Help For Hemorrhoids

Overview

Hemorrhoids are swollen veins in or around the anus and lower rectum. The anus is the opening at the end of the bowel, and the rectum is the last part of the bowel before it. These swollen veins can be inside the rectum or just under the skin around the anus. They may itch, feel uncomfortable, or bleed a little, especially when you pass stool.

Yes, hemorrhoids are very common. Many adults get them at some point, and they become more likely as people get older.

They can affect anyone, but they are especially common during pregnancy, after childbirth, in people who are often constipated, and in older adults. People who sit for long periods or lift heavy objects often may also be more likely to get them.

Symptoms

Common symptoms

• Bright red blood on toilet paper or in the toilet after passing stool
• Itching or irritation around the anus
• A soft lump or swelling near the anus
• Discomfort or pain when sitting or passing stool
• A feeling that the bowel has not emptied fully
• Mucus on the toilet paper or in the stool

Symptoms in children

• Hemorrhoids are uncommon in children. Rectal bleeding in a child is more often caused by a small tear in the skin around the anus or by constipation.
• A child with rectal bleeding, pain, or a lump near the anus should be checked by a doctor.

Symptoms in older adults

• Hemorrhoids are more common in older adults, partly because constipation and changes in bowel habits are more common.
• Some medicines can cause constipation, which can make hemorrhoids more likely. Ask a pharmacist or doctor if you think a medicine is affecting your bowels.
• New rectal bleeding in an older adult should always be checked, because other bowel conditions can cause similar symptoms.

Causes

Main causes

• Straining to pass hard stool, often because of constipation
• Sitting for long periods on the toilet
• Pregnancy and childbirth, when pressure and hormones can affect veins
• Long-term diarrhea or frequent loose stools
• Lifting heavy objects regularly
• Being overweight, which can increase pressure in the lower bowel

Risk factors

• Getting older, as the tissues that support veins can weaken
• A diet low in fiber and not drinking enough fluids
• Not getting enough physical activity
• Being pregnant or having recently given birth
• Chronic constipation or chronic diarrhea
• Sitting for long periods, including for work or travel
• A family history of hemorrhoids

When to see a doctor

See a doctor urgently if:

• You have heavy rectal bleeding, or bleeding with dizziness or fainting
• You have severe pain around the anus or a hard, very painful lump
• You have fever with painful swelling near the anus
• You have severe abdominal pain with vomiting or a swollen belly

Book a routine appointment if:

• You notice rectal bleeding for the first time
• Bleeding continues or keeps coming back
• Symptoms do not improve after a few weeks of self-care
• You have a lump near the anus that is new or changing
• You have a change in bowel habits that lasts more than a few weeks
• You are worried about your symptoms

Diagnosis

A doctor can usually diagnose hemorrhoids by asking about your symptoms and examining the area around the anus. They may gently insert a gloved finger into the rectum or use a small, thin scope to look inside. The examination is quick and private, and your doctor will explain what they are doing.

Tests that may be done

• Physical examination of the anus and surrounding skin
• Digital rectal examination, where a doctor gently feels inside the rectum with a gloved finger
• Anoscopy or proctoscopy, using a small tube-like scope to look at the lower rectum and anus
• Sigmoidoscopy or colonoscopy if there is bleeding and the doctor needs to check further inside the bowel
• Blood tests if there has been a lot of bleeding or if anemia is suspected

What to expect at your appointment

You may feel embarrassed, but doctors and nurses examine this area every day and will help you feel as comfortable as possible. You can ask for a chaperone, and you can ask questions at any time. Most examinations take only a few minutes.

Treatment

Many hemorrhoids improve with self-care and time. Treatment depends on your symptoms, how much they bother you, and whether they keep coming back. Your doctor or pharmacist can help you choose safe options.

Self-care at home

• Eat more fiber from fruit, vegetables, whole grains, beans, and lentils, and drink enough fluids to keep stool soft
• Avoid straining or holding your breath when passing stool
• Go to the toilet when you feel the urge, rather than waiting
• Do not sit on the toilet for long periods; keep phone use out of the bathroom
• Keep the area clean with gentle washing and patting dry
• A warm bath or warm compress may ease discomfort
• Ask a pharmacist about non-prescription creams or pads that are suitable for you
• Avoid rubbing or scratching the area

Medical treatments

If self-care is not enough, a doctor may suggest medicines that soften stool or ease pain, or they may recommend a minor procedure. Clinic procedures can include rubber band ligation, where a small band is placed around a hemorrhoid, or treatments that use heat, freezing, or an injection to shrink the tissue. Your doctor will explain the benefits and risks and help you decide what is right for you.

When is surgery considered?

Surgery is usually only needed if other treatments have not worked, if hemorrhoids are very large or troublesome, or if they keep coming back. The type of procedure depends on your situation. Your doctor will discuss the options, recovery time, and possible risks with you.

Living with this condition

Hemorrhoids can be uncomfortable, but they often settle with simple changes. Try to keep your bowel movements regular and soft, and avoid rushing or straining. If symptoms flare up, warm baths and gentle cleaning can help. See your doctor if things are not improving.

Lifestyle tips

• Build fiber into meals slowly so your body can adjust
• Drink water regularly throughout the day
• Stay physically active in a way that suits you
• Avoid lifting heavy objects with poor technique; ask for help or use proper lifting methods
• Take breaks from long periods of sitting
• Keep a regular toilet routine and avoid delaying when you need to go

Diet and exercise

A diet rich in fiber and enough fluids helps prevent hard stool, which is one of the main causes of straining. Fresh fruit, vegetables, whole grains, beans, and lentils are good choices. Regular movement, such as walking or other gentle exercise, helps keep the bowels moving. If you need to increase fiber, do it gradually to avoid bloating.

Mental health and emotional wellbeing

Hemorrhoids can feel embarrassing or worrying, and ongoing discomfort can affect your mood and confidence. It may help to remember that these problems are very common and doctors are used to discussing them. If you feel anxious, low, or overwhelmed, talk to a healthcare professional. If you feel hopeless or in crisis, contact your local crisis service or emergency number.

Prevention

You cannot always prevent hemorrhoids, but you can lower your chance of getting them or making them worse. The most helpful steps are keeping stool soft, avoiding straining, and not sitting on the toilet for long periods.

Vaccines

There is no vaccine for hemorrhoids.

Screening programmes

There is no special screening test for hemorrhoids. However, routine bowel cancer screening is recommended for some age groups in many countries. If you have rectal bleeding, do not assume it is a hemorrhoid — ask your doctor whether you need any tests.

Complications

If left untreated

• Ongoing bleeding can sometimes lead to anemia, which can cause tiredness and shortness of breath
• A hemorrhoid can become thrombosed, meaning a blood clot forms inside it, which can be very painful
• A prolapsed hemorrhoid can slip outside the anus and become difficult to push back
• Skin around the anus can become irritated or infected
• Symptoms can become more persistent or uncomfortable

Long-term outlook

The outlook is generally good. Most hemorrhoids improve with self-care, and many people find simple changes make a big difference. If symptoms continue, safe treatments are available. Seeing a doctor for new or ongoing bleeding is important, but most people do not have a serious cause.

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