What are hemorrhoids?

Hemorrhoids are swollen and inflamed veins in your anus or rectum. There are two types of hemorrhoids, internal and external.

The external veins swell to form external hemorrhoids. They can be seen around the outside of the anus.

Internal hemorrhoids are located inside the rectum. Internal hemorrhoids cannot be seen or felt, but may bleed.

Hemorrhoids are most common during middle age, in pregnant women, people who are obese, and in people who are frequently constipated or have frequent diarrhea. People with liver disease are also more likely to develop hemorrhoids. They do not cause cancer and are rarely life threatening.

What causes hemorrhoids?

Hemorrhoids form because of repeated excess pressure in the rectal or anal veins, usually from straining to pass a bowel movement. Straining causes the blood to enlarge and swell, causing bulging veins. Once a rectal vein has been stretched, it is difficult to get rid of it.

Overeating, inadequate exercise, and prolonged sitting, especially on the toilet, can cause hemorrhoids to form.

What are the symptoms?

The most common symptoms of hemorrhoids include:

Bleeding during a bowel movement. A few drops can be seen on the stool, in the toilet bowl, or on the toilet paper.


Rectal pain. Pain may be experienced when you clean the anal area.

The first symptom of an internal hemorrhoid is blood that can be seen on the stool, toilet paper, and in the toilet bowl. An internal hemorrhoid can protrude through the anal opening.

With external hemorrhoids, a blood clot forms as a result of painful swelling or a hard lump. This condition is known as a thrombosed external hemorrhoid.

How are hemorrhoids diagnosed?

Bleeding may be a symptom of other digestive diseases, including colon cancer, so it is important to get a thorough examination and diagnosis as soon as possible.

The doctor begins with a visual examination of the anus to look for swollen blood vessels, followed by an internal examination. For the internal examination, the doctor inserts a gloved and lubricated finger into the anus to look for abnormalities.

If a closer evaluation is needed, the doctor uses an anoscope, a hollow, lighted tube that is useful in diagnosing hemorrhoids or a proctoscope which allows the doctor to view the entire rectum.

To rule out other causes of gastrointestinal bleeding, the doctor may order a sigmoidoscopy or a colonoscopy. These procedures involve