Hemorrhoids are normal cushions of blood vessels and supporting tissue in the anal canal. They become a medical problem when they swell, bleed, protrude, itch, or hurt. Many symptoms improve without an operation. This page is retained for general education; hemorrhoid procedures are not a current Zadeh Surgical service.
Rectal bleeding should not automatically be blamed on hemorrhoids.
Hemorrhoids are common, but bleeding can also come from a fissure, inflammation, a polyp, or colorectal cancer. New, persistent, heavy, or unexplained bleeding deserves a proper evaluation.
What is the difference between internal and external hemorrhoids?
Internal hemorrhoids form inside the anal canal. They can cause painless bright-red bleeding or tissue that protrudes during a bowel movement. External hemorrhoids are under the skin near the anal opening. A clot can form inside an external hemorrhoid and cause a sudden, firm, painful lump.
What symptoms can hemorrhoids cause?
- Bright-red blood on toilet paper, on the stool, or in the bowl
- Itching, irritation, moisture, or difficulty cleaning
- Tissue that protrudes during a bowel movement
- Pressure or discomfort near the anus
- A tender lump from a clotted external hemorrhoid
Sharp pain during and after a bowel movement is often more typical of an anal fissure than an uncomplicated internal hemorrhoid.
What can help without a procedure?
Initial treatment focuses on making bowel movements soft, formed, and easy to pass. This commonly includes adequate fiber, enough fluid, avoiding prolonged sitting and straining on the toilet, regular activity, and treatment of constipation or frequent diarrhea. Short-term topical treatments may ease symptoms, but they do not correct every cause of anal pain or bleeding.
What office treatments are available?
When internal hemorrhoids continue to bleed or protrude despite bowel-habit changes, office procedures may be considered. Rubber-band ligation is commonly used for selected internal hemorrhoids. Other approaches include injection treatment or infrared treatment. The choice depends on the hemorrhoid type, size, symptoms, medications, and examination.
When is surgery considered?
Surgical removal may be considered for large external hemorrhoids, combined internal and external disease, advanced protruding hemorrhoids, or symptoms that continue despite less invasive treatment. Surgery can be effective but generally causes more recovery discomfort than an office procedure, so the operation should match the problem.
A newly clotted external hemorrhoid may sometimes be treated by removing the clot and overlying skin, particularly when severe pain began recently. In other cases, symptom control and time are more appropriate.
When should someone seek prompt care?
Seek prompt evaluation for heavy bleeding, fainting, black stool, fever, rapidly worsening pain or swelling, drainage of pus, unexplained weight loss, or a persistent change in bowel habits. These are not symptoms to manage by assuming hemorrhoids are the cause.