Hemorrhoids are part of normal anatomy. They are present in everybody. Some people may develop symptomatic hemorrhoids like enlargement, bleeding and pain. Two types are described: internal and external.

External hemorrhoids: Painful. May bleed if ruptures. People notice problems with itching or cleaning.

Internal hemorrhoids: Painless. Can be painful if prolapsed. Protrude during bowel movement.

Causes: Increased pressure in the abdomen. Straining at defecation, constipation, diarrhea, pregnancy, irregular bowel movements, and upright posture. As a result, the vessels dilate, their walls become thin and bleed. If pressure continues the weakened vessels protrude.

Symptoms: Bleeding and protrusion during defecation, anal itching, anal pain, sensitive swellings in the anus, problems with hygiene due to protrusions.

Treatment: Sitz bath can provide some relief. Most symptomatic external hemorrhoids will decrease in 2 to 7 days and the firm lump should recede within 4 to 6 weeks. Occasionally an excess tissue (skin tag) is left.

Symptomatic internal hemorrhoids may require special treatments including rubber band ligation, injection and infrared coagulation, hemorrhoid stapling, and hemorrhoidectomy.

Hemorrhoidectomy: Is the surgery to remove the hemorrhoids. Is the complete method for removal of internal hemorrhoids. It is necessary when ligation fails, protruding hemorrhoids cannot be reduced, and there is persistent bleeding.

A hemorrhoidectomy removes excess tissue that causes bleeding and protrusion.

Do hemorrhoids lead to cancer? No. However, symptoms of hemorrhoids can be similar to colorectal cancer. Therefore, a physician investigation is necessary. Everyone 50 years or older or with an increased risk should undergo screening tests for colorectal cancer.

(Simplified from Patient Eduction Brochures of The American Society of Colon and Rectal Surgeons)