Hemorrhoids are swollen (varicose) veins in the lining of the anus and rectum. Hemorrhoids may result from straining during bowel movements. Other possible causes include heredity, aging, and chronic constipation or diarrhea. In general, hemorrhoids can be irritating and painful but are considered normal and do not threaten your health.
Symptoms of hemorrhoids include persistent itching or discomfort around the anus and pain, especially during bowel movements. Hemorrhoids also can bleed. Be sure to tell your doctor if you see blood in your stool, on toilet paper, or in the toilet; bleeding can be a sign of colorectal cancer (see page 273).
A doctor can diagnose hemorrhoids by examining the anus and rectum with a gloved ﬁnger. To conﬁrm the diagnosis, the doctor probably will perform a visual examination of the inside of the anus and rectum in a procedure called proctoscopy (see “Diagnostic Procedures,” page 282). In some cases the doctor may perform a colonoscopy (see “Diagnostic Procedures,” page 282) to examine the colon to rule out cancer and other possible causes of bleeding.
There are a number of steps you can take to relieve symptoms of hemor- rhoids: eat a high-ﬁber diet that includes plenty of fruits, vegetables, and whole grains; drink at least eight 8-ounce glasses of water every day (but avoid alco- hol and caffeine, which can irritate hemorrhoids); soak in a bath of plain warm water once or twice a day and cleanse the affected area with mild soap; apply ice packs to the area (to reduce swelling); and apply an over-the-counter hemorrhoidal cream to the affected area for a limited time (be sure to follow package directions). Outpatient procedures to remove hemorrhoids include rubber band ligation, in which rubber bands are placed around the base of a hemorrhoid to cut off its blood supply, causing it to shrink and fall off, and sclerotherapy, in which a chemical solution is injected directly into a hemor- rhoid, causing it to shrink. In another procedure, heat is used to seal a hemor- rhoid and stop it from bleeding. Some hemorrhoids must be removed surgically.