Hemorrhoids

Hemorrhoids (HEM-uh-roids), also called piles, are swollen veins in your anus and lower rectum, similar to varicose veins. 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. Hemorrhoids may be located inside the rectum (internal hemorrhoids), or they may develop under the skin around the anus (external hemorrhoids).
Hemorrhoids are very common. 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.
Occasionally, a clot may form in a hemorrhoid (thrombosed hemorrhoid). 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.

Symptoms

Signs and symptoms of hemorrhoids may include:
  • Painless bleeding during bowel movements — you might notice small amounts of bright red blood on your toilet tissue or in the toilet
  • Itching or irritation in your anal region
  • Pain or discomfort
  • Swelling around your anus
  • A lump near your anus, which may be sensitive or painful (may be a thrombosed hemorrhoid)
Hemorrhoid symptoms usually depend on the location.
Internal hemorrhoids. These lie inside the rectum. 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.
External hemorrhoids. These are under the skin around your anus. When irritated, external hemorrhoids can itch or bleed.
Thrombosed hemorrhoids. Sometimes blood may pool in an external hemorrhoid and form a clot (thrombus) that can result in severe pain, swelling, inflammation and a hard lump near your anus.


Causes

The veins around your anus tend to stretch under pressure and may bulge or swell. Swollen veins (hemorrhoids) can develop from increased pressure in the lower rectum due to:
  • Straining during bowel movements
  • Sitting for long periods of time on the toilet
  • Chronic diarrhea or constipation
  • Obesity
  • Pregnancy
  • Anal intercourse
  • Low-fiber diet
Hemorrhoids are more likely with aging because the tissues that support the veins in your rectum and anus can weaken and stretch.

Complications

Complications of hemorrhoids are very rare but include:
  • Anemia. 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.
  • Strangulated hemorrhoid. If the blood supply to an internal hemorrhoid is cut off, the hemorrhoid may be "strangulated," another cause of extreme pain.





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