Hemorrhoids, commonly known as piles, represent enlarged veins in anal canal (external piles) and may involve lower rectum as well (internal piles). Both internal and external can occur together as well.
This is a very common condition. Some do not even have symptoms while for others it can become a severe problem.
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.
- Hemorrhoid to push through the anal opening (prolapsed or protruding hemorrhoid), resulting in pain and irritation.
Thrombosed hemorrhoids
If blood pools in 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 colour 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.
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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-fibre 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:
- 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, hemorrhoids may be “strangulated,” which can cause extreme pain.
- Blood clot. Occasionally, a clot can form in 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 fibre — 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 fibre 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.
- 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.
