Doctors Explain How to Tell if Hemorrhoids Are Causing Your Butt Discomfort
Most people have at least heard of hemorrhoids before—and know they're no spring picnic. They're also super common: Hemorrhoids impact about 1 in 20 American men and women, and roughly half of adults older than 50, per the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
But if you’ve never had hemorrhoids, it can be difficult to tell what's going on back there. Friendly reminder that seeing a doctor can be helpful for this reason! Meantime, here's a buncha fun stuff to know about hemorrhoids—and how to get rid of them ASAP.
What are hemorrhoids, exactly?
Hemorrhoids, a.k.a. piles, are swollen, inflamed veins around the anus or lower rectum, according to the U.S. National Library of Medicine. And you're not weird if you 'em. Not at all.
“Hemorrhoids are normal anatomy, like having hands,” says Jeffery Nelson, M.D., a colorectal surgeon and surgical director of The Center for Inflammatory Bowel and Colorectal Diseases at Mercy Medical Center in Baltimore. “Everyone has hemorrhoidal tissue.”
There are two types: Internal hemorrhoids form in the lining of the anus and lower rectum, while external hemorrhoids form under the skin around the anus, per the NIDDK.
What causes hemorrhoids?
It’s unclear why some people struggle with hemorrhoids and others don’t, Dr. Nelson says. “But there can be a genetic component to it,” meaning it can run in families. There are a few things that may also up your risk of developing hemorrhoids, the NIDDK says, including:
straining to poop
sitting on the toilet for long periods of time
having chronic constipation or diarrhea
eating a low-fiber diet
weakening of the supporting tissues in your anus and rectum that happens with aging
pregnancy
regularly lifting heavy objects
What are the symptoms of hemorrhoids? Are they painful?
It depends on the type of hemorrhoids you have, Dr. Nelson says. If you have external hemorrhoids, you’ll probably have the following symptoms:
anal itching
one or more hard, tender lumps near your anus
an anal ache or pain that you feel or gets worse when you sit
If you have internal hemorrhoids, you’ll likely have these symptoms:
bleeding from your rectum (which shows up as bright red blood in your poop, on toilet paper, or in the toilet bowl after you poop)
a hemorrhoid that has fallen through your anus, which is called prolapse
“Hemorrhoids, for the most part, do not cause pain when you have a bowel movement,” says Rudolph Bedford, M.D., a gastroenterologist at Providence Saint John’s Health Center in Santa Monica, CA. However, if you have a prolapsed hemorrhoid, you can also experience swelling and pain if it doesn’t go back inside your body, Dr. Nelson says.
What’s the best way to get rid of hemorrhoids?
There are a few remedies you can try to treat hemorrhoids at home, Dr. Bedford says. First, eating a high-fiber diet, exercising regularly, and drinking plenty of liquids can help make your poop softer and move it along more easily, so it doesn’t cause extra irritation to your hemorrhoids. Avoiding sitting for long periods of time can also minimize discomfort.
Taking a sitz bath for 20 minutes a night for a week or two will also help keep the anal area clean, reduce inflammation, and generally make you feel more comfortable. Simply sit in a bathtub filled with 3 to 4 inches of warm water or buy a plastic tub that holds the water and fits over your toilet seat.
If you’re still having trouble, there are over-the-counter hemorrhoid creams and ointments that can help, like Preparation H. “These can help decrease inflammation and help shrivel up or shrink hemorrhoids,” Dr. Bedford says. If that doesn’t do the trick, your doctor may recommend a prescription cream or suppository to try to fix the situation.
When should you see a doctor for hemorrhoids?
If you’re ever concerned about your hemorrhoids or you’re not sure what’s happening down there, you should call your doctor, Dr. Nelson says, especially if you’ve had symptoms for more than a week. (Don’t worry, they deal with this kind of thing all the time!)
Your doctor will likely recommend that you use medication first but, if that doesn’t help, there are other treatment options available like:
Rubber band ligation, where a doctor essentially cuts off the blood supply to the hemorrhoid with a rubber band
Sclerotherapy, in which a doctor injects a solution into a hemorrhoid, cutting off the blood supply
Infrared photocoagulation, which uses infrared light to cut off the blood supply
Electrocoagulation, which uses an electric current to cut off the blood supply
Surgical removal, in more severe cases
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