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If you think you might have hemorrhoids, finding relief is as easy as talking to your provider about treatment options.

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, so we can find the best hemorrhoid treatment to bring you fast relief.”

What are hemorrhoids?

Hemorrhoids, also known as piles, are swollen, irritated veins around your anus and the lowest part of your rectum — often described as varicose veins of the anus. 

There are 3 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 under the skin around the anus. It may look like a pink or purple bump. Depending on the severity, symptoms of external hemorrhoids include:

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

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

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 or excessive straining, it can make the veins in your lower rectum and anus stretch and 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
  • Frequently lifting heavy objects or weights

By understanding what causes hemorrhoids, you can make informed choices to prevent and manage the condition effectively.

Hemorrhoid treatments

It’s best to talk to your doctor about your hemorrhoid symptoms. They’ll check for external hemorrhoids, internal hemorrhoids and other potential issues. 

After your exam, your provider can work with you to find the right treatment, as it will depend on the severity of your condition. Fortunately, most people find relief for mild to moderate hemorrhoids in about a week with home treatments and lifestyle changes.  

Eat 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. 

Good sources of fiber include fruits, vegetables and whole grains. Just be sure to add fiber to your diet slowly to avoid issues with gas.

“Staying hydrated by drinking plenty of fluids throughout the day also is key to avoiding constipation and hard-to-pass stools,” adds Dr. Buzas. 

Avoid straining

It’s important to avoid straining during bowel movements, as it can contribute to the development or worsening of hemorrhoids. Instead, take your time and allow nature to take its course.

To help avoid straining, Dr. Buzas recommends scheduling a set time each day to sit on the toilet for a few minutes to help establish a regular bowel habit. You can also try stool softeners to help reduce constipation and straining. 

Use hemorrhoid cream

Hemorrhoid cream, such as hydrocortisone, helps relieve symptoms like itching, burning and inflammation. 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.

Try wet wipes

Too much rubbing or cleaning around your anus can cause additional irritation. Instead, try using toilet paper with lotion or wet wipes to gently pat yourself clean.

Take 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 and promote healing,” 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 10 to 20 minutes after a bowel movement. For added relief, add some Epsom salts.

Hemorrhoid removal

If your hemorrhoids are serious enough and home treatments don’t provide adequate relief, your provider may recommend minimally invasive procedures or surgery to remove them.

When to follow up with your doctor

While hemorrhoids are generally not a cause for concern and can often be managed with self-care measures, certain symptoms may indicate the need for medical attention.

See your healthcare provider if:

  • You have excessive rectal bleeding or if bright red blood on your toilet paper persists despite home care.
  • You have severe pain and discomfort in your rectum or anus.
  • You’ve tried over-the-counter remedies for longer than 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 from other serious conditions like Crohn’s disease, colorectal or anal cancer.

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

“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 medical attention — can help you get back to feeling like yourself again.”

Next steps:

Learn about general surgery services at Geisinger
What to do about constipation
Why you may need a colonoscopy sooner than you think

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