hemorrhoids in children

Overview

Hemorrhoids are swollen veins in the lower part of the rectum or around the anus. They can feel like small lumps and sometimes bleed, itch, or hurt, especially during or after a bowel movement.

Hemorrhoids are much more common in adults, but they can happen in children too, especially if the child has chronic constipation.

Children of any age can get hemorrhoids, but school-age children who are toilet training or who hold in bowel movements may be more likely to develop them.

Symptoms

Common symptoms

• Itching around the anus
• Pain or discomfort during or after a bowel movement
• Bright red blood on toilet paper or in the toilet bowl
• A small lump or swelling near the anus

Symptoms in children

• Children may complain of a 'boo-boo' or itching in the bottom
• They may strain or cry during bowel movements
• You might notice blood streaks on stool or toilet paper
• They may avoid going to the toilet because it hurts

Symptoms in older adults

• Older adults can get hemorrhoids due to weaker tissues and constipation, with symptoms like itching, pain, and bleeding.
• They may also feel a bulging lump outside the anus.
• Sitting for long periods can make symptoms worse.

Causes

Main causes

• Constipation and hard stools, which make a child strain to poop
• Sitting on the toilet for too long, especially while reading or playing
• Diarrhea, which can irritate the area
• Weakness in the veins around the anus, sometimes passed down in families

Risk factors

• Not eating enough fiber from fruits, vegetables, and whole grains
• Drinking too little water
• Withholding stool to avoid pain or discomfort
• Obesity or being overweight
• A family history of hemorrhoids

When to see a doctor

See a doctor urgently if:

• Any blood in the stool or on toilet paper, because it may have another cause
• Pain or itching that lasts more than a few days
• A lump near the anus that does not go away
• Your child is very uncomfortable or avoids going to the toilet

Book a routine appointment if:

• If home care doesn't improve symptoms within a week
• If you have questions about toilet habits or constipation
• If your child has had recurring constipation and straining

Diagnosis

A doctor will ask about your child's symptoms and toileting habits. They will usually gently look at the area around the anus to see if there are any swollen veins or skin tags.

Tests that may be done

• A visual inspection of the anus and surrounding skin
• A dental-gloved finger examination of the lower rectum (only if the child is comfortable and cooperative)
• In rare cases, a small tube with a light (proctoscope) to look inside the rectum

What to expect at your appointment

The exam is usually quick and painless. The doctor will explain what they are doing and will only do the examination with your consent. If a procedure is needed, they will use numbing medicine to keep your child comfortable.

Treatment

Treatment for hemorrhoids in children focuses on making bowel movements softer, reducing straining, and soothing the area. Most cases improve with home care and small lifestyle changes.

Self-care at home

• Give your child warm sitz baths for 10 to 15 minutes after bowel movements to help relax the area
• Encourage your child to drink plenty of water throughout the day
• Add more fiber to meals, such as fruits, vegetables, beans, and whole-grain cereals
• Help your child use the toilet as soon as they feel the urge; don't make them wait
• Use gentle, unscented wipes or plain toilet paper, and pat the area dry instead of rubbing

Medical treatments

If self-care is not enough, a doctor may recommend over-the-counter creams, ointments, or suppositories that help reduce swelling and pain. Always talk to your doctor or pharmacist before using any medicine on your child, and never use adult-strength hemorrhoid products without checking first.

When is surgery considered?

Surgery is rarely needed for children with hemorrhoids. A doctor might consider a simple office procedure if a hemorrhoid is very large, painful, or does not get better with other treatments.

Living with this condition

Help your child build a regular toilet routine, such as trying to poop at the same time each day, and keep a step stool near the toilet so their feet are supported. Encourage them not to sit longer than 5 to 10 minutes at a time.

Lifestyle tips

• Set a calm, unhurried toilet time to reduce pressure
• Provide meals and snacks that include fresh fruits and vegetables
• Make water available all day
• Give your child regular physical activity like playing outside or walking

Diet and exercise

A diet high in fiber and plenty of fluids help prevent hard stools. Aim for at least 2 to 3 servings of fruit and 3 to 4 servings of vegetables each day, along with whole grains. Regular exercise helps the gut move normally.

Mental health and emotional wellbeing

Children may feel embarrassed or worried about having pain or bleeding in a private area. Let them know it's a common problem that many people have, and that it will get better. Be patient and praise them for using the toilet regularly.

Prevention

Yes. Most hemorrhoids in children can be prevented by avoiding constipation, encouraging regular toileting, eating a high-fiber diet, drinking enough water, and not sitting on the toilet for long periods.

Complications

If left untreated

• Long-term pain and itching
• Bleeding that may lead to anemia (low blood count) in rare cases
• A hard, painful blood clot inside a hemorrhoid (thrombosed hemorrhoid)
• Skin irritation or infection around the anus

Long-term outlook

With the right care and consistency, hemorrhoids in children usually clear up completely. Even if they come back in the future, simple prevention strategies can keep them under control. Your child's doctor can help you adjust these strategies as your child grows.

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