When veins in the lower rectum or anus swell and become painful, they are known as hemorrhoids or piles. Though hemorrhoids are common and uncomfortable, they are not serious and can be addressed with a variety of treatments.

What are Hemorrhoids?

Hemorrhoids are normal vascular structures that help to control bowel movements, but increased pressure on the anorectal region can lead to the bulging and discomfort for which they are known. There are many factors that may put you at increased risk for hemorrhoids, including:

  • Constipation, diarrhea and strain during bowel movements
  • Sedentary lifestyle or long periods spent sitting
  • Anal infections
  • Liver conditions like cirrhosis
  • Excess weight
  • Pregnancy

Hemorrhoids come in two varieties based on their location:

  • Internal hemorrhoids form in the wall of the anal canal and may not be immediately visible, but can bulge and protrude through the anus (prolapsed hemorrhoid). Though internal hemorrhoids often do not cause pain, they may still result in rectal bleeding.
  • External hemorrhoids occur near the opening of the anus and are visible from the exterior. Because of the sensitive nerves in this area, they are often very painful. They can also result in a blood clot that causes a noticeable lump under the skin (thrombosis).

You may suffer from one or both types of hemorrhoids. Both internal and external hemorrhoids share similar symptoms that include:

  • Itching in the anal area
  • Pain and aching around the anus, which may worsen when sitting or cleaning the affected area
  • Blood during bowel movements, which may appear on the toilet paper, in the toilet bowl or on the surface of the stool
  • Protrusions or lumps in the anal area

Treating Hemorrhoids

Generally, hemorrhoids can be diagnosed with a physical examination. If necessary, your doctor may also use diagnostic procedures like anoscopy or sigmoidoscopy to further illuminate the cause of the problem.

The symptoms of hemorrhoids, especially external hemorrhoids, can often be relieved with conservative, at-home treatments like:

  • High-fiber diet
  • Regular exercise
  • Sitz baths
  • Topical creams

When such options prove unsuccessful, your doctor may recommend medical treatments like:

  • Coagulation. Heat is used to coagulate and shrink the hemorrhoid.
  • Sclerotherapy. Your doctor injects a chemical solution next to the vein that shrinks the tissue.
  • Rubber band ligation. A small elastic band is wrapped around the hemorrhoid to cut off blood flow, reduce swelling and promote healing in the area.
  • Hemorrhoidectomy. The swollen blood vessel is surgically removed. This is an older, more traditional form of the surgical procedure.
  • Stapled hemorrhoidectomy. The hemorrhoids are surgically anchored at their original position and blood flow is blocked. As this procedure allows for a much less painful and quicker return to the activities of dailiy living, it has become a commonly used form of hemorrhoidectomy
  • Transanal hemorrhoidal dearterialization. A suture is used to block the flow of blood into the tissue, but blood continues to flow out, shrinking the hemorrhoid without excision. THD is also becoming a commonly perfomed procedure as it too allows for a more rapid return to the activities of daily living.

Treatment for hemorrhoids is especially important when bleeding becomes severe or thrombosis occurs. Talk to your doctor to learn more about the risks of hemorrhoids and the most appropriate treatments in your individual case.