Symptoms: External Hemorrhoids

Hemorrhoids (HEM-uh-roids), also called piles, are swollen veins in your anus and
lower rectum, similar to varicose veins. Hemorrhoids can develop inside the rectum
(internal hemorrhoids) or under the skin around the anus (external hemorrhoids).
Nearly three out of four adults will have hemorrhoids from time to time. Hemorrhoids
have a number of causes, but often the cause is unknown.
Fortunately, effective options are available to treat hemorrhoids. Many people get relief
with home treatments and lifestyle changes.
Symptoms
Signs and symptoms of hemorrhoids usually depend on the type of hemorrhoid.
External hemorrhoids
These are under the skin around your anus. Signs and symptoms might include:
 Itching or irritation in your anal region
 Pain or discomfort
 Swelling around your anus
 Bleeding
Internal hemorrhoids
Internal hemorrhoids lie inside the rectum. You usually can't see or feel them, and they
rarely cause discomfort. But straining or irritation when passing stool can cause:
 Painless bleeding during bowel movements. You might notice small amounts of
bright red blood on your toilet tissue or in the toilet.
 A hemorrhoid to push through the anal opening (prolapsed or protruding

hemorrhoid), resulting in pain and irritation.
Thrombosed hemorrhoids
If blood pools in an external hemorrhoid and forms a clot (thrombus), it can result in:
 Severe pain
 Swelling
 Inflammation
 A hard lump near your anus
When to see a doctor
If you have bleeding during bowel movements or you have hemorrhoids that don't
improve after a week of home care, talk to your doctor.
Don't assume rectal bleeding is due to hemorrhoids, especially if you have changes in
bowel habits or if your stools change in color or consistency. Rectal bleeding can occur
with other diseases, including colorectal cancer and anal cancer.
Seek emergency care if you have large amounts of rectal bleeding, lightheadedness,
dizziness or faintness.
Request an Appointment at Mayo Clinic
Causes
The veins around your anus tend to stretch under pressure and may bulge or swell.
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
 Having chronic diarrhea or constipation
 Being obese
 Being pregnant
 Having anal intercourse
 Eating a low-fiber diet

 Regular heavy lifting
Risk factors
As you age, your risk of hemorrhoids increases. That's because the tissues that support
the veins in your rectum and anus can weaken and stretch. This can also happen when
you're pregnant, because the baby's weight puts pressure on the anal region.
Complications
Complications of hemorrhoids are 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," which can cause extreme pain.
 Blood clot. Occasionally, a clot can form in a hemorrhoid (thrombosed

hemorrhoid). Although not dangerous, it can be extremely painful and sometimes
needs to be lanced and drained.
Prevention
The best way to prevent hemorrhoids is to keep your stools soft, so they pass easily. To
prevent hemorrhoids and reduce symptoms of hemorrhoids, follow these tips:
 Eat high-fiber foods. 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.
 Drink plenty of fluids. Drink six to eight glasses of water and other liquids (not
alcohol) each day to help keep stools soft.
 Consider fiber supplements. Most people don't get enough of the

recommended amount of fiber — 20 to 30 grams a day — in their diet. Studies
have shown that over-the-counter fiber supplements, such as psyllium (Metamucil)
or methylcellulose (Citrucel), improve overall symptoms and bleeding from
hemorrhoids.
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 or worsen
constipation.
 Don't strain. 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 dry out and be harder to pass.
 Exercise. 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 might be contributing to your hemorrhoids.
 Avoid long periods of sitting. Sitting too long, particularly on the toilet, can
increase the pressure on the veins in the anus.

Symptoms: External Hemorrhoids

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Hemorrhoids (HEM-uh-roids), also called piles, are swollen veins in your anus and

Signs and symptoms of hemorrhoids usually depend on the type of hemorrhoid.

 Itching or irritation in your anal region

 Swelling around your anus

 A hemorrhoid to push through the anal opening (prolapsed or protruding

 A hard lump near your anus

When to see a doctor

Request an Appointment at Mayo Clinic

 Straining during bowel movements

 Sitting for long periods of time on the toilet

 Having chronic diarrhea or constipation

 Having anal intercourse

 Eating a low-fiber diet

Complications of hemorrhoids are rare but include:

 Anemia. Rarely, chronic blood loss from hemorrhoids may cause anemia, in

 Strangulated hemorrhoid. If the blood supply to an internal hemorrhoid is cut

 Blood clot. Occasionally, a clot can form in a hemorrhoid (thrombosed

 Consider fiber supplements. Most people don't get enough of the

 Exercise. Stay active to help prevent constipation and to reduce pressure on

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