Hemorrhoids

What are hemorrhoids?

Hemorrhoids are swollen blood vessels around your anus or in the lower rectum. They can look or feel like lumps. Hemorrhoids are common. In some cases, they can often go away on their own. If they are causing pain or bleeding, talk to your provider about ways to treat them. 

There are two types of hemorrhoids:

• External hemorrhoids are found under the skin around the anus. 
• Internal hemorrhoids are found in the lining of the anus and lower rectum. 

If the hemorrhoid collects a pool of blood and forms a clot this is called a thrombosed hemorrhoid.

What are the symptoms of hemorrhoids?

Hemorrhoids can cause:

• Pain or discomfort, often when sitting or having a bowel movement.
• Itching.
• Irritation around the anus.
• Bleeding during bowel movements.  

What causes hemorrhoids?

They are caused by pressure on the veins around the anus. This increase in pressure can be caused by:

• Constipation and diarrhea. 
• A diet with low fiber intake. 
• Straining to have a bowel movement. 
• Sitting on the toilet for longer than you should. 
• Advanced age, as the tissues that support the veins can weaken and stretch. 
• Heavy lifting.
• Obesity. 

How are they diagnosed?

Hemorrhoids are diagnosed by your provider looking at the area, doing a digital exam in which a lubricated finger is placed into your anus to feel for anything abnormal, or using a scope placed into the rectum to look for changes.  

How are they treated?

Often, hemorrhoids can be treated at home depending on the cause. You should talk to your provider about what treatment is right for you and if it could affect your cancer treatment. 

• If your hemorrhoids are related to your diet, you can increase your water and fiber intake to promote easier movement of stool. 
• Treating underlying constipation and/or diarrhea can relieve hemorrhoids. 
• You can use over-the-counter topical cream, pads, or suppositories that contain witch hazel and numbing agents or cortisone to relieve pain and itching. Some topical medications contain steroids and should not be used for more than a week because they can thin the skin. 
• A warm bath or sitz bath a few times a day can relieve discomfort. 
• Oral pain relievers can be used to manage your pain, but you should contact your provider before taking any of these. 

In some cases, hemorrhoids need to be removed in a provider’s office or as an outpatient procedure:

• A rubber band can be placed at the base of the hemorrhoid to cut off the circulation, causing it to fall off. 
• A chemical solution may be injected into it to shrink it. 
• A laser or infrared light or heat can be used to harden or shrivel it. 
• Hemorrhoidectomy is the removal of the hemorrhoid using anesthesia. This is used to treat severe hemorrhoids that do not go away with other treatments. 
• Hemorrhoid stapling blocks blood flow to the hemorrhoid. It can also be used to put a prolapsed internal hemorrhoid back into the anus. Anesthesia is also used during this treatment. 

When should I contact my provider?

Often, rectal bleeding is caused by hemorrhoids rather than a more serious issue. However, if you are having bleeding, you should contact your provider to figure out the cause. If you are having a lot of bleeding or become dizzy, light-headed or faint, call your provider right away. If you are on any kind of treatment for cancer, call your provider right away if you notice any bleeding.