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  • Cynthia M. Johnson, MA
Publication Type:





Hemorrhoids are swollen veins. They are found in and around the anus and lower rectum. External hemorrhoids grow under the skin around the anus. Internal ones grow inside the anus.


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The exact cause of hemorrhoids is not known. It may be due to:

  • Chronic constipation that results in straining during bowel movements
  • A buildup of pressure or fluid inside the belly, such as from pregnancy or health problems

Risk Factors

This problem is more common in older adults. Other things that may raise the risk are:

  • Having any of the problems that cause hemorrhoids
  • Having other family members who have hemorrhoids
  • Sitting on the toilet for long periods of time
  • Chronic coughing
  • Chronic diarrhea
  • Obesity
  • Long term use of enemas or laxatives
  • Liver disease


Some people may not have symptoms. Others may have problems that range from mild to severe. Common ones are:

  • Bleeding, which may be seen:
    • On stool (poop)
    • On toilet paper
    • In the toilet bowl
  • Anal itching and burning
  • Swelling and pain during bowel movements
  • Sensitive lumps around the anus


The doctor will ask about your symptoms and health history. A physical exam may be done. It will focus on the anal area. An anoscope may be used to see internal structures. This is often enough to make the diagnosis.


The goal of treatment is to ease symptoms and promote healing.


To lower the risk of this problem:

  • Do not strain or read while passing stool (poop).
  • Treat constipation.
  • Drink plenty of fluids during the day.
  • Eat a high fiber diet.

Initial Treatments

Initial treatments may be:

  • Supportive care, such as warm baths or cold packs
  • Lifestyle changes, such as a high-fiber diet and drinking plenty of fluids
  • Medicines to ease pain, such as:
    • Ointments, creams, and suppositories applied to the area
    • Over the counter pain medicine taken by mouth




  • Hemorrhoids. American Society of Colon and Rectal Surgeons website. Available at: https://fascrs.org/patients/diseases-and-conditions/a-z/hemorrhoids.
  • Hemorrhoids. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hemorrhoids.
  • Hemorrhoids. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gastrointestinal-disorders/anorectal-disorders/hemorrhoids.
  • Jacobs D. Clinical practice. Hemorrhoids. N Engl J Med. 2014 Sep 4;371(10):944-951.


  • April Scott, NP
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.