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Hemorrhoids

What are Hemorrhoids?

Hemorrhoids, sometimes called piles, are swollen veins that occur in the very lowest part of the rectum or around the anal canal. Small hemorrhoids are normal, and symptomatic hemorrhoids are very common. They have a range of causes and respond to a variety treatments. Some people have hemorrhoids and never notice a symptom. For others, they cause itching, pain, and bleeding, especially during a bowel movement.

What causes hemorrhoids?

Because the veins around the anus tend to stretch or swell when under pressure, any increase in pressure can give rise to hemorrhoids. Causes include:

    • Excessive straining during bowel movements
    • Sitting on the toilet too long
    • Prolonged sitting
    • Pelvic tumors
    • Chronic diarrhea or constipation
    • Obesity
    • Pregnancy
    • Low-fiber diet

Hemorrhoids become more common as you age and your veins become more fragile. It’s common for many people to never know the exact cause of their hemorrhoids.

What are the symptoms of hemorrhoids?

If you have a symptomatic hemorrhoid, you may experience:

    • Bleeding, especially during bowel movements
    • Itching and irritation near the anus
    • Pain or discomfort
    • Swelling
    • A tender lump forming near the anus

Two locations for hemorrhoids

If hemorrhoids occur inside the anal canal, they are termed internal hemorrhoids. Internal hemorrhoids may cause of bleeding, mucus discharge, or difficulty passing the stool.

If hemorrhoids occur outside the anal canal, they are termed external hemorrhoids. External hemorrhoids may also cause bleeding, and are more commonly itchy or uncomfortable.

What should I do if I notice a swollen or painful hemorrhoid?

Often, symptomatic hemorrhoids will heal with simple measures like warm soaks, over the counter creams, and stool softeners

If the problem persists for longer than a week or so, or if you are unsure about the cause of your symptoms, you should see a physician. Rarely, anal cancer and other more serious diseases can masquerade as hemorrhoids. Likewise, rectal bleeding can indicate underlying colorectal cancer.

Occasionally, you can experience acute and severe pain in the anal area. This can be due to a clot formation in a hemorrhoid (a “thrombosed hemorrhoid”) or to a small tear called a fissure. These problems require more immediate attention.

Internal hemorrhoids occur inside the rectum and usually cause bleeding but no pain or noticeable swelling. External hemorrhoids are more easily irritated and painful. Sometimes blood can pool in an external hemorrhoid, forming a thrombosed hemorrhoid. These can be the most painful and may require treatment that is more intensive.

If you experience any rectal bleeding, it is important to see your doctor to determine the cause.

Caring for Hemorrhoids: A variety of treatments

Hemorrhoid treatment options include over-the-counter remedies for mild cases.

Internal hemorrhoids are often treated with infrared coagulation, a minimally invasive technique that applies infrared light to the location, causing shrinkage during the following few days. This technique can cause less discomfort than other options, and no sedation is needed. Patients frequently have this performed on a lunch break and then return to work.

Other options to treat hemorrhoids include rubber band ligation, an injection designed to shrink the hemorrhoid or surgery.

How do we manage hemorrhoids?

We use numerous strategies to treat hemorrhoidal symptoms, including diet, lifestyle, medications, and mechanical treatments such as infrared coagulation and rubber band ligation, which can be done in the office. In some instances, surgery definitely fixes the problem. If anal symptoms are a persistent issue for you, we can provide relief.

Meet New York Gastroenterology Associates

New York Gastroenterology Associates (NYGA) is a premier independent gastroenterology practice in New York City. NYGA consists of caring gastroenterologists practicing in office locations around New York City. Recognized for providing top-quality GI care, all of our physicians are board-certified and affiliated with Mount Sinai... Learn More »

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