by Amy Scholten, MPH
Hemorrhoids are swollen blood vessels in and around the anus and lower rectum. They stretch under pressure and are similar to varicose veins in the legs. Hemorrhoids are either internal or external.
The exact cause of hemorrhoids is unknown. The major contributing factor appears to be too much pressure on the veins in the rectum. If the pressure continues, the veins become enlarged and protrude.
Risk Factors TOP
Hemorrhoids are more common in older adults. Factors that increase your risk of getting hemorrhoids include:
In most cases, symptoms will go away within several days. Although many people have hemorrhoids, not all experience symptoms.
Common symptoms include:
Bleeding from the rectum or blood in the stool can be a symptom of other diseases involving gastrointestinal tract or colon/rectal cancer. It is important to see a doctor if you have any rectal bleeding.
You will be asked about your symptoms and medical history. A physical exam will be done. Your anus and rectum will be examined to look for swollen blood vessels. A digital rectal exam will be done. This is done by inserting a gloved, lubricated finger into the rectum to feel for abnormalities. Sometimes, it is necessary to do the exam with the use of an endoscope that allows the rectal canal and other parts of the colon to be viewed.
Initial medical treatment of hemorrhoids is aimed at relieving symptoms. Measures to reduce symptoms include:
If these treatments do not provide relief, one of several nonsurgical procedures may be used to shrink or destroy the hemorrhoidal tissue. These procedures, which are generally performed in a doctor’s office, include:
If nonsurgical procedures are not an option or fail to resolve the problem, surgery may be needed.
Hemorrhoidectomy is the permanent removal of hemorrhoids by cutting the hemorrhoidal tissue away. Some of the newest surgical treatments involve using stainless steel staples. While many surgeons favor these treatments, there is some evidence that techniques that are more traditional produce more consistent and long-lasting relief.
American Society of Colon and Rectal Surgeons
National Digestive Diseases Information Clearinghouse
The Canadian Association of Gastroenterology
The College of Family Physicians of Canada
Alonso-Coello P, Guyatt G, Heels-Ansdell D, et al. Laxatives for the treatment of hemorrhoids. Cochrane Database Syst Rev. 2005;(4):CD004649.
Altomare DF, Rinaldi M, La Torre F, et al. Red hot chili pepper and hemorrhoids: the explosion of a myth: results of a prospective, randomized, placebo-controlled, crossover trial. Dis Colon Rectum. 2006;49:1018-1023.
Hemorrhoids. American Society of Colon and Rectal Surgeons website. Available at: https://www.fascrs.org/patients/disease-condition/hemorrhoids. Accessed June 20, 2016.
Hemorrhoids. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated December 2, 2015. Accessed June 20, 2016.
Hemorrhoids. National Digestive Diseases Information Clearinghouse website. Available at:
...(Click grey area to select URL)
Updated November 2013. Accessed June 20, 2016.
Jayaraman S, Colquhoun PH, Malthaner RA. Stapled versus conventional surgery for hemorrhoids. Cochrane Database Syst Rev. 2006;(4):CD005393.
Last reviewed June 2016 by Marcin Chwistek, MD
Last Updated: 5/28/2015
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