This content does not have an English version. This content does not have an Arabic version. Internal hemorrhoids are usually painless, but tend to bleed. Hemorrhoids have a number of causes, although often the cause is unknown. They may result from straining during bowel movements or from the increased pressure on these veins during pregnancy. Nearly three out of four adults will have hemorrhoids from time to time. Sometimes they don’t cause symptoms but at other times they cause itching, discomfort and bleeding.
These are not dangerous but can be extremely painful and sometimes need to be lanced and drained. Fortunately, many effective options are available to treat hemorrhoids. Many people can get relief from symptoms with home treatments and lifestyle changes. Hemorrhoid symptoms usually depend on the location. You usually can’t see or feel these hemorrhoids, and they rarely cause discomfort. But straining or irritation when passing stool can damage a hemorrhoid’s surface and cause it to bleed.
Occasionally, straining can push an internal hemorrhoid through the anal opening. This is known as a protruding or prolapsed hemorrhoid and can cause pain and irritation. These are under the skin around your anus. When irritated, external hemorrhoids can itch or bleed. When to see a doctor Bleeding during bowel movements is the most common sign of hemorrhoids. Your doctor can do a physical examination and perform other tests to confirm hemorrhoids and rule out more-serious conditions or diseases. Also talk to your doctor if you know you have hemorrhoids and they cause pain, bleed frequently or excessively, or don’t improve with home remedies.
Don’t assume rectal bleeding is due to hemorrhoids, especially if you are over 40 years old. Rectal bleeding can occur with other diseases, including colorectal cancer and anal cancer. If you have bleeding along with a marked change in bowel habits or if your stools change in color or consistency, consult your doctor. These types of stools can signal more extensive bleeding elsewhere in your digestive tract. Seek emergency care if you experience large amounts of rectal bleeding, lightheadedness, dizziness or faintness. Hemorrhoids are more likely with aging because the tissues that support the veins in your rectum and anus can weaken and stretch. Rarely, chronic blood loss from hemorrhoids may cause anemia, in which you don’t have enough healthy red blood cells to carry oxygen to your cells.
If the blood supply to an internal hemorrhoid is cut off, the hemorrhoid may be “strangulated,” another cause of extreme pain. Eat more fruits, vegetables and whole grains. Doing so softens the stool and increases its bulk, which will help you avoid the straining that can cause hemorrhoids. Add fiber to your diet slowly to avoid problems with gas. Most people don’t get enough of the recommended amount of fiber — 25 grams a day for women and 38 grams a day for men — in their diet. Studies have shown that over-the-counter fiber supplements, such as Metamucil and Citrucel, improve overall symptoms and bleeding from hemorrhoids. These products help keep stools soft and regular. If you use fiber supplements, be sure to drink at least eight glasses of water or other fluids every day.
Otherwise, the supplements can cause constipation or make constipation worse. Straining and holding your breath when trying to pass a stool creates greater pressure in the veins in the lower rectum. Go as soon as you feel the urge. If you wait to pass a bowel movement and the urge goes away, your stool could become dry and be harder to pass. Stay active to help prevent constipation and to reduce pressure on veins, which can occur with long periods of standing or sitting. Exercise can also help you lose excess weight that may be contributing to your hemorrhoids. Sitting too long, particularly on the toilet, can increase the pressure on the veins in the anus. ACG clinical guideline: Management of benign anorectal disorders. In: Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management.
Hemorrhoids are lumps or masses of tissue in the anus, which contain enlarged blood vessels. Any increase in abdominal pressure may produce hemorrhoids. Repeated straining to have a bowel movement, especially in people who suffer from frequent constipation. Many patients have no apparent explanation for the formation of hemorrhoids, however. Internal hemorrhoids lie inside the anal canal, where they primarily cause the symptom of intermittent bleeding, usually with bowel movements, and sometimes mucous discharge. Usually the prolapsed hemorrhoid can be pushed back into the anus with a finger tip.
These lie just outside the anal opening, where they primarily cause symptoms of swelling or bothersome protrusions, and sometimes discomfort. Swelling and discomfort may occur only intermittently. External hemorrhoids may also cause difficulties keeping the anal area clean after bowel movements. Many patients have both internal and external hemorrhoids. Hemorrhoids are a very common health problem. Hemorrhoids are more likely to develop in individuals who eat insufficient dietary fiber and don’t get enough exercise, which can lead to repeated episodes of constipation and straining to have bowel movements. Bright red blood on the toilet paper after having a bowel movement, especially if the stool was very hard or very large.
Blood also may streak the surface of the stool, or color the water in the toilet bowl. For a prolapsed hemorrhoid, a soft, grape-like mass protruding from the anus that may discharge mucous. For external hemorrhoids, bothersome protrusions and difficulties keeping the anal area clean. External hemorrhoids may also cause intermittent swelling, irritation, and mild discomfort, especially after a period of diarrhea or constipation. For thrombosis of an external hemorrhoid, a painful bulge or firm lump suddenly appears at the rim of the anus. The lump may have a blue or purple tint. If there is rectal bleeding, it is important that a physician also checks for other more dangerous causes of bleeding, such as colorectal cancer.
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