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They’ve heard everything, so don’t be embarrassed about asking.

Hemorrhoids. They’re uncomfortable, annoying and even embarrassing. And on the list of things you’d like to talk about with your healthcare provider, they’re probably at the bottom (appropriately). The only thing that stands in the way of getting relief? A conversation.

“Getting your hemorrhoids checked out is no different than — and as important as — getting a routine colonoscopy, Pap test, mammogram or prostate exam,” says Christopher Buzas, DO, a colorectal surgeon at Geisinger. “We want you to ask about your symptoms.”

What are hemorrhoids?

Hemorrhoids are swollen, irritated veins around your anus and the lowest part of your rectum. There are two types of hemorrhoids.

Internal hemorrhoids

As the name implies, an internal hemorrhoid is inside the rectum, so you won’t be able to see it. They’re usually painless. And the only symptom may be bright red blood on the toilet paper or in the toilet after a bowel movement. You may also notice a bump sticking out of your anal opening.

External hemorrhoids

This type of hemorrhoid forms on the skin around the anus. It may look like a pink or purple bump. Symptoms of external hemorrhoids include:

  • Itching around the anus
  • Bleeding
  • Pain/discomfort
  • Swelling

Occasionally, blood from an external hemorrhoid can form a clot. This can lead to severe pain, swelling or a hard lump.

Prolapsed hemorrhoids

This type of hemorrhoid forms inside your anus and protrudes out. Symptoms of prolapsed hemorrhoids include:

  • Painless lump near your anus
  • Itching
  • Mucus
  • Bright red bleeding after using the bathroom

What causes hemorrhoids?

“When something causes an increase in pressure, it can make the veins in your lower rectum and anus swell,” says Dr. Buzas. That swelling can lead to hemorrhoids.

Common causes of hemorrhoids include: 

  • Straining during bowel movements
  • Pregnancy
  • Sitting on the toilet for long periods
  • Chronic constipation or diarrhea
  • Not getting enough fiber in your diet
  • Being overweight
  • Lifting heavy objects

When to see your doctor

It might be time to see your healthcare provider if:

  • You have rectal bleeding or see bright red blood on your toilet paper.
  • You have pain and discomfort in your rectum or anus.
  • You’ve tried over-the-counter remedies for over a week without relieving your symptoms.
  • You have bowel movements that are maroon or dark like tar in color, which can be a sign of bleeding.

If your rectal bleeding won’t stop and you feel dizzy or faint, call 911 or visit your nearest emergency room.

When you see your provider for hemorrhoids, they’ll talk with you about your symptoms. Then they’ll check for external hemorrhoids, internal hemorrhoids and other potential issues. 

Treatments for hemorrhoids

After your exam, your provider will work with you to find the right treatment. They may recommend the following:

Eating more fiber

Adding more fiber-rich foods to your diet softens your stool, making it easier to pass. That means less straining and constipation, which reduces your risk of developing more hemorrhoids.

Using hemorrhoid cream

Hemorrhoid cream helps relieve symptoms like itching or burning. It’s available by prescription or over the counter. Depending on the type and severity of your hemorrhoids, your provider can help you find the right one for your needs. 

Taking a sitz bath

A good soak is relaxing in more ways than one. “Taking a sitz bath relaxes your sphincter muscle, which can reduce hemorrhoid symptoms,” Dr. Buzas says. Making a sitz bath for yourself is simple. Start by filling your tub with a few inches of warm water. Then soak for 20 to 30 minutes. For added relief, add some Epsom salts.

Hemorrhoid removal

If your hemorrhoids are serious enough, your provider may recommend a procedure to remove them.

“While most people think of hemorrhoids as a minor problem, they can be very painful,” explains Dr. Buzas. “Knowing when to treat conditions such as hemorrhoids on your own — and when it’s better to seek help — can help you get back to feeling like yourself again.”

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