• Dr. Dooreck with Nicole Lerebours | Physician Assistant Student

What are Hemorrhoids?

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If you have ever experienced a sharp, pinching, prickly sensation around your anus followed by temporary or persistent discomfort, pain, and bleeding then you might have hemorrhoids. Don't worry, hemorrhoids are fairly common, affecting nearly 1 in 20 Americans and nearly 50% of individuals over the age of 50. Despite bleeding and discomfort, hemorrhoids are not life-threatening.

What are hemorrhoids?

Hemorrhoids, also known as piles, are swollen veins in the lowest part of your rectum and anus. There are two types of hemorrhoids: internal and external. Internal hemorrhoids are so far inside your rectum that you can't usually see or feel them. External hemorrhoids are under the skin around your anus.

Individuals over the age of 50 are more likely to suffer from hemorrhoids.

What causes hemorrhoids?

The blood vessels in your rectum and around your anus often stretch so thin due to the surrounding pressure of passing stool that the veins bulge and are prone to inflammation and irritation. Increased pressure on the lower rectum that in turn produces hemorrhoids can be caused by:

  • Obesity

  • Regular heavy lifting

  • Straining during bowel movements

  • Pregnancy

  • Chronic constipation

  • Sitting on the toilet for extended periods of time

You might read the list above and think to yourself, "I have hemorrhoids, but none of these apply to me." Well, sometimes the simple natural anatomy of our unique bodies can work against us. Although not as common a reason, studies have found that individuals with tighter than average smooth muscles in their anal canal are at a greater risk for developing hemorrhoids.

To prevent hemorrhoids, avoid excessive straining and sitting on the toilet for extended periods of time.

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What are the symptoms of hemorrhoids?

Symptoms of hemorrhoids are dependent on the type of hemorrhoid present. Internal hemorrhoid symptoms include but are not limited to:

  • Painless bleeding, often presented with bright red spots of blood on tissue paper

  • A vein protruding through the anus and resulting in discomfort or pain

External hemorrhoid symptoms include but are not limited to:

  • Itching or irritation around the anus

  • Swelling around the anus

  • Bleeding

  • Pain or discomfort, especially when passing a bowel movement

It is important to note that in some instances, blood can pool in external hemorrhoids and form a clot. This is known as a thrombosed hemorrhoid and can cause the following symptoms:

  • Swelling

  • Inflammation

  • Intense pain

  • A solid lump around the anus

If you are experiencing any of the above symptoms, contact your primary care physician for an appointment.

How are hemorrhoids diagnosed and treated?

In order to diagnose hemorrhoids, your doctor will have to examine your anus and rectum. External hemorrhoids can often be seen with a simple visual examination of the anus. Internal hemorrhoids, however, require digital examination in which your doctor inserts a lubricated, gloved, finger into the rectum to feel for any abnormalities. These simple exams are typically all that is needed to confirm the presence of hemorrhoids.

More often than not, hemorrhoids clear up on their own anywhere between 7 to 10 days. When they do not, and they cause continual bleeding, pain, or discomfort then the following treatments may be applied:

  • Topical creams: These creams often contain steroids and numbing agents to reduce swelling/inflammation and help manage pain.

  • High fiber diet: Consuming more fiber (leafy greens, legumes, plenty of fruits, and vegetables) can help to reduce straining or pressure when passing bowel movements.

  • Low-intensity exercise: Workouts such as yoga, swimming, or even basic stretching can aid in hemorrhoid relief due to encouraging more regular bowel movements with minimal straining.

  • Warm water soaks: Doing this can aid in reducing pain and swelling.

  • Oral pain relievers: These medications aid in managing pain.

  • Surgical removal of varying degrees: This treatment option is often reserved for more extreme cases, clot removals, and persistent, recurring hemorrhoids. Surgery typically offers a permanent solution, but it can sometimes come back depending on diet and bowel habits.

Remember: prevention is key 🔑. Paying attention to your body, maintaining a well-balanced diet 🍽 and an active lifestyle are significant factors in reducing your risk of developing hemorrhoids.

Check out this short informational video on hemorrhoids by MountainStar Health:


I eat a high fiber, mostly plant-based 🌱 diet, no red meat, drink 4 liters of water a day, exercise, and am focused on keeping nutrition simple. I am sharing what works for me and what I routinely recommend to my patients.

"Balance. Portion control. Keep nutrition simple. Eat Smart. Eat Healthy. 🌱 🌾 🌿"

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