hemorrhoids that comes and goes

Overview

Hemorrhoids (also called piles) are swollen veins in the lower rectum and anus. They can come and go, meaning you may have symptoms for a few days, then they go away for a while before coming back again.

Yes, hemorrhoids are very common. About 3 out of 4 adults will have hemorrhoids at some point in their lives.

Anyone can get hemorrhoids, but they are more common in people who are pregnant, overweight, or over 50 years old. Long periods of sitting or straining on the toilet also increase the risk.

Symptoms

Common symptoms

• Bleeding from the anus – you might see bright red blood on toilet paper or in the toilet bowl.
• Itching or irritation in the anal area.
• Pain or discomfort, especially when sitting.
• Swelling or a lump near the anus.
• A feeling of not completely emptying your bowels.

Symptoms in children

• Hemorrhoids are rare in children, but if they occur, symptoms may include blood on the stool or toilet paper and pain during bowel movements.

Symptoms in older adults

• Older adults may experience more bleeding or prolapse (hemorrhoid sticking out), especially if they have chronic constipation or take certain medications.

Causes

Main causes

• Increased pressure in the veins of the lower rectum and anus from straining during bowel movements.
• Chronic constipation or diarrhea.
• Sitting on the toilet for a long time.
• Pregnancy – the growing uterus puts pressure on veins.

Risk factors

• Being overweight or obese.
• A diet low in fiber.
• Lifting heavy objects regularly.
• Family history of hemorrhoids.
• Aging – tissues supporting the anal veins weaken over time.

When to see a doctor

See a doctor urgently if:

• Heavy bleeding with dizziness or weakness.
• Pain that prevents you from sitting or walking normally.
• A hemorrhoid that turns purple or black (sign of strangulation).

Book a routine appointment if:

• Blood in your stool that doesn't go away after a week.
• Symptoms that keep coming back and affecting your daily life.
• A lump near the anus that you're worried about.

Diagnosis

A doctor can usually diagnose hemorrhoids by asking about your symptoms and doing a simple physical exam of your bottom area.

Tests that may be done

• Digital rectal exam – the doctor inserts a gloved, lubricated finger into your rectum to feel for swollen veins.
• Anoscopy – a small, lighted tube is used to look inside your anus and lower rectum.
• Proctoscopy or sigmoidoscopy – a more flexible tube to see further up the bowel, especially if there is bleeding.

What to expect at your appointment

The exam may feel a little uncomfortable but is usually quick and not painful. Your doctor will explain what they are doing and why. If you are embarrassed, remember that doctors see this condition every day.

Treatment

Treatment for hemorrhoids that come and go focuses on relieving symptoms during flare-ups and preventing future episodes. Most treatments can be done at home.

Self-care at home

• Take warm baths (sitz baths) several times a day to soothe the area.
• Apply a cold pack wrapped in a cloth to reduce swelling.
• Use witch hazel pads or soft, moist toilet paper instead of dry paper.
• Avoid sitting for long periods – take breaks to stand or walk.
• Try over-the-counter creams or suppositories (ask your pharmacist for advice).

Medical treatments

For persistent symptoms, a doctor may recommend prescription creams or procedures done in the office. These include rubber band ligation (placing a small band around the hemorrhoid to cut off blood flow), sclerotherapy (injecting a solution to shrink the hemorrhoid), or coagulation therapy (using heat or laser).

When is surgery considered?

Surgery is rarely needed for hemorrhoids that come and go. It may be considered if symptoms are severe, other treatments have not helped, or the hemorrhoid is very large.

Living with this condition

Most people with intermittent hemorrhoids can manage them at home. Keep track of what triggers your flare-ups (like constipation or heavy lifting) and adjust your habits accordingly.

Lifestyle tips

• Eat a high-fiber diet – include fruits, vegetables, whole grains, and legumes.
• Drink 8–10 glasses of water a day to keep stools soft.
• Go to the toilet as soon as you feel the urge – don't delay.
• Avoid straining during bowel movements.
• Maintain a healthy weight – excess weight increases pressure on the anal veins.

Diet and exercise

A diet rich in fiber and plenty of water helps prevent constipation, a major cause of hemorrhoids. Gentle exercise like walking or swimming improves circulation and helps reduce pressure on the veins.

Mental health and emotional wellbeing

Having hemorrhoids that keep coming back can be frustrating and embarrassing. Some people feel anxious or withdrawn. It helps to talk to a doctor or a trusted person about your concerns.

Prevention

Yes, you can often prevent hemorrhoids from coming back by keeping your stools soft and regular, not straining on the toilet, and staying active. Eating more fiber and drinking more water are the most effective steps.

Complications

If left untreated

• Pain and discomfort may become more frequent or severe.
• Rarely, a hemorrhoid can become strangulated – cut off from blood supply, which requires medical attention.
• Blood clots can form inside a hemorrhoid (thrombosed hemorrhoid), causing severe pain.

Long-term outlook

For most people, hemorrhoids that come and go are a manageable, though sometimes bothersome, condition. With simple lifestyle changes and home treatments, flare-ups can become less frequent and less intense. Serious complications are very rare.

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