| Basic Information |
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| Description |
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Dilated (varicose) veins of the rectum or anus. Hemorrhoids
may be located at the beginning of the anal canal (internal
hemorrhoids), or at the anal opening (external hemorrhoids).
Hemorrhoids may be present for years, but go undetected until bleeding occurs.
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| Frequent Signs and Symptoms |
- Rectal bleeding. Bright-red blood may appear as streaks
on toilet paper adhering to fecal residue, or it may be a slow
trickle for a short while following bowel movements. It
almost always colors the toilet water.
- Pain, itching or mucus discharge after bowel movements.
- A lump that can be felt in the anus.
- A sensation that the rectum has not emptied completely
after a bowel movement (large hemorrhoids only).
- Inflammation and swelling.
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| Causes |
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Repeated pressure in the anal or rectal veins.
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| Risk Increases With |
- Diet that lacks fiber.
- Prolonged sitting or prolonged standing.
- Obesity.
- Pregnancy.
- Constipation.
- Loss of muscle tone in old age.
- Rectal surgery or episiotomy.
- Liver disease.
- Anal intercourse.
- Colon malignancy.
- Portal hypertension.
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| Preventive Measure |
- Don't try to hurry bowel movements, but do avoid straining and prolonged sitting on the toilet.
- Lose weight if you are overweight.
- Include plenty of fiber in your diet.
- Drink 8 to 10 glasses of water a day.
- Exercise regularly.
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| Expected Outcome |
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Hemorrhoids usually clear up with proper care, but symptoms may come and go (may flare up after a bout of constipation). Stubborn cases may require surgery.
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| Possible Complications |
- Iron-deficiency anemia if blood loss is significant.
- Severe pain caused by a blood clot in a hemorrhoid.
- Infection or ulceration of a hemorrhoid.
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| Treatment/Post Procedure Care |
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| General Measures |
- Diagnosis may include an anoscopy (visual examination
of the anus by means of a short tube called an anoscope, an
optical instrument with lenses and a lighted tip), or proctoscopy (method of examining the rectum and lower part of the colon with a proctoscope, an optical instrument with
a lighted tip).
- Treatment is aimed at easing the symptoms.
- Never strain to push stool out.
- When sitting on the toilet, place feet on a low footstool to
aid bowel movement.
- Clean the anal area gently with soft, moist paper after
each bowel movement.
- To relieve pain, sit in 8 to 10 inches of warm water for 10
to 20 minutes several times a day.
- To reduce pain and swelling of a blood clot or protruding
hemorrhoid, stay in bed for 1 day and apply ice packs to the
anal area.
- Surgery may be required in stubborn cases. Procedures
include ligation (tying off hemorrhoid with a rubber band
to strangulate it); sclerotherapy (injection of chemical to
induce scarring); cryosurgery (freezing the hemorrhoid
with liquid nitrogen); coagulation (by infrared light or laser)
or hemorrhoidectomy (surgical removal).
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| Medication |
- For minor pain, itching, or to reduce swelling, you may
use nonprescription drugs that are formulated to relieve
symptoms of hemorrhoids. If these symptoms occur during
pregnancy, ask your doctor which medications are appropriate to use.
- Use a stool softener, if a laxative is needed.
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| Activity |
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No restrictions. Bowel function improves with good physical conditioning.
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| Diet |
- To prevent constipation, eat a well-balanced diet that contains many high-fiber foods such as fresh fruit, bran muffins, beans, vegetables and whole grain cereals.
- Drink 8 to 10 glasses of fluid daily.
- Weight loss diet if overweight.
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| Notify Your Healthcare Provider If |
- A hard lump develops where a hemorrhoid has been.
- Hemorrhoids cause severe pain that is not relieved by
treatment above.
- Rectal bleeding is excessive (more than a trace or streak
on toilet paper or stool). Rectal bleeding can be an early
sign of cancer.
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