Hemorrhoids: Causes, Symptoms, Types & Tests

Hemorrhoids, also known as piles, are swollen veins in the lower rectum and anus that affect millions of people worldwide. Though often seen as an embarrassing or minor issue, hemorrhoids can cause significant discomfort, pain, and disruption to daily life when left untreated. They may lead to symptoms like itching, bleeding, swelling, and even severe pain if complications arise. Despite being common—especially among adults over the age of 50—hemorrhoids can often be effectively managed or prevented with proper care and awareness. Understanding what causes them, how they present, and what tests help diagnose them is the first step toward relief and better digestive health.

Hemorrhoids

Hemorrhoids are enlarged, swollen veins located in the lower part of the rectum or around the anus. These veins become stretched and irritated due to increased pressure, leading to symptoms such as discomfort, itching, and bleeding. While they can occur at any age, the risk increases with aging, pregnancy, and lifestyle habits such as prolonged sitting or low-fiber diets.

Hemorrhoids are generally divided into two main types based on their location:

• Internal hemorrhoids: Develop inside the rectum and are usually painless but may bleed.
• External hemorrhoids: Form under the skin around the anus and can cause itching, swelling, and pain.

In some cases, hemorrhoids may become thrombosed, meaning a blood clot forms inside, leading to sudden and severe pain.

Causes of Hemorrhoids

The exact cause of hemorrhoids is not always clear, but several risk factors and conditions increase the likelihood of developing them:

• Straining during bowel movements: Often due to chronic constipation.
• Chronic diarrhea: Repeated bowel movements can irritate veins.
• Prolonged sitting: Especially on the toilet, which increases pressure in the anal veins.
• Low-fiber diet: Makes stools harder, increasing straining.
• Obesity: Excess weight can increase pressure in the pelvic veins.
• Pregnancy: Increased pressure on the pelvic veins during pregnancy often leads to hemorrhoids.
• Aging: Tissues supporting veins in the rectum and anus weaken over time.
• Heavy lifting: Regularly lifting heavy objects can also strain veins.

Symptoms of Hemorrhoids

Symptoms vary depending on the type and severity of hemorrhoids but typically include:

• Bleeding: Bright red blood after bowel movements, often seen on toilet paper or in the toilet bowl.
• Itching or irritation: Around the anus due to inflammation.
• Pain or discomfort: Especially with external hemorrhoids.
• Swelling: Noticeable lumps near the anus.
• Mucus discharge: From internal hemorrhoids.
• Feeling of incomplete evacuation: Sensation of needing to pass stool even after using the toilet.
• Thrombosed hemorrhoid: Severe pain, swelling, and a hard lump near the anus.

While bleeding hemorrhoids are common, any rectal bleeding should be checked by a doctor to rule out other conditions like colorectal cancer or inflammatory bowel disease.

Types of Hemorrhoids

Hemorrhoids can be categorized into several types:

1. Internal Hemorrhoids

• Located inside the rectum and usually not visible.
• Typically painless but may cause bleeding during bowel movements.
• Graded based on severity:
  • Grade I: No prolapse; may bleed.
  • Grade II: Prolapse during straining but retracts spontaneously.
  • Grade III: Prolapse requires manual reduction.
  • Grade IV: Permanently prolapsed and cannot be pushed back.

2. External Hemorrhoids

• Under the skin around the anus.
• Often visible and can cause itching, pain, and swelling.
• Can become thrombosed, leading to intense pain and bluish discoloration.

3. Thrombosed Hemorrhoids

• Both internal and external hemorrhoids can develop blood clots.
• These clots can cause sudden and severe pain, swelling, and tenderness.

Tests Used to Detect Hemorrhoids

Diagnosing hemorrhoids usually begins with a medical history and physical examination, but sometimes further tests are needed to confirm the diagnosis and rule out other conditions:

• Visual examination: A doctor may look for external hemorrhoids or prolapsed internal hemorrhoids.
• Digital rectal exam (DRE): The doctor gently inserts a gloved, lubricated finger into the rectum to check for abnormalities.
• Anoscopy: A small, lighted tube helps view internal hemorrhoids inside the rectum.
• Proctoscopy or sigmoidoscopy: Used to examine deeper parts of the rectum and lower colon, especially if bleeding or other concerning symptoms are present.
• Colonoscopy: Recommended if rectal bleeding is unexplained or if the patient has risk factors for colorectal cancer.

Conclusion

Hemorrhoids are a common yet often uncomfortable condition that can significantly affect quality of life if untreated. From minor itching and mild bleeding to severe pain and swelling, hemorrhoids present in different ways, influenced by lifestyle, diet, and genetics. Understanding their causes and symptoms is the first step toward prevention and management. Thankfully, treatment options range from simple lifestyle changes like eating more fiber and staying hydrated, to medical procedures when necessary. With the right approach, most people can find relief and avoid complications. Remember, any persistent rectal bleeding or severe pain warrants medical attention to ensure proper diagnosis and care.

Frequently Asked Questions (FAQ’s)

1. What are hemorrhoids?
Hemorrhoids are swollen veins in the lower rectum and anus, which can cause discomfort, bleeding, and itching.

2. Are hemorrhoids dangerous?
Most hemorrhoids are not life-threatening but can cause significant discomfort. Persistent bleeding should be evaluated by a doctor.

3. Can hemorrhoids go away on their own?
Yes, mild hemorrhoids often improve with self-care, but chronic or severe cases may need medical treatment.

4. What causes hemorrhoids?
Straining during bowel movements, pregnancy, obesity, low-fiber diet, and aging are common causes.

5. How can I prevent hemorrhoids?
Eating a high-fiber diet, drinking enough water, avoiding straining, and staying active help prevent hemorrhoids.

6. Do hemorrhoids always hurt?
Internal hemorrhoids often don’t hurt, but external or thrombosed hemorrhoids can cause significant pain.

7. When should I see a doctor?
If you have persistent bleeding, severe pain, or changes in bowel habits, you should see a doctor.

8. Can hemorrhoids come back after treatment?
Yes, hemorrhoids can recur if risk factors like constipation and straining are not managed.