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Hemorrhoids (HEM-o-roids), sometimes called “piles,” are enlarged veins in the rectum, which is the lower portion of the digestive tract. They are similar to varicose veins of the legs. Hemorrhoids may bleed and cause pain.

Where Do People Get Hemorrhoids?

Hemorrhoids occur in two places. When they are located in the upper part of the rectum, the hemorrhoids are called internal hemorrhoids. In the lower part of the rectum, they are called external hemorrhoids. Hemorrhoids are said to be prolapsed if they have slipped down from their usual position and extend outside of the anal opening.

What Causes Hemorrhoids?

Hemorrhoids have a number of different causes. They occur often in women who are pregnant or who have just given birth to babies. People with chronic constipation are at risk for hemorrhoids because of added pressure to the anorectal area when they pass stools (solid waste matter) that are hard and dry.

What Are the Symptoms of Hemorrhoids?

Pain during bowel movements and blood in the stool are the usual symptoms that accompany hemorrhoids. Sometimes there is a discharge of mucus, and there may also be itching, burning, or pain in the area. The enlarged vein in the rectum sometimes develops a clot, which can be very painful. People with hemorrhoids sometimes develop iron deficiency anemia* from the bleeding that occurs.

*anemia results when people have too few red blood cells and hemoglobin to carry oxygen in the blood.

How Are Hemorrhoids Diagnosed and Treated?

The doctor first examines the anal area through a viewing tube called an anoscope to rule out other conditions that cause similar symptoms. For mild cases of hemorrhoids, doctors may recommend:

* a diet with adequate amounts of fiber (whole grains, vegetables, and fruit) to prevent constipation
* drinking lots of liquids to prevent constipation
* sitz baths, which are shallow baths of warm water
* medicines that soften stools and make them easy to pass
* creams that can be applied to the hemorrhoids to reduce pain, swelling, and itching.

When the hemorrhoids are internal, they can be removed in the doctor’s office by a simple procedure. Tiny rubber bands are wrapped tightly around the hemorrhoids. Following this procedure, the hemorrhoids wither away and drop off without causing pain.

Internal hemorrhoids that stay prolapsed outside the body, or external hemorrhoids that have clotted, are often removed surgically. This method of removal is usually done on an outpatient* basis with local anesthesia*.

*outpatients are people who go to a doctor’s office or hospital for treatment but do not stay overnight in a hospital bed.

*local anesthesia (an-es-THEE-zha) means using medicine to block or numb pain in one part of the body while patients remain awake. General anesthesia blocks pain over the entire body while patients sleep,


U.S. National Digestive Diseases Information Clearinghouse, 2 Information Way, Bethesda, MD 20892-3570. This division of the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) posts information about hemorrhoids at its website.


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