Published: 18 Jun 2025

ICD9: 455.6      ICD10: K64.9      ICD11: DB60

Hemorrhoids, also known as piles, are swollen and inflamed veins in the rectum and anus.
They are very common, affecting about half of adults by the age of 50. Think of them like varicose veins, but located in your rectal area.

Here's a breakdown:

What they are:

Swollen veins: The veins in and around the anus and rectum can stretch under pressure.
Location: They can be inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids).
Painful, irritating: While some hemorrhoids cause no symptoms, others can be painful, itchy, and cause bleeding.

Causes:

Straining during bowel movements: This is a major contributor.
Chronic constipation or diarrhea: Both can put stress on the rectal veins.
Pregnancy: The weight of the fetus and hormonal changes can increase pressure.
Obesity: Excess weight puts added pressure on the veins.
Sitting for long periods, especially on the toilet: This can restrict blood flow.
Aging: The tissues that support the veins in the rectum and anus can weaken with age.
Genetics: A predisposition can run in families.
Heavy lifting: Repeatedly lifting heavy objects can contribute.

Symptoms:

Symptoms vary depending on the type of hemorrhoid (internal or external) and their severity.

Internal Hemorrhoids:
Painless bleeding during bowel movements: You might see bright red blood on the toilet paper or in the toilet bowl.
Prolapse: A hemorrhoid may protrude through the anus, causing pain and irritation. This is often felt as a lump outside the anus.
External Hemorrhoids:
Itching or irritation in the anal region:
Pain or discomfort: Especially when sitting.
Swelling around the anus:
Bleeding: Especially if irritated or thrombosed.
Thrombosed hemorrhoid: This is a blood clot inside the hemorrhoid, which can cause severe pain, swelling, and inflammation. It may feel like a hard, tender lump.

Diagnosis:

A doctor can diagnose hemorrhoids through:

Physical examination: Visual inspection of the anus and rectum.
Digital rectal exam (DRE): The doctor inserts a gloved, lubricated finger into the rectum to feel for abnormalities.
Anoscopy, sigmoidoscopy, or colonoscopy: These procedures use a small camera to visualize the inside of the rectum and colon, especially to rule out other causes of bleeding.

Treatment:

Treatment depends on the severity of the hemorrhoids.

Home remedies:
High-fiber diet: Helps soften stools and reduce straining.
Increased fluid intake: Helps prevent constipation.
Sitz baths: Soaking the anal area in warm water several times a day.
Over-the-counter creams and suppositories: Contain ingredients like hydrocortisone or witch hazel to relieve pain and itching.
Stool softeners: Can help make bowel movements easier.
Medical procedures: If home remedies don't work, a doctor may recommend:
Rubber band ligation: A small rubber band is placed around the base of the hemorrhoid to cut off its blood supply.
Sclerotherapy: A solution is injected into the hemorrhoid to shrink it.
Infrared coagulation: Uses heat to destroy hemorrhoid tissue.
Hemorrhoidectomy: Surgical removal of the hemorrhoid. This is typically reserved for severe or recurring hemorrhoids.
Hemorrhoid stapling: A surgical procedure that uses staples to reposition the hemorrhoid.

When to see a doctor:

If you experience rectal bleeding, even if you think it's just hemorrhoids. Bleeding can be a symptom of other, more serious conditions, such as colon cancer.
If your hemorrhoids are severe or don't improve with home treatment.
If you experience a sudden increase in pain or swelling.

Important note: This information is for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment. Self-treating can be dangerous. A doctor can properly diagnose your condition and recommend the best course of treatment for you.