Hemorrhoids

National Digestive Diseases Information Clearinghouse

What are hemorrhoids?

U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH

Hemorrhoidsareswollenandinflamedveins [Link] rectumisthelastpartofthelargeintestine [Link] attheendofthedigestivetractwherebowel contentsleavethebody. Externalhemorrhoidsarelocatedunder [Link] hemorrhoidsmayprotrude,orprolapse, [Link] [Link] protrudepermanentlyandrequiretreatment.

What are the symptoms of hemorrhoids?

Themostcommonsymptomofinternal hemorrhoidsisbrightredbloodonstool, ontoiletpaper,orinthetoiletbowlafter [Link] [Link], discomfort,andanalitching. [Link] [Link],painfulswelling,ora [Link] clotdissolves,[Link] skincanbecomeirritatedoritch. Excessivestraining,rubbing,orcleaning aroundtheanusmaymakesymptoms,such asitchingandirritation,worse.

Internal hemorrhoid

Hemorrhoidsarenotdangerousorlife [Link] withinafewdays,andsomepeoplewith hemorrhoidsneverhavesymptoms.

Rectum Anus

External hemorrhoid Hemorrhoids

How common are hemorrhoids?

About75percentofpeoplewillhavehemorrhoidsatsomepointintheirlives.1Hemorrhoidsaremostcommonamongadultsages 45to65.2Hemorrhoidsarealsocommonin pregnantwomen.

How are hemorrhoids diagnosed?

Thedoctorwillexaminetheanusandrectum [Link] thesymptomsofotheranorectalproblems, suchasfissures,abscesses,warts,andpolyps. Thedoctorwillperformaphysicalexamto [Link] examwithagloved,lubricatedfingerandan anoscopeahollow,lightedtubemaybe performedtoviewtherectum. Athoroughevaluationandproperdiagnosis byadoctorisimportantanytimeaperson noticesbleedingfromtherectumorblood [Link] otherdigestivediseases,includingcolorectal cancer. Additionalexamsmaybedonetoruleout othercausesofbleeding,especiallyinpeople age40orolder: [Link],lightedtube calledacolonoscopeisinsertedthrough theanus,therectum,andtheupperpart ofthelargeintestine,calledthecolon. Thecolonoscopetransmitsimagesof theinsideoftherectumandtheentire colon. [Link] similartocolonoscopy,butitusesa shortertubecalledasigmoidoscopeand transmitsimagesoftherectumandthe sigmoidcolon,thelowerportionofthe colonthatemptiesintotherectum. Barium enema x [Link] colontomakethecolonmorevisiblein x-raypictures.

What causes hemorrhoids?

Swellingintheanalorrectalveinscauses [Link] swelling,including chronicconstipationordiarrhea strainingduringbowelmovements sittingonthetoiletforlongperiodsof time alackoffiberinthediet Anothercauseofhemorrhoidsistheweakeningoftheconnectivetissueintherectum andanusthatoccurswithage. Pregnancycancausehemorrhoidsbyincreasingpressureintheabdomen,whichmay enlargetheveinsinthelowerrectumand [Link],hemorrhoidscaused bypregnancydisappearafterchildbirth.

[Link]:LongeJL,[Link] Encyclopedia of [Link]:Gale;2006: 17661769. 2ChongPS,[Link] [Link] Clinics of North America. 2008;37:627644.

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How are hemorrhoids treated?

At-home Treatments
Simpledietandlifestylechangesoften reducetheswellingofhemorrhoidsand [Link] high-fiberdietcanmakestoolssofterand easiertopass,reducingthepressureonhemorrhoidscausedbystraining. [Link] humanbodycannotdigestfiber,butfiber [Link] fruits,vegetables,[Link] average,Americanseatabout15gramsof fibereachday.3TheAmericanDietetic Associationrecommends25gramsoffiber perdayforwomenand38gramsoffiberper dayformen.3 Doctorsmayalsosuggesttakingabulk stoolsoftenerorafibersupplementsuch aspsyllium(Metamucil)ormethylcellulose (Citrucel). Otherchangesthatmayhelprelievehemorrhoidsymptomsinclude drinkingsixtoeight8-ounceglassesof waterorothernonalcoholicfluidseach day sittinginatubofwarmwaterfor
10minutesseveraltimesaday
exercisingtopreventconstipation notstrainingduringbowelmovements

Over-the-countercreamsandsuppositories maytemporarilyrelievethepainanditching [Link] onlybeusedforashorttimebecauselongtermusecandamagetheskin.

Medical Treatment
Ifat-hometreatmentsdonotrelievesymptoms,medicaltreatmentsmaybeneeded. Outpatienttreatmentscanbeperformedin [Link] treatmentsforinternalhemorrhoidsinclude thefollowing: Rubber band [Link] placesaspecialrubberbandaroundthe [Link] offcirculation,causingthehemorrhoid [Link] performedonlybyadoctor. [Link] chemicalsolutionintothebloodvessel toshrinkthehemorrhoid. Infrared [Link] heattoshrinkthehemorrhoidtissue. Largeexternalhemorrhoidsorinternalhemorrhoidsthatdonotrespondtoothertreatmentscanbesurgicallyremoved.

DieteticAssociation:healthimplicationsofdietary [Link] of the American Dietetic Association. 2008;108(10):17161731.

[Link]

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What foods have fiber?

Examples of foods that have fiber include Beans, cereals, and breads 1/2cupofnavybeans 1/2cupofkidneybeans 1/2cupofblackbeans
Whole-graincereal,cold 1/2cupofAll-Bran 3/4cupofTotal 3/4cupofPostBranFlakes 1packetofwhole-graincereal,hot (oatmeal,Wheatena) 1whole-wheatEnglishmuffin

Fiber 9.5grams 8.2grams 7.5grams

9.6grams 2.4grams 5.3grams 3.0grams

4.4grams

Fruits 1mediumapple,withskin 1mediumpear,withskin 1/2cupofraspberries 1/2cupofstewedprunes Vegetables 1/2cupofwintersquash 1mediumsweetpotatowithskin 1/2cupofgreenpeas 1mediumpotatowithskin 1/2cupofmixedvegetables 1cupofcauliflower 1/2cupofspinach 1/2cupofturnipgreens

3.3grams 4.3grams 4.0grams 3.8grams

2.9grams 4.8grams 4.4grams 3.8grams 4.0grams 2.5grams 3.5grams 2.5grams

Source:[Link],Dietary Guidelines for Americans,2005.

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Points to Remember
Hemorrhoidsareswollenand inflamedveinsaroundtheanusor inthelowerrectum. Hemorrhoidsarenotdangerousor lifethreatening,andsymptomsusuallygoawaywithinafewdays. Athoroughevaluationandproper diagnosisbyadoctorisimportant anytimeapersonnoticesbleeding fromtherectumorbloodinthe stool. Simpledietandlifestylechanges oftenreducetheswellingofhemorrhoidsandrelievehemorrhoid symptoms. Ifat-hometreatmentsdonotrelieve symptoms,medicaltreatmentsmay beneeded.

For More Information

American College of Gastroenterology P.O.Box342260 Bethesda,MD208272260 Phone:3012639000 Internet:[Link] American Gastroenterological Association 4930DelRayAvenue Bethesda,MD20814 Phone:3016542055 Fax:3016545920 Email:member@[Link] Internet:[Link] American Society of Colon and Rectal Surgeons 85WestAlgonquinRoad,Suite550 ArlingtonHeights,IL60005 Phone:8472909184 Fax:8472909203 Email:ascrs@[Link] Internet:[Link]

Acknowledgments Hope through Research

TheNationalInstituteofDiabetesand DigestiveandKidneyDiseases(NIDDK) sponsorsresearchtoimprovetreatmentfor peoplewithdigestivedisorders,including [Link] arestudyingnewdrugsandsurgicalprocedurestotreatorpreventhemorrhoids. Participantsinclinicaltrialscanplayamore activeroleintheirownhealthcare,gain accesstonewresearchtreatmentsbefore theyarewidelyavailable,andhelpothers [Link] informationaboutcurrentstudies,visit [Link]. PublicationsproducedbytheClearinghouse [Link] [Link],M.B.B.S., M.D.,MayoClinic,Rochester,MN.

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National Digestive Diseases Information Clearinghouse

2InformationWay Bethesda,MD208923570 Phone:18008915389 TTY:18665691162 Fax:7037384929 Email:nddic@[Link] Internet:[Link] TheNationalDigestiveDiseasesInformation Clearinghouse(NDDIC)isaserviceofthe NationalInstituteofDiabetesandDigestive andKidneyDiseases(NIDDK).The NIDDKispartoftheNationalInstitutesof [Link] andHumanServices.Establishedin1980, theClearinghouseprovidesinformation aboutdigestivediseasestopeoplewith digestivedisordersandtotheirfamilies, healthcareprofessionals,andthepublic. TheNDDICanswersinquiries,developsand distributespublications,andworksclosely withprofessionalandpatientorganizations andGovernmentagenciestocoordinate resourcesaboutdigestivediseases.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health

NIHPublicationNo.113021 November 2010

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