Hemorrhoids exist in everyone, but only sometimes cause symptoms when blood vessels located in the anorectal region become swollen or inflamed. Hemorrhoids may be internal (inside the anus) or external (under the skin around the outside of the anus).


Symptoms of external hemorrhoids may include painful swelling or a hard lump near the anus. Symptoms of internal hemorrhoids include bleeding, itching, pain, and irritation.

Hemorrhoid symptoms can resemble other conditions, including fissures, fistula, abscesses, or pruritus ani (irritation and itching in the anus). Constipation and diarrhea may exacerbate hemorrhoids or cause similar symptoms. It is important to consult with a physician if you have any of these symptoms to determine the exact cause.

Risk Factors

Pregnancy increases the risk of hemorrhoids by putting pressure on the veins in the anus as does chronic constipation and chronic diarrhea. Hemorrhoids tend to run in families and the risk increases with age.


Diagnosis is based on examination of the perianal area for swollen blood vessels and digital rectal examination to detect any abnormalities in the region. An anoscope or proctoscope may be used to view the anal tract. In addition, a colonoscopy or sigmoidoscopy may be used to examine the colon and rule out other causes of bleeding.


Treatment depends on your age, health, medical history, and the severity of the condition. Symptom relief usually includes taking warm sitz (tub) baths several times a day for 10-15 minutes to shrink blood vessels and soothe itching and irritation; using witch hazel wipes to reduce irritation; and using creams or suppositories as recommended by a physician to help shrink hemorrhoids. Ice packs may also help relieve inflammation.

Relieving or preventing constipation is important to eliminate straining and reduce pressure on hemorrhoids. This means drinking at least 6-8 glasses of water a day and increasing dietary fiber by eating whole grains, vegetables, and fruits and taking a stool softener or fiber supplement if necessary.

Infrequently, large or symptomatic hemorrhoids may need to be surgically removed.

Following treatment for hemorrhoids, it is important to prevent recurrence by keeping stools soft so they pass without pressure and straining. Increased dietary fiber, exercise, and drinking 6 to 8 glasses of water a day may help reduce chances of a recurrence.


Digestive and Liver Diseases
NewYork-Presbyterian/Columbia University Irving Medical Center


Center for Advanced Digestive Care
NewYork-Presbyterian/Weill Cornell Medical Center