Health Conditions A-Z Digestive Disorders What Are Hemorrhoids (Piles)? By Sarah Bradley Sarah Bradley Sarah Bradley is a freelance writer with six years of experience creating personal essays, reported features, and commerce content related to health and parenting topics. health's editorial guidelines Published on April 27, 2023 Medically reviewed by Sameena Zahoor, MD Medically reviewed by Sameena Zahoor, MD Sameena M. Zahoor, MD, is a practicing family medicine specialist at Village Medical. She also volunteers at the Hope Clinic, which provides free primary medical care to uninsured and under-insured patients. learn more In This Article View All In This Article Types Symptoms Causes Diagnosis Treatment Prevention Complications Living With Hemorrhoids FAQs Hemorrhoids—sometimes also called piles—are swollen veins around or within the anus and rectum, causing symptoms such as tenderness, discomfort, and pain when sitting. They are fairly common and can affect anyone, regardless of age or sex. You may experience hemorrhoids temporarily or they may be a recurring concern. Gastrointestinal disorders, pregnancy, aging, and low-fiber diets can all cause hemorrhoids. Knowing what is causing your hemorrhoids can help you and your healthcare provider figure out next steps and find a treatment plan that is right for you. Types of Hemorrhoids Healthcare providers typically categorize hemorrhoids by their location. Usually, this means whether your hemorrhoids formed inside or outside of the anus or rectum. Internal hemorrhoids Internal hemorrhoids develop inside your anus or rectum. They are located beneath something called the mucosa, which is the lining of the rectum. Internal hemorrhoids can also be prolapsed—meaning, the hemorrhoids have started to bulge outside of the anus or rectum. The severity of the bulge of internal hemorrhoids can vary from no prolapse to severe prolapse. External hemorrhoids External hemorrhoids appear just outside the opening of the anus and form underneath the skin. These types of hemorrhoids can develop into blood clots, which are known as thrombosed hemorrhoids. TimoninaIryna / Getty Images Symptoms The symptoms of hemorrhoids you experience will depend largely on where they are located. Symptoms of internal hemorrhoids tend to be milder than the symptoms of external hemorrhoids. If you have internal hemorrhoids, you may experience: Some strain or difficulty passing bowel movements Painless bleeding while passing stool Blood in the toilet bowl or on toilet paper after a bowel movement Irritation and tenderness if the hemorrhoids prolapse External hemorrhoids tend to have more uncomfortable symptoms, such as: Itching or tenderness Hard lumps around the outside of your anus Pain when sitting or straining (either during a bowel movement or lifting heavy items) Discomfort or burning while wiping after a bowel movement Causes Hemorrhoids occur when the veins in and around your rectum and anus are exposed to high amounts of pressure. As a result, they can become swollen and inflamed, causing hemorrhoids to form. There are many reasons vein pressure can increase, including: Living with chronic constipation or diarrhea Straining to pass stool or spending long periods of time on the toilet Having weak rectal tissue as a result of pregnancy or aging Not eating enough fiber Lifting heavy objects regularly Risk Factors While anyone can get hemorrhoids, you may be at a higher risk for developing them if you: Are over the age of 50 Are pregnant Are obese Live a sedentary lifestyle Have hypertension (high blood pressure) Have a gastrointestinal condition that causes frequent constipation or diarrhea (e.g., Crohn's disease or irritable bowel syndrome) Smoke cigarettes Diagnosis Hemorrhoids are fairly easy to diagnose. If you think you may have hemorrhoids, it's good practice to visit your healthcare provider for testing. At your appointment, your provider will ask about your medical history, learn about your symptoms, and perform a physical exam to take a closer look at your anus for external hemorrhoids. If you have internal hemorrhoids, your provider may employ other testing measures such as: A rectal exam to feel the inside of your anus An anoscopy, which involves inserting a small tube and camera into your anus and rectum to get a closer look at your hemorrhoids Treatment The goal in treating hemorrhoids is to both relieve ongoing symptoms and prevent future hemorrhoids from occurring. Your healthcare provider will target the cause of your hemorrhoids to ensure that your symptoms reduce. Stool Softening One of the most common methods to treat hemorrhoids is to soften your stool. Straining on the toilet and having pain during bowel movements can increase the pressure in your veins, causing hemorrhoids to form. To counter this, your provider will look for ways to make your stool soft. They may recommend one of the following treatment options: Using a stool-softening supplement Taking an over-the-counter (OTC) laxative Eating a high-fiber diet with foods like fresh fruit, vegetables, and whole grains Drinking plenty of water Constipated? Here's How You Can Get Immediate Relief Home Remedies Alongside supplements and dietary changes, your provider can also recommend at-home therapies to help you reduce symptoms. These remedies may include: Applying topical creams to relieve itching, pain, or irritation Taking OTC pain relievers Soaking in a sitz bath of warm water Using an ice pack on the affected area Advanced Treatments If home remedies and prevention strategies don’t work to resolve your hemorrhoids, there are some advanced treatments that can help you relieve pain. These treatments include: Rubber band ligation: This is the most common intervention and works very well in relieving symptoms. A healthcare provider will cut off the blood supply to the hemorrhoids using a surgical ring. After a few days, the hemorrhoid tissue will slowly die off and shrink. Laser or infrared coagulation: Light or heat therapy that targets internal hemorrhoids and destroys the inflamed rectal or anal tissue. Sclerotherapy: Involves injecting a chemical into the hemorrhoids which causes them to shrink and prevents regrowth from occurring. Hemorrhoidectomy: A surgery that removes the hemorrhoids. Keep in mind: most people don’t need surgery. But, if you have both internal and external hemorrhoids, a severe prolapse, or extremely large external hemorrhoids, you may be a candidate for surgical removal. While this procedure is a more complicated method of treatment, it’s highly effective. How to Prevent Hemorrhoids There are several things you can do to avoid hemorrhoids from forming. These prevention techniques include: Eating a high-fiber diet Drinking plenty of water throughout the day Getting regular exercise Maintaining a weight that is right for you Using the restroom as soon as you feel the need to go Avoiding long periods of sitting Following your treatment plan for underlying conditions that may be causing hemorrhoids Complications Hemorrhoids are not usually a serious condition, but there are side effects that can occur if you leave them untreated. Bleeding: Hemorrhoids that aren’t treated can develop into blood clots. If these blood clots break open and cause frequent bleeding, you may be at a higher risk of developing anemia. Infection: Open sores around hemorrhoids can make it easier for germs and bacteria to enter your system and cause infections. Skin tags: Small flaps of excess skin can grow on or near the site of external hemorrhoids. Living With Hemorrhoids The good news: most hemorrhoids are treatable with at-home remedies and lifestyle changes. In the case that you need further treatment, help is available. Whether this involves a surgical procedure or prescription medication, you can reduce your symptoms and prevent further hemorrhoids from occurring. The important thing is to get tested if you think you have hemorrhoids. Leaving your hemorrhoids untreated can cause complications, which can make your hemorrhoids worse and add to your discomfort. Your healthcare provider is in the best position to help you get the treatment you need. Frequently Asked Questions What happens if you let hemorrhoids go untreated? Mild external hemorrhoids will often resolve on their own, but moderate or severe cases of hemorrhoids can cause some complications when left untreated. You may be at a higher risk of experiencing anemia, infections, and skin tags. What's the difference between hemorrhoids and polyps? Hemorrhoids are swollen veins or blood vessels in and around your anus and rectum, while polyps are abnormal growths that develop in your colon or rectum. What causes hemorrhoids to flare up? A low fiber diet, straining during bowel movements, frequent constipation or diarrhea, pregnancy, aging, and lifting heavy objects can all cause hemorrhoids to flare up. Does insurance cover hemorrhoid surgery? All insurance plans are different, but if your provider can demonstrate that hemorrhoid surgery is a required form of treatment for your condition, it’s likely that your insurance company will cover this procedure. Was this page helpful? Thanks for your feedback! Tell us why! Other Submit 9 Sources Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Institute of Diabetes and Digestive and Kidney Diseases. Treatment for constipation. National Institute of Diabetes and Digestive and Kidney Diseases. Definition & facts of hemorrhoids. American Society of Colon and Rectal Surgeons. Hemorrhoids: Expanded information. American Academy of Family Physicians. Hemorrhoids. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of hemorrhoids. MedlinePlus. Hemorrhoids. De Marco S, Tiso D. Lifestyle and risk factors in hemorrhoidal disease. Front Surg. 2021;8:729166. doi:10.3389/fsurg.2021.729166 Bleday R. Patient education: Hemorrhoids (Beyond the basics). In: Lamont JT, Chen W, eds. UpToDate. UpToDate; 2022. American Society of Colon and Rectal Surgeons. Polyps of the colon and rectum.