Hemorrhoids: Causes, Types, Symptoms, and Treatment Options

Hemorrhoids are swollen, enlarged veins in the rectum and anus. They are the most common cause of rectal vein pain and related symptoms.

Causes

• Straining during bowel movements (constipation)
• Prolonged sitting on the toilet
• Chronic diarrhea
• Pregnancy and childbirth (increased pelvic pressure)
• Obesity
• Low-fiber diet
• Heavy lifting

Types

• Internal hemorrhoids: Inside the rectum; usually painless but may bleed.
• External hemorrhoids: Under the skin around the anus; can be painful, itchy, bleed.
• Thrombosed hemorrhoids: Blood clot forms in an external hemorrhoid → severe pain, swelling, bluish lump.

Symptoms

• Bright red blood on toilet paper or in toilet bowl
• Itching or irritation around the anus
• Pain or discomfort, especially during bowel movements or sitting
• Swelling or a lump near the anus
• Leakage of feces or mucus

Treatment

Conservative

• High-fiber diet, increased fluids, stool softeners
• Sitz baths
• OTC creams/ointments (hydrocortisone, witch hazel)

Office Procedures

• Rubber band ligation
• Sclerotherapy
• Infrared coagulation

Surgical

• Hemorrhoidectomy (for severe or recurrent cases)
• Stapled hemorrhoidopexy

When to See a Doctor

• Rectal bleeding (to rule out other causes like colorectal cancer)
• Severe pain or thrombosed hemorrhoid
• Symptoms persist >1 week despite home treatment
• Changes in bowel habits or stool caliber