hemorrhoids on one side

Overview

Hemorrhoids are swollen veins in or around your bottom (anus and lower rectum). When a hemorrhoid appears on one side, it often means a single vein is swollen or a blood clot has formed inside one hemorrhoid. This can cause a painful lump on one side of the anus.

Yes, hemorrhoids are one of the most common digestive issues. About 3 out of 4 adults will have hemorrhoids at some time. Having one on one side is a typical way they can appear.

Anyone can get hemorrhoids, but they are more common during pregnancy, after age 50, and in people who have chronic constipation or strain during bowel movements.

Symptoms

Common symptoms

• A painful lump or swelling on one side of the anus
• Itching or irritation around the anus
• Pain, especially when sitting or passing stool
• Bleeding – you might see bright red blood on toilet paper or in the toilet bowl
• Discomfort or a feeling of fullness in the rectum

Symptoms in children

• Hemorrhoids are less common in children. If a child has a lump on one side, it could be a hemorrhoid, but other causes like anal fissures or infections are more likely.
• Symptoms in children are similar to adults: pain, itching, and sometimes small amounts of blood on the stool or toilet paper.

Symptoms in older adults

• In older adults, hemorrhoids on one side may be more persistent due to weaker tissues and more frequent constipation.
• Symptoms are the same as in younger adults, but older people should be extra cautious about any rectal bleeding, as it can also be a sign of other conditions.

Causes

Main causes

• Straining during bowel movements – this puts pressure on the veins in the anal area
• Sitting on the toilet for too long
• Chronic constipation or diarrhea
• Heavy lifting or other activities that increase abdominal pressure
• Pregnancy – the growing uterus and hormonal changes can enlarge hemorrhoidal veins

Risk factors

• Being overweight or obese
• Having a family history of hemorrhoids
• Eating a low-fiber diet
• Getting older – tissues become weaker as you age
• Anal intercourse

When to see a doctor

See a doctor urgently if:

• You have heavy bleeding or pass clots
• You have severe pain that makes it hard to sit or walk
• The lump becomes very large, changes color, or feels hard and tender to touch

Book a routine appointment if:

• You have a lump on one side that doesn't improve after a week of home care
• You notice blood on the toilet paper or in the stool for more than a few days
• You have itching or discomfort that keeps coming back
• You want to confirm that the lump is a hemorrhoid and not something else

Diagnosis

A doctor can often diagnose a hemorrhoid on one side just by asking about your symptoms and doing a quick physical exam. They may look at the area around your anus and gently feel inside with a gloved finger (digital rectal exam).

Tests that may be done

• Digital rectal exam – the doctor inserts a lubricated, gloved finger into the rectum to feel for swollen veins or other problems.
• Anoscopy – a small, lighted tube used to see the lining of the anus and lower rectum.
• Sigmoidoscopy or colonoscopy – if there is bleeding or other concerning symptoms, a doctor may recommend a more complete look inside the bowel to rule out other causes.

What to expect at your appointment

The exam is usually quick and not painful, though you may feel some pressure. You will be asked to lie on your side or bend over the exam table. The doctor will explain what they are doing. Most people do not need any special preparation, but sometimes you may be asked to use an enema before the exam.

Treatment

Treatment for a hemorrhoid on one side depends on how bad your symptoms are. Many get better with simple self-care. If that doesn't work, a doctor can offer other options. The goal is to reduce pain, swelling, and bleeding, and prevent it from coming back.

Self-care at home

• Take warm sitz baths – sit in warm water for 10 to 15 minutes, two to three times a day. This helps relax the muscles and increase blood flow.
• Use a cold pack or ice wrapped in a cloth on the painful side for 10 minutes at a time to reduce swelling.
• Keep the area clean – gently wash with warm water after each bowel movement and pat dry. Avoid scented soaps or wipes.
• Take over-the-counter pain relief such as paracetamol (acetaminophen) or ibuprofen – always follow the instructions on the packet.
• Use a soft cushion or a donut pillow when sitting to reduce pressure on the area.
• Avoid straining during bowel movements – drink plenty of water and eat more fiber.

Medical treatments

If self-care is not enough, a doctor may recommend prescription creams or ointments that help shrink the hemorrhoid and relieve pain. These medicines often contain a local anaesthetic or a mild steroid. Do not use these without a doctor’s advice, especially for more than a week. For a thrombosed hemorrhoid (one with a blood clot), a doctor can make a small cut and remove the clot in their office, which gives quick relief.

When is surgery considered?

Surgery is rarely needed for a single hemorrhoid. It may be considered if the hemorrhoid is very large, keeps coming back, or causes significant pain and bleeding that does not respond to other treatments. Options include rubber band ligation (placing a small band around the base to cut off blood flow) or hemorrhoidectomy (surgical removal). Your doctor will explain the best option for your situation.

Living with this condition

Living with a hemorrhoid on one side can be uncomfortable, but most people manage well with home care. You may need to avoid sitting for long periods and take breaks if you have a desk job. Warm baths can be a soothing part of your daily routine until the hemorrhoid heals.

Lifestyle tips

• Drink plenty of water – aim for 8 glasses a day to keep stools soft.
• Eat a high-fiber diet with fruits, vegetables, and whole grains.
• Try to go to the toilet as soon as you feel the urge – holding it can make stools harder.
• When you do go, sit on the toilet for only a few minutes. Do not strain or push.
• Stay active – gentle walking helps keep your bowels regular.

Diet and exercise

A diet rich in fiber is key. Good choices include oats, beans, lentils, berries, apples, broccoli, and whole-wheat bread. Aim for 25 to 30 grams of fiber per day. If you increase fiber, do it gradually and drink more water to avoid gas and bloating. Regular exercise like walking, swimming, or yoga also helps prevent constipation and improve blood flow.

Mental health and emotional wellbeing

Hemorrhoids can be embarrassing and stressful. The discomfort may affect your sleep or mood. It is normal to feel frustrated or anxious. Remember that this is a common medical issue – there is no need to feel ashamed. Talking to a trusted friend or healthcare provider can help. If you feel very worried or sad, ask your doctor about support options.

Prevention

You may not be able to prevent hemorrhoids entirely, but you can lower your risk by avoiding constipation and straining. Eating enough fiber, staying hydrated, and going to the toilet when you need to are the most important steps. Also, try not to sit on the toilet for more than a few minutes.

Complications

If left untreated

• Thrombosis – a blood clot can form inside the hemorrhoid, causing sudden, severe pain and a hard lump.
• Strangulation – if blood supply to the hemorrhoid is cut off, it can cause severe pain and tissue death (gangrene). This is rare but serious.
• Anemia – from slowly losing small amounts of blood over a long time, which can lead to low red blood cell counts.
• Infection – very rarely, a hemorrhoid can become infected, causing fever and increasing pain.

Long-term outlook

The vast majority of hemorrhoids, including ones on one side, get better with home care or simple medical treatment. Even thrombosed hemorrhoids usually resolve within a week or two. With the right self-care and lifestyle changes, you can reduce the chance of them coming back. If you have any concerns, your doctor is there to help you find relief.

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