Hemorrhoids (HEM-or-roids), sometimes called piles, are enlarged veins in the rectum, which is the lower portion of the digestive tract. They are similar to varicose veins of the legs. Hemorrhoids may bleed and cause pain.
Hemorrhoids occur in two places. When they are located in the upper part of the rectum, the hemorrhoids are called internal hemorrhoids. In the lower part of the rectum, they are called external hemorrhoids.
Hemorrhoids are said to be prolapsed if they have slipped down from their usual position and extend outside of the anal * opening.
Hemorrhoids have a number of different causes. They occur often in women who are pregnant or who have just given birth. People with chronic constipation are at risk for hemorrhoids because of added pressure to the anorectal (pertaining to the anus and rectum) area when they pass stools (solid waste matter, feces) that are hard and dry. Among other causes are sitting for long periods, diets low in fiber, and obesity.
Pain during bowel movements and blood in the stool are the usual symptoms that accompany hemorrhoids. Sometimes there is a discharge of mucus, and there may also be itching, burning, or pain in the area. The enlarged vein in the rectum sometimes develops a clot, which can be very painful. People with hemorrhoids sometimes develop iron deficiency anemia * from the bleeding that occurs.
The doctor first examines the anal area through a viewing tube called an anoscope to rule out other conditions that cause similar symptoms. For mild cases of hemorrhoids, doctors may recommend the following:
When the hemorrhoids are internal, they can be removed in the doctor's office by a simple procedure. Tiny rubber bands are wrapped tightly around the hemorrhoids. Following this procedure, the hemorrhoids wither away and drop off without causing pain.
Internal hemorrhoids that stay prolapsed (outside the body), or external hemorrhoids that have clotted, are often removed surgically. This method of removal is usually done on an outpatient * basis with local anesthesia * .
See also Constipation • Varicose Veins
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MedlinePlus. “Hemorrhoids.” U.S. National Library of Medicine. https://www.nlm.nih.gov/medlineplus/ency/article/000292.htm (accessed June 9, 2016).
American Gastroenterological Association. 4930 Del Ray Ave., Bethesda, MD 20814. Telephone: 301-654-2055. Website: http://www.gastro.org (accessed July 16, 2015).
National Institute of Diabetes and Digestive and Kidney Diseases. 9000 Rockville Pk., Bethesda, MD 20892-2560. Telephone: 301-496-3583. Website: http://www.niddk.nih.gov (accessed March 28, 2016).
* anal refers to the anus, the opening at the end of the digestive system through which waste leaves the body.
* anemia (uh-NEE-me-uh) is a blood condition in which there is decreased hemoglobin in the blood and, usually, fewer than normal numbers of red blood cells.
* outpatient is a medical procedure that is conducted in a doctor's office or hospital but does not require an overnight stay in a hospital bed.
* local anesthesia (an-es-THEEzha) means using medicine to block or numb pain in one part of the body while the patient remains awake. General anesthesia blocks pain over the entire body while the patient sleeps.
* inflammation (in-fla-MAY-shun) is the body's reaction to irritation, infection, or injury that often involves swelling, pain, redness, and warmth.
* acute describes an infection or other illness that comes on suddenly and usually does not last very long.
* chronic (KRAH-nik) means lasting a long time or recurring frequently.
* autoimmune (AW-toe-im-YOON) refers to disorders that result from the body's immune system attacking body cells.