Dermatology Information and Resources


Hemorrhoids or piles, are swollen veins in the anus and lower rectum. These veins begin to become irritated the more they swell, causing painful discomfort. There are two hemorrhoid types: Internal hemorrhoids remain deep inside the rectum and typically can’t be seen or felt. External hemorrhoids are the most common, appearing around the anus. Hemorrhoids is a common condition that affects 3 out of 4 adults in their lifetime.

[1]Common Symptoms: Internal hemorrhoids, because they occur deep inside the rectum where no pain-responsive nerves are, may not have any obvious symptoms and most people may not know they have them. However, blood in your stool may indicate that they are present. External hemorrhoids cause bulbous veins or lumps to appear around the anus, causing pain and discomfort during bowel movements and often while walking or during other activities since more pain-sensitive nerves are located there. Bleeding from the anus is another common symptom of hemorrhoids, as well as itching and irritation. Thrombosed hemorrhoids can form a blood clot due to blood pooling in an external hemorrhoid near the anus, causing severe pain, swelling, inflammation and a purple or blue, hard lump. The clot typically dissolves leaving left over skin.[2]

Causes: Hemorrhoids normally form due to increased pressure on the lower rectum and anus as a result of straining during bowel movements, pregnancy, constipation, sitting on the toilet for too long, and chronic hard stools. Obese patients, those with low fiber diets, and/or individuals with low levels of physical activity are highly likely to experience hemorrhoids due to hard stools and a sluggish digestive system.[3]

Treatment: A fiber-rich diet and increased water intake will soften bowel movements, preventing constipation and straining. Experts recommend consistent exercise as well to keep the digestive system running smoothly. Though bleeding is often one of the first symptoms of hemorrhoids, any rectal bleeding should be promptly checked by a doctor who can conduct a thorough rectal exam to rule out any other conditions. If you’ve developed hemorrhoids, their severity will determine the best treatment. For mild cases, a doctor may suggest OTC ointments such a Preparation-H or other creams, pads, or suppositories to minimize pain and itching, reduce swelling, and ease the discomfort of bowel movements during the healing process. Using witch hazel on inflamed hemorrhoids or 1% hydrocortisone cream on the skin outside the anus (not inside) can relieve itching. For large hemorrhoids, Hemorrhoid removal or a Hemorrhoidectomy can remove excess tissue from the area to prevent further development. Hemorrhoid stapling is another option that blocks blood flow to hemorrhoidal tissue in the case of internal hemorrhoids.[4]


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