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What is it

Hemorrhoids, also known as piles, are a familiar disorder, and usually not a serious one. It’s thought that 75 percent of Americans will have them at some time in their lives. The term originates from hemo (blood) and rrhoos (discharging or flowing), and certainly the first indication of hemorrhoids is commonly a spot of bright red blood on toilet paper or in the stool afterward a bowel movement. (The term piles come from Latin pila or ball, so called because occasionally a hemorrhoid takes the shape of a lump.)

The muscle of the anus is a pad of muscle, blood vessels and connective tissue.  Hemorrhoid is actually an enlargement or inflammation of the veins in this tissue, triggered by additional stress in the abdominal or anal area. The enlargement may be internal or external. It’s the external kind which are often felt as hard, itchy, tender bumps that are likely to be painful. Bright red blood indicates an external hemorrhoid.

Internal hemorrhoids are painless. Because they develop inside the rectum about an inch above the anus, they cannot be seen or readily felt. They may go undetected for years, but when they become swollen, they often bleed a dark, rust-colored blood, a common sign of this condition. However, this color of blood can also indicate colorectal cancer or some other medical condition.

Hemorrhoids are not tumors or growths. Many people have them without experiencing symptoms, or they have symptoms no more serious than occasional, brief bleeding.


  • Bright red blood on the toilet paper, stool, or in the toilet bowl after a bowel movement.
  • Painful, hard bump on the edge of or just outside the anus (external hemorrhoid).
  • Pain upon defecation.
  • Discharge of mucus.
  • Anal itching.
  • An often painful, moist swelling of skin protruding outside the anal sphincter (prolapsed hemorrhoid).

What causes it

It used to be said that constipation was the chief cause. Now doctors are not so sure. A study published in 1994 in the American Journal of Gastroenterology found that constipation and hemorrhoids were not linked; instead, diarrhea seemed to be a more likely cause.

Still, excess pressure in the anal area can promote hemorrhoids. That’s why habitually straining while moving your bowels can promote or aggravate hemorrhoids. So can pregnancy, because the uterus puts additional pressure on the lower abdomen (though the hemorrhoid soften disappear in the weeks following delivery). Other possible contributors to hemorrhoids include eating a low-fiber diet, being overweight, and being sedentary. It’s also thought that genetics plays an important role

What if you do nothing

Hemorrhoids are more of a nuisance than anything else and are rarely a serious risk to health. With proper care, pain or bleeding from an external hemorrhoid resolves itself very quickly in most cases. If you can withstand the pain and itching, the hemorrhoids may eventually diminish so living with them becomes tolerable. But when you do notice the bleeding for the first time, you should get a doctor’s opinion. Probably it’s only a hemorrhoid, but in a very small number of cases, rectal bleeding may be the first sign of serious gastrointestinal disease, including cancer.

Home remedies

If a doctor has confirmed that you do have hemorrhoids, there may be no need for medical treatment. The following measures can ease the discomfort of hemorrhoids if you have them.

Don’t strain or hold your breath on the toilet

When possible, choose a time for defecating when you aren’t rushed, and when the internal action of peristalsis can be helpful for you perhaps after breakfast or soon after drinking a glass of water. Avoiding constipation also helps ease straining during a bowel movement (see prevention tips).

Practice good personal hygiene

Keep the anal area clean, but clean very gently. Avoid using rough toilet paper. Wipe with wet paper or pre-moistened wipes.

Try frequent warm baths

For painful hemorrhoids, try warm-water sitz baths two or three times daily, in a squatting position. (For convenience you can buy a plastic sitz-bath seat that fits over the toilet rim.)

Apply zinc oxide paste or powder or petroleum jelly

To, ease defecation and soothe itching. Nonprescription cortisone cream (0.5 percent strength) or witch hazel (which has an astringent effect) may also help.

Try cold compresses or ice packs several times a day

These can help reduce both inflammation and discomfort. Wear cotton underwear and loose clothing.

Be careful of what you eat

Some people find that certain foods and beverages aggravate hemorrhoids. Prime offenders may include nuts, red pepper, mustard, regular and decaffeinated coffee, and alcohol. You can try eliminating foods that seem to be making matters worse.

What won’t help

Vitamin B6 or other vitamin and mineral supplements are ineffective against hemorrhoids.


Though hemorrhoids may not be avoidable in all cases, you can do many things to prevent them from developing.

Eat a high-fiber diet

This helps to prevent constipation. Fruits, whole grains, and vegetables form the base of a well-balanced diet, and this helps produce soft but formed, regular bowel movements. The increased fecal bulk is easily eliminated without straining the hemor-rhoidal veins. To prevent painful gas, cramping, bloating, or diarrhea, increase your fiber intake gradually.

Drink plenty of water

Eight to 10 glasses a day will help improve digestion and bowel movements.

Don’t self-prescribe laxatives

Laxatives frequently cause diarrhea, which can be as rough on the hemorrhoids as the straining associated with constipation.

Avoid sitting or standing for long periods

If your job is sedentary and you must sit for long periods, stand up now and then and take a short walk. If you have to stand for long stretches of time, you may stress your rectal veins. Sit or lie down for brief periods whenever possible.

Reduce your weight

Excess pounds increase pressure and cause hemorrhoids.

Exercise regularly

Daily exercise improves circulation, prevents constipation, helps prevent hemorrhoids from developing, and aids in the shrinkage of existing hemorrhoids.

Be careful lifting

Abdominal strain can increase pressure on the rectal-anal veins. When-ever lifting heavy objects, bend your knees first and pull up with our arms, straightening your legs simultaneously. Get someone to help extremely heavy objects.


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