Hemorrhoids are swollen veins in the anal canal and lower rectum. This common problem can be painful, but it’s usually not serious. Veins can swell inside the anal canal to form internal hemorrhoids. Or they can swell near the opening of the anus to form external hemorrhoids. You can have both types at the same time. The symptoms and treatment depend on which type you have. Many people have hemorrhoids at some time. Too much pressure on the veins in the pelvic and rectal area causes hemorrhoids.
Normally, tissue inside the anus fills with blood to help control bowel movements. If you strain or sit on the toilet a long time to move stool, the increased pressure causes the veins in this tissue to swell and stretch. This can cause hemorrhoids. Diarrhea or constipation also may lead to straining and can increase pressure on veins in the anal canal.
Hemorrhoids & Pregnancy
Pregnant women can get hemorrhoids during the last 6 months of pregnancy. This is because of increased pressure on the blood vessels in the pelvic area. Straining to push the baby out during labor can make hemorrhoids worse.
The most common symptoms of both internal and external hemorrhoids include:
- Bleeding during bowel movements. You might see streaks of bright red blood on toilet paper after you strain to have a bowel movement.
- Rectal pain. It may be painful to clean the anal area.
- Hemorrhoid thrombus (blood clot)
With internal hemorrhoids, you may see bright red streaks of blood on toilet paper or bright red blood in the toilet bowl after you have a normal bowel movement. You may see blood on the surface of the stool.
Internal hemorrhoids often are small, swollen veins in the wall of the anal canal. But they can be large, sagging veins that bulge out of the anus all the time. They can be painful if they bulge out and are squeezed by the anal muscles. They may be very painful if the blood supply to the hemorrhoid is cut off. If hemorrhoids bulge out, you also may see mucus on the toilet paper or stool.
A blood clot (thrombus) can develop in an external hemorrhoid. This may lead to severe pain and sometimes bleeding. One treatment is called Incision & Drainage (I&D); if the blood clot has formed within the past 48 to 72 hours, Dr. Schlotter may remove it from within the hemorrhoid. This is a simple procedure that can relieve pain. Another treatment option is Hemorrhoid Banding. Rubber band ligation is a procedure in which the hemorrhoid is tied off at its base with rubber bands, cutting off the blood flow to the hemorrhoid. The hemorrhoid then shrinks and dies, falling off in about a week. This procedure is very successful and is done in the office.