Hemorrhoids are swollen veins in the anus or lower part of the rectum.
Rectal lump; Piles; Lump in the rectum
Hemorrhoids are very common. They result from increased pressure on the anus. This can occur during pregnancy, childbirth, and due to constipation. The pressure causes the normal anal veins and tissue to swell. This tissue can bleed, often during bowel movements.
Hemorrhoids may be caused by:
Straining during bowel movements
Sitting for long periods of time, especially on the toilet
Internal hemorrhoids occur just inside the anus, at the beginning of the rectum. When they are large they may fall outside (prolapse). The most common problem with internal hemorrhoids is bleeding during bowel movements.
External hemorrhoids occur outside the anus. They can result in difficulty cleaning the area after a bowel movement. If a blood clot forms in an external hemorrhoid, it can be very painful (thrombosed external hemorrhoid).
Hemorrhoids are most often not painful, but if a blood clot forms, they can be very painful.
Common symptoms include:
Painless bright red blood from the rectum
Anal ache or pain, especially while sitting
Pain during bowel movements
One or more hard tender lumps near the anus
Exams and Tests
Most of the time, a health care provider can often diagnose hemorrhoids simply looking at the rectal area. External hemorrhoids can often be detected this way.
Over-the-counter corticosteroid (for example, cortisone) creams to help reduce pain and swelling
Hemorrhoid creams with lidocaine to help reduce pain
Stool softeners help reduce straining and constipation
Things you can do to reduce itching include:
Apply witch hazel to the area with a cotton swab.
Wear cotton underwear.
Avoid toilet tissue with perfumes or colors. Use baby wipes instead.
Try not to scratch the area.
Sitz baths can help you to feel better. Sit in warm water for 10 to 15 minutes.
If your hemorrhoids do not get better with home treatments, you may need some type of office treatment to shrink the hemorrhoids.
If office treatment is not enough, some type of surgery may be necessary, such as removal of the hemorrhoids (hemorrhoidectomy). These procedures are generally used for people with severe bleeding or prolapse who have not responded to other therapy.
The blood in the hemorrhoid may form clots. This can cause tissue around it to die. Surgery is sometimes needed to remove hemorrhoids with clots.
Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.