Hemorrhoids are very common and by age 50, nearly half of Americans have hemorrhoids. Nearly 5% of the US population (15,000,000 people) have seen a doctor for hemorrhoids. Many more have problems with hemorrhoids, but never see a doctor.

Types of Hemorrhoids

• External hemorrhoids: Enlarged veins under the skin near the anal opening. They may feel like tender lumps or bulges and can cause pain or itching, especially when swollen. They are sometimes mistaken for skin tags.

  
  

• Internal hemorrhoids: Enlarged veins inside the rectum above the anal opening. They often cause no pain but may bleed. In some cases, they can protrude through the anus (prolapse), which may cause discomfort or pain.

Symptoms

Symptoms depend on the type of hemorrhoid and may include:

External hemorrhoids

• Anal itching

  
  

• Pain or aching, especially when sitting

  
  

• One or more hard, tender lumps near the anus

Internal hemorrhoids

• Painless rectal bleeding, often seen as bright red blood on toilet paper, in the stool, or in the toilet bowl

  
  

• Prolapse (tissue protruding from the anus)

  
  

• Discomfort or pain if prolapsed

Many hemorrhoids cause no symptoms. When present, symptoms often improve within a few days, especially with conservative care.

Not all anal symptoms or rectal bleeding are caused by hemorrhoids. Bleeding may also be a sign of other conditions, such as inflammatory bowel disease or colorectal cancer, and should be evaluated by a healthcare professional.

Causes

Common causes of hemorrhoids include:

• Straining during bowel movements

  
  

• Prolonged sitting on the toilet

  
  

• Chronic constipation or diarrhea

  
  

• Low-fiber diet

  
  

• Age-related weakening of rectal support tissues

  
  

• Pregnancy

  
  

• Frequent heavy lifting

When to See a Doctor

Seek medical care if you:

• Have symptoms that persist after one week of at-home treatment

  
  

• Experience rectal bleeding

Important Reminder: This information is intended only to provide general guidance. It does not provide definitive medical advice. It is very important that you consult your doctor about your specific condition.

Hemorrhoids | ACG