inside the anus and holds it there.

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How To Treat Hemorrhoids

Schedule an appointment

National statistics show that hemorrhoids affect about 1 in 20 Americans and about half of adults older than 50. So, theres a good chance that once you reach 50, youll have to deal with hemorrhoids at one point or another.

Hemorrhoid tissues are veins and blood vessels inside and outside the anus that swell slightly during bowel movements. If you exert too much pressure, they may stay enlarged and inflamed. If you have hemorrhoids, you know what problems this can cause.

What Causes External Hemorrhoids

External hemorrhoids are when one or more tender bumps form beneath the skin surrounding your anus. These are dilated blood vessels that have become so enlarged that they protrude.

Blood may clot, or thrombose, inside the protruding blood vessel. This can form a hard lump and cause considerable pain in some cases.

External and internal hemorrhoids are caused by many of the same factors. These include:

• Straining while pooping. The most common cause of external hemorrhoids is repeated straining while having a bowel movement. This is often caused by severe cases of constipation or diarrhea. Straining makes blood pool in the area.
• Sitting on the toilet for a long time. This can also put pressure on the tissues around your rectum and anus.
• Weakened support tissues. As you age, the tissues tend to weaken around the anus and rectum.
• Pregnancy.Pregnant people may also be at an increased risk of hemorrhoids because of the increased pressure of the abdomen on these veins.
• Obesity. Having excess weight has been associated with having hemorrhoids.
• Heavy lifting. You may have a higher risk of hemorrhoids if you frequently lift heavy objects.
• Not eating enough fiber. A low fiber diet may lead to constipation, which can cause hemorrhoids.

A range of symptoms can affect a person with external hemorrhoids. Symptoms vary depending on the severity. Some of the symptoms that you may have include:

Symptoms of external hemorrhoids may go away after a few days, according to the

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What Do Bad Hemorrhoids Look Like

Bad hemorrhoids, or severe grades of hemorrhoids, look different depending on which type of hemorrhoid they are.

Considerably severe external hemorrhoids can take the shape of a cluster of lumps, with tight skin stretching over the highly inflamed areas of the blood vessels.

If your external hemorrhoids are bad, then it is probable that they have become thrombosed, which will look like large lumps that are bluish or purple due to the underlying blood clot.

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Internal hemorrhoids can become prolapsed, and this appears as a cluster of mucous covered bulges emerging from the anal opening.

Later stages of hemorrhoids become enlarged and painful, and sometimes are a visible mix of blood, flesh-colored engorgements, or a purplish blue hue if a blood clot is present.

When Should I See A Doctor

While it is true that hemorrhoids usually do clear up on their own, it is recommended to consult a doctor if they are causing pain, there is bleeding or they seem to be getting worse.

Bleeding during bowel movements is a symptom of hemorrhoids but it can also be an indication of another underlying condition.

In addition to bleeding, if you see a significant change in the color and consistency of your stools or are above forty years of age, speak to your doctor as the symptoms could also indicate colorectal or anal cancer.

Usually doctors conduct a physical examination along with a few tests to rule out any other conditions. A physical examination, sometimes coupled with anoscopy, can help identify the presence of hemorrhoids and your doctor can guide you accordingly.

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They Do It For Themselves First

Your desire to maintain must be driven by something thats deeper and consistent with your own internal values, says Scott Kahan, MD, director of the National Center for Weight and Wellness.

Take some time to think about whats really important to you and how your weight ties into it. For example, you want to be there to see your grandkids grow up, or to take that biking vacation youve always wanted to do.

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Related Conditions And Causes Of Hemorrhoids

Gastrointestinal problems such as constipation and diarrhea can lead to or worsen hemorrhoids. The prolonged sitting or straining that may occur when you’re dealing with these issues puts pressure on the hemorrhoidal tissue.

Hemorrhoids also often develop during pregnancy. This is similarly due to greater pressure in the area but can also be due to an increase in blood volume and as a result of hormonal changes that increase the likelihood of swelling. Constipation during pregnancy is a common cause of hemorrhoids.

What Do Hemorrhoids Look Like When They Fall Out

Internal hemorrhoids can get to the stage where they become prolapsed. Prolapsed hemorrhoids are internal hemorrhoids that become so big that they bulge outside of the opening of the anus.

So, if your hemorrhoid has fallen out, you have an internal prolapsed hemorrhoid.

When you have a prolapsed hemorrhoid, you will notice a moist bump that is pinker than the surrounding area. What does a prolapse look like? This is a picture of a prolapsed hemorrhoid.

Prolapsed hemorrhoids usually go back on their own, but some can be gently pushed back into place.

Internal hemorrhoids are generally divided into one of four stages. The more serious the stage of the internal hemorrhoid is, the more likely it is to be seen. Stage one internal hemorrhoids are not seen externally.

Although they cause some hemorrhoid bleeding, they will not push out of the opening of the anus. Internal hemorrhoids at stage 2 begin to prolapse.

Although they might be seen on the outside of the opening of the anus, they generally retract back into the rectal cavity on their own.

Stage 3 internal hemorrhoids have prolapsed externally and often require at-home or physician treatment.

The most serious internal hemorrhoids, stage 4, protrude out of the opening of the anus and are likely to become thrombosed.

Prolapses can often be the result of the combination of hemorrhoids and pregnancy, when there is a big increase in the pressure surrounding the veins in the anal canal.

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Diagnosis For Hemorrhoids Vs Rectal Prolapse

If you notice symptoms like blood in your stool or constant irritation around your anus, it is a good idea to see a physician. They can evaluate you and determine whether you have hemorrhoids or a rectal prolapse.

Diagnosis for hemorrhoids

Doctors typically diagnose hemorrhoids by performing a physical exam and asking you about your symptoms. They may also request additional testing like:

• Digital rectal examination : The doctor covers their hand with a lubricated glove, then inserts their finger inside your rectum to check for issues.
• Anoscopy: The doctor inserts a hollow, lighted tube inside your anus to get a view of any internal hemorrhoids.
• Proctoscopy: The doctor places a lighted tube inside your anus to get a view of your entire rectum.
• Sigmoidoscopy: The doctor looks at part of your large intestine with a small, flexible, lighted tube that blows air into your rectum so that it swells.
• Coloscopy: This test lets the doctor see the entire length of your large intestine, which allows them to check for abnormal growths, red or swollen tissue, ulcers, or any bleeding.

Diagnosis for rectal prolapse

In addition to performing a physical exam, your doctor may request the following tests when checking for rectal prolapse:

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When To See A Doctor

Although a hemorrhoid isn’t a necessarily a serious condition and most symptoms will resolve on their own without intervention, it’s important to see your doctor if your symptoms persist longer than a few days or recur frequently. Bleeding during a bowel movement is usually the most common symptom. However, some conditions or diseases that are more serious, such as colorectal or anal cancer, can mimic the symptoms of a hemorrhoid. Your doctor can help rule these conditions out through a physical exam and additional testing. Your doctor can also help to ease your hemorrhoid symptoms, including excessive bleeding, if they’re painful or don’t improve over time. Call your doctor right away if you’re having excessive rectal bleeding, dizziness, or lightheadedness.

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How Are External Hemorrhoids Diagnosed

To diagnose external hemorrhoids, a doctor will ask about your health history and symptoms. They will also likely do a physical exam.

In the case of external hemorrhoids, they will generally be able to see the hemorrhoids by examining the area around your anus.

They may also perform a digital rectum exam and anoscopy to check for issues inside your anal canal and rectum, including internal hemorrhoids.

During a digital rectal exam, your doctor will insert their gloved, lubricated finger into your anus. Theyll be able to feel abnormalities inside.

During an anoscopy, the doctor will insert a device called an anoscope into your rectum that allows them to see abnormalities.

If you also have rectal bleeding, your doctor will likely request that you get a sigmoidoscopy or colonoscopy to rule out colorectal cancer. These methods will also detect any internal hemorrhoids.

Do You Really Have Hemorrhoids

Many people who experience pain, irritation or anything outof the ordinary in the anal region probably assume its a hemorrhoid. But dontgo reaching for the medicated cream or pads just yet. Manyother conditions could be the culprit, including anal fissure, analwarts, an infection, anal cancer in serious cases, or even just a cut.

Work with a doctor to rule out those things and determinewhat treatment you need.

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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.

References

What Does A Thrombosed Hemorrhoid Look Like

Thrombosed hemorrhoids are a form of external hemorrhoid that are visible. When external hemorrhoids become prolapsed, they form soft clumps around the outside of the opening of the anus.

In some cases, external hemorrhoids could form a blood clot. These can be extremely painful and are called a thrombosis.

Thrombosed hemorrhoids can be frightening. They can form into a hard lump and can turn purple or blue. They may also bleed.

Most thrombosed hemorrhoids appear as a lump on the edge of the opening of the anus and protrude out.

They appear in a dark bluish color because of the blood clot that is contained inside the swollen vessel.

When thrombosed hemorrhoids are treated medically, a hemorrhoid surgery is typically involved.

A healed thrombosed hemorrhoid may leave behind scarring or a tag of skin protruding from the anus.

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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.

Medicines For Treating Piles

Theres a range of medicines that can help to relieve the symptoms of piles. Always read the patient information leaflet that comes with your medicine and ask your pharmacist for advice if you have any questions.

• If youre passing hard poo, a fibre supplement such as ispaghula husk or mild laxative such as lactulose will soften it.
• Over-the-counter painkillers, such as paracetamol, may help to ease any pain from piles. Dont take painkillers that have an opioid in them , as these could make you constipated and add to your problems.
• Soothing creams, ointments and suppositories may ease any pain and itchiness from piles. There are lots of different products available over the counter. Some contain a local anaesthetic such as lidocaine. Only use these for a few days as they may affect the sensitivity of your skin ask your pharmacist for more information.
• Products that contain corticosteroids, such as Anusol HC and Proctosedyl, may reduce swelling and pain. Dont use these for more than a week as they can damage the skin around your anus. Most are available over the counter and others on prescription.

It can sometimes take up to a month for self-help measures and medicines to work. If your symptoms dont improve after this time, contact your GP. They may refer you to a specialist.

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How Do Doctors Treat Hemorrhoids

Doctors treat hemorrhoids with procedures during an office visit or in an outpatient center or a hospital.

Office treatments include the following:

• Rubber band ligation. Rubber band ligation is a procedure that doctors use to treat bleeding or prolapsing internal hemorrhoids. A doctor places a special rubber band around the base of the hemorrhoid. The band cuts off the blood supply. The banded part of the hemorrhoid shrivels and falls off, most often within a week. Scar tissue forms in the remaining part of the hemorrhoid, often shrinking the hemorrhoid. Only a doctor should perform this procedureyou should never try this treatment yourself.
• Sclerotherapy. A doctor injects a solution into an internal hemorrhoid, which causes scar tissue to form. The scar tissue cuts off the blood supply, often shrinking the hemorrhoid.
• Infrared photocoagulation. A doctor uses a tool that directs infrared light at an internal hemorrhoid. Heat created by the infrared light causes scar tissue to form, which cuts off the blood supply, often shrinking the hemorrhoid.
• Electrocoagulation. A doctor uses a tool that sends an electric current into an internal hemorrhoid. The electric current causes scar tissue to form, which cuts off the blood supply, often shrinking the hemorrhoid.

Outpatient center or hospital treatments include the following:

Sometimes complications of hemorrhoids also require treatment.