What Are Hemorrhoids? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Hemorrhoid Treatment in a Doctor’s Office, With or Without Surgery

Medical procedures may be needed for hemorrhoids that don’t go away with home treatments.

Painful external hemorrhoids can be excised (cut off) during an office visit following a shot of local anesthetic to numb the area.

For internal hemorrhoids, a few office procedures may be considered. In rubber band ligation, the most common hemorrhoid procedure performed in the United States, the doctor places a small rubber band around the base of the hemorrhoid, cutting off the hemorrhoid’s blood supply. (6) The hemorrhoid typically shrinks and falls off within about a week, though several quick follow-up visits may be required to completely get rid of the hemorrhoid. (1)

Other procedures include sclerotherapy, in which a chemical injected into the hemorrhoid causes scar tissue to form, shrinking the hemorrhoid; and infrared coagulation, in which an intense beam of infrared light causes the scar tissue to form, cutting off the blood supply and shrinking the hemorrhoid. (4)

If you have a large external hemorrhoid, both internal and external hemorrhoids, or an internal hemorrhoid that’s prolapsed (popped out through the anus), a surgical operation called a hemorrhoidectomy may be necessary, though few patients require this procedure. (1)

During a hemorrhoidectomy, the hemorrhoid and surrounding tissue are removed via a small incision, which is usually closed up with stitches afterward. The procedure is performed in an operating room with either localized or general anesthesia, or a spinal block that numbs the bottom half of the body. The procedure is successful in 95 percent of cases, though patients may experience postoperative pain. (6)

Another option that aims to reduce postoperative pain is a stapled hemorrhoidopexy, in which a device pulls the hemorrhoidal tissue upward and to its normal position, stapling it in place. (The staples fall out over time.) (1)

Learn More About Treatment for Hemorrhoids: Medication, Alternative and Complementary Therapies, Surgery Options, and More

Prevention of Hemorrhoids

Keeping your stool soft and having regular bowel movements is one of the best ways to prevent hemorrhoids.

The following tips may help you prevent constipation.

Get plenty of fiber in your diet. A high-fiber diet can make stool softer and bulkier so that it passes easily. According to the USDA’s Dietary Guidelines for Americans, adult men younger than 50 should aim for at least 34 grams (g) of fiber a day, and adult women under 50 should aim for 25 g. For those older than 50, the recommendation is slightly lower: 28 g for men and 22 g for women. (8) But be careful to add fiber to your diet slowly to avoid excessive gas or bloating.

There are a number of easy, healthy ways to incorporate more fiber into your diet. Fiber-filled foods include fruits such as berries, avocados, and pears (especially when you eat the skin). Broccoli, artichokes, and Brussels sprouts are among the vegetables that can up your fiber intake. Whole grains, such as brown rice, quinoa, and oatmeal, are also an important source. Legumes, including lentils, various beans, and green peas, are a great way to get fiber. Nuts and seeds make for a great fiber-filled snack, too.

If you’re having trouble getting enough fiber in your regular diet, consider a fiber supplement. (7)

If you experience chronic constipation and suspect that may be contributing to your hemorrhoids, avoid eating too many foods that contain little or no fiber, such as cheese and fast and processed foods.

Drink plenty of water and other fluids. Recommendations for daily water intake vary and depend on the individual, but the Institute of Medicine of the National Academies has set adequate intake levels at 2.7 liters (91 ounces [oz]) for women and approximately 3.7 liters (125 oz) for men. (9) This can come from beverages and food, but caffeinated beverages and alcohol can be dehydrating and should not be counted in reaching this intake goal.

Exercise regularly. Exercise, especially 20 to 30 minutes of moderate aerobic activity a day, can help keep bowel movements regular. (6) And regular exercise may help you lose weight, which may be contributing to the formation of hemorrhoids.

Other tips for preventing hemorrhoids include:

Don’t strain or hold your breath during bowel movements. Straining can put excess pressure on veins and lead directly to hemorrhoid development.

Go to the bathroom as soon as you feel the urge. Letting the urge subside can make your stool harder to pass.

Avoid long periods of sitting. Sitting for too long, especially on the toilet, can stress veins in the anus.