|Other encyclopedia topics:||A-Ag Ah-Ap Aq-Az B-Bk Bl-Bz C-Cg Ch-Co Cp-Cz D-Di Dj-Dz E-Ep Eq-Ez F G H-Hf Hg-Hz I-In Io-Iz J K L-Ln Lo-Lz M-Mf Mg-Mz N O P-Pl Pm-Pz Q R S-Sh Si-Sp Sq-Sz T-Tn To-Tz U V W X Y Z 0-9|
|Contents of this page:|
Alternative Names Return to topRectal lump; Piles; Lump in the rectum
Definition Return to top
Hemorrhoids are painful, swollen veins in the lower portion of the rectum or anus.
Causes Return to top
This condition is very common, especially during pregnancy and after childbirth. Hemorrhoids result from increased pressure in the veins of the anus. The pressure causes the veins to bulge and expand, making them painful, particularly when you are sitting.
The most common cause is straining during bowel movements. Hemorrhoids may result from constipation, sitting for long periods of time, and anal infections. In some cases they may be caused by other diseases, such as liver cirrhosis.
Internal hemorrhoids occur just inside the anus, at the beginning of the rectum. External hemorrhoids occur at the anal opening and may hang outside the anus.
Symptoms Return to top
Symptoms of hemorrhoids include:
Exams and Tests Return to top
A doctor can often diagnose hemorrhoids simply by examining the rectal area. If necessary, tests that may help diagnose the problem include:
Treatment Return to top
Over-the-counter corticosteroid creams can reduce pain and swelling. Hemorrhoid creams with lidocaine can reduce pain. Witch hazel (applied with cotton swabs) can reduce itching. Other steps for anal itching include:
Sitz baths can help you to feel better. Sit in warm water for 10 to 15 minutes. Stool softeners help reduce straining and constipation.
For cases that don't respond to home treatments, a surgeon or gastroenterologist can apply heat treatment, called infrared coagulation, to shrink internal hemorrhoids. This may help avoid surgery. Surgery that may be done to treat hemorrhoids includes rubber band ligation or surgical hemorrhoidectomy. These procedures are generally used for patients with severe pain or bleeding who have not responded to other therapy.
Outlook (Prognosis) Return to top
Most treatments are effective, but to prevent the hemorrhoids from coming back, you will need to maintain a high-fiber diet and drink plenty of fluids.
Possible Complications Return to top
The blood in the enlarged veins may form clots, and the tissue surrounding the hemorrhoids can die. Hemorrhoids with clots generally require surgical removal.
Severe bleeding may also occur. Iron deficiency anemia can result from prolonged loss of blood. Significant bleeding from hemorrhoids is unusual, however.
When to Contact a Medical Professional Return to top
Call for an appointment with your health care provider if hemorrhoid symptoms do not improve with home treatment. You should also be seen if you have rectal bleeding. Your provider may want to check for other, more serious causes of the bleeding, especially if you have never bled from hemorrhoids before.
Call 911 if blood loss is significant or if you feel dizzy, lightheaded, or faint.
Prevention Return to top
Avoid straining during bowel movements. You can help prevent hemorrhoids by preventing constipation. Drink plenty of fluids, at least eight glasses per day. Eat a high-fiber diet of fruits, vegetables, whole grains. Consider fiber supplements.
References Return to top
American Gastroenterological Association medical position statement: Diagnosis and treatment of hemorrhoids. Gastroenterology. 2004 May;126(5):1461-2.
Feldman M, Friedman LS, Sleisenger MH. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 7th ed. Philadelphia, Pa: Saunders; 2002.
Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002.
Rakel P.Textbook of Family Practice. 6th ed. Philadelphia, Pa: Saunders; 2002.Update Date: 5/15/2009 Updated by: Todd Eisner, MD, Private practice specializing in Gastroenterology, Boca Raton, FL. Clinical Instructor, Florida Atlantic University School of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.