Approximately, 75% of all adults in the U.S. will experience hemorrhoids at some point in their lives.  Internal hemorrhoids, which lie inside the rectum, usually have no symptoms and most people are not aware of them because they're not generally painful. However, they may cause painless rectal bleeding if symptoms do appear.

You may not notice that you have internal hemorrhoids unless you notice streaks of blood on in the stool or blood on toilet paper. Straining when passing a stool may cause bleeding. Straining can also push an internal hemorrhoid so that it protrudes through the anus; this is called a protruding or prolapsed hemorrhoid.

By contrast, external hemorrhoids lie under the skin around the anus. They can become very itchy and may bleed. Sometimes, the blood may accumulate and form a thrombus (clot), which can be painful and the area may swell and become inflamed. External hemorrhoids are more likely to be painful.

Spectrum Health’s Gastroenterology and Gastrointestinal Surgery programs are ranked nationally as one of the top 50 programs by U.S. News & World Report.

Our team of board-certified gastroenterologists specializes in the diagnosis, treatment and prevention of disorders of the digestive tract, liver and pancreas.  Our advanced technologies and treatment options include minimally invasive outpatient endoscopic procedures as an alternative to complex invasive surgeries.

Treatments for Hemorrhoids

When over-the-counter creams and medications don't seem to be helping, seeking treatment from a specialist for your hemorrhoids may be the next step. At Spectrum Health, our gastroenterologists and colorectal surgeons specialize in treating hemorrhoids and bring a wealth of experience and treatment options, including sclerotherapy and minimally invasive surgery.

Diet and Nutrition Counseling
Even if you've tried dietary measures, talking to a dietitian may help. Our dietitians have more ways to boost fiber and fluids to help soften stools. Less strain means reduced pressure on your hemorrhoids.

Topical Prescription Medicine
Your doctor can prescribe stronger topical and swelling relievers. There are other medicines that can speed relief from irritation, too. Let's find the best ones for you.

Stool Softeners
Stool softeners and fiber supplements may help. Your doctor can prescribe stronger options if you've had little luck with over-the-counter brands.

Procedure for Prolapse and Hemorrhoids Surgery
This minimally invasive procedure is also called a stapled hemorrhoidopexy. What you need to know is that it results in less pain and shorter hospital stays.

What Are Hemorrhoids?

Hemorrhoids (also called piles) are inflamed, swollen blood vessels located in and around the anus and lower rectum. These vessels can stretch under pressure, like varicose veins in the legs. Hemorrhoids are either inside the anus (internal) or under the skin around the anus (external). About 50% of the adult population of the United States, both men and women, have hemorrhoids.

Hemorrhoids aren’t usually dangerous or life-threatening. They aren’t contagious.

What Causes Hemorrhoids?

Causes include increased pressure and swelling from straining to move the bowel and conditions such as pregnancy and chronic constipation or diarrhea. Heredity and aging are other factors.

What Are the Symptoms of Hemorrhoids?

Many people have hemorrhoids but not all have symptoms. Pain or tenderness can occur during bowel movements. The most common symptom of internal hemorrhoids is bright red blood covering stools (bowel movements), on toilet paper, or in the toilet. Internal hemorrhoids may poke through to outside the body and become irritated and painful. These are protruding hemorrhoids. Symptoms of external hemorrhoids include painful swelling or hard lump near the anus. Straining, rubbing, or cleaning around the anus may cause irritation with bleeding and itching. Draining mucus may cause itching.

How Are Hemorrhoids Diagnosed?

The health care provider may suspect hemorrhoids from the symptoms and will make a diagnosis by doing a physical examination. Hemorrhoids can be painless, and the health care provider may find them on routine physical examinations.

How Are Hemorrhoids Treated?

Soft bowel movements are important for preventing and treating hemorrhoids. Eating a high-fiber diet and drinking plenty of fluids are important. Measures to reduce symptoms include warm tub or sitz baths several times a day. Ice packs can help reduce swelling. Cream or suppositories can be applied to the affected area. If hemorrhoids are very inflamed, the health care provider may prescribe creams or ointments to decrease inflammation. Daily use of stool softeners such as docusate during flare-ups helps. Most people get better in about 2 weeks if they follow the doctor’s suggestions.

Some hemorrhoids are treated surgically to remove or reduce the size of hemorrhoids. These methods include rubber band ligation, sclerotherapy, electric or laser heat (laser coagulation) or infrared light (infrared photocoagulation), and hemorrhoidectomy. For ligation, a rubber band around the bottom of the hemorrhoid cuts off circulation, and the hemorrhoid goes away. Sclerotherapy uses a chemical to shrink hemorrhoids. For heat and light methods, special tools are used to burn hemorrhoids. Hemorrhoidectomy is surgery to remove hemorrhoids permanently.

DOs and DON’Ts in Managing Hemorrhoids:
  • DO eat more grains, fruits, and vegetables.
  • DO drink more liquid, especially water.
  • DO remember that many problems in your rectal area have similar symptoms and are incorrectly said to be hemorrhoids. Call your health care provider for an examination.
  • DO avoid anything that will cause constipation.
  • DO remember that straining can make hemorrhoids worse.
  • DO call your health care provider if you see blood on your stool or toilet paper or in the toilet.
  • DO call your health care provider if you have anal pain, burning, or itching or if you have fever or drainage after surgery.
  • DON’T strain during bowel movements.

Contact the following sources:

  • American Gastroenterological Association
    Tel: (301) 654-2055
    Website: http://www.gastro.org
  • National Digestive Diseases Information Clearinghouse
    Tel: (800) 891-5389
    Website: http://www.niddk.nih.gov/health/digest/nddic.htm
  • American College of Surgeons
    Tel: (312) 202-5000, (800) 621-4111
    Website: http://www.facs.org

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor