Hemorrhoids are one of the most common yet least talked-about health issues. According to the National Institute of Diabetes and Digestive and Kidney Diseases, about 75% of adults will experience hemorrhoids at some point in their lives. Despite how widespread they are, many people feel embarrassed to discuss them or seek help. Understanding what hemorrhoids are, what causes them, and how to prevent them can save you a great deal of discomfort.
What Are Hemorrhoids?
Hemorrhoids are swollen, inflamed veins in the lower rectum and anus, similar to varicose veins. They develop when increased pressure on the veins causes them to stretch, bulge, and swell. Everyone has hemorrhoidal tissue — cushions of blood vessels, connective tissue, and muscle — but they only become a problem when those cushions become enlarged or irritated.
There are two main types: internal hemorrhoids and external hemorrhoids, classified by where they form relative to the dentate line (the boundary between the rectum and the anal canal).
Internal Hemorrhoids
Internal hemorrhoids form inside the rectum, above the dentate line. Because the tissue in this area has few pain-sensing nerves, internal hemorrhoids usually do not hurt. The most common sign is painless bleeding during a bowel movement — you might notice bright red blood on toilet paper or in the bowl. In more severe cases, an internal hemorrhoid can prolapse, meaning it pushes through the anal opening.
External Hemorrhoids
External hemorrhoids develop under the skin around the anus, below the dentate line. This area is rich in pain-sensing nerves, which is why external hemorrhoids tend to be painful, itchy, and uncomfortable. If a blood clot forms inside an external hemorrhoid (a thrombosed hemorrhoid), it can cause sudden, severe pain and a hard, discolored lump near the anus.
Internal vs. External Hemorrhoids at a Glance
| Feature | Internal | External |
|---|---|---|
| Location | Inside the rectum | Under the skin around the anus |
| Pain | Usually painless (unless prolapsed) | Often painful, especially if thrombosed |
| Visibility | Not visible externally (unless prolapsed) | Visible as lumps near the anus |
| Main symptom | Painless rectal bleeding | Itching, swelling, pain |
| Bleeding | Bright red blood during bowel movements | Less common; may bleed if irritated |
| First-line treatment | Dietary changes, rubber band ligation | Warm sitz baths, topical treatments |
Common Causes
Several factors contribute to the development of hemorrhoids, most of which involve increased pressure on the rectal and anal veins:
- Straining during bowel movements. This is the leading cause. Pushing hard to pass stool puts enormous pressure on the veins in the anal canal, causing them to swell over time.
- Chronic constipation or diarrhea. Both conditions force repeated straining or irritation that weakens the hemorrhoidal tissue.
- Sitting on the toilet for prolonged periods. Spending extended time on the toilet — often while scrolling on a phone — keeps pressure on the anal veins. Limit your time to five minutes or less.
- Low-fiber diet. A diet lacking in fiber produces harder stools that are more difficult to pass, leading to straining.
- Pregnancy. The growing uterus puts pressure on the pelvic veins and the inferior vena cava, slowing blood return from the lower body. Hormonal changes also relax vein walls. Hemorrhoids are especially common in the third trimester and during labor.
- Heavy lifting. Repeatedly lifting heavy objects while holding your breath increases abdominal pressure, which in turn puts stress on rectal veins.
- Obesity. Excess body weight increases pressure on the pelvic and rectal veins.
- Aging. As you age, the connective tissue supporting the veins in the rectum and anus weakens, making hemorrhoids more likely.
Symptoms to Watch For
Hemorrhoid symptoms vary depending on the type and severity:
- Painless bleeding during bowel movements (bright red blood)
- Itching or irritation around the anus
- Swelling or a lump near the anus
- Pain or discomfort, especially when sitting
- A feeling of fullness or incomplete evacuation after a bowel movement
- Mucus discharge after a bowel movement
Many of these symptoms overlap with more serious conditions such as colorectal cancer or inflammatory bowel disease. If you experience persistent bleeding or a change in bowel habits, it is important to see a healthcare provider for a proper diagnosis.
Prevention: Six Habits That Make a Difference
The good news is that hemorrhoids are largely preventable with consistent lifestyle habits.
1. Eat Plenty of Fiber
Aim for 25 to 30 grams of fiber per day from fruits, vegetables, whole grains, and legumes. Fiber softens stool and adds bulk, making it easier to pass without straining. If your current intake is low, increase gradually and drink extra water to avoid bloating.
2. Stay Hydrated
Drinking six to eight glasses of water daily helps keep stools soft. Dehydration hardens stool, which leads to straining — the primary trigger for hemorrhoids.
3. Do Not Strain
If a bowel movement does not come easily, stand up and try again later. Forcing it only worsens pressure on the veins. A consistent high-fiber diet and adequate hydration will make this much easier over time.
4. Limit Toilet Time
Get in, do what you need to do, and get out. Sitting on the toilet for more than five to ten minutes increases pressure on the hemorrhoidal cushions. Leave your phone outside the bathroom if necessary.
5. Stay Active
Regular physical activity helps prevent constipation and reduces pressure on veins. Even a 20-to-30-minute walk each day can improve bowel regularity. Avoid prolonged sitting whenever possible — if you have a desk job, take standing or walking breaks every hour.
6. Go When You Feel the Urge
Delaying bowel movements allows stool to dry out and harden in the colon, making it more difficult to pass later. Respond to the urge promptly.
Home Remedies for Flare-Ups
If hemorrhoids do develop, several home treatments can provide relief:
- Sitz baths. Soak the anal area in warm (not hot) water for 10 to 15 minutes, two to three times per day. This improves blood flow and relaxes the surrounding muscles.
- Over-the-counter creams and suppositories. Products containing hydrocortisone or witch hazel can reduce itching and swelling temporarily. Do not use hydrocortisone products for more than one week without consulting a doctor, as prolonged use can thin the skin.
- Witch hazel pads. Applying witch hazel directly to the area has a natural anti-inflammatory effect and can soothe irritation.
- Cold compresses. Applying an ice pack wrapped in a cloth for 10 to 15 minutes can reduce swelling and numb the area.
- Stool softeners. An over-the-counter stool softener can help if constipation is contributing to the problem.
When to See a Doctor
While most hemorrhoids resolve on their own or with home treatment within a week or two, certain situations require medical attention:
- Persistent or heavy bleeding during bowel movements
- Hemorrhoids that do not improve after one week of home treatment
- Severe pain, especially sudden onset (may indicate a thrombosed hemorrhoid)
- Bleeding accompanied by dizziness or lightheadedness
- Changes in stool color (dark, tarry, or maroon-colored stools) — this could indicate bleeding higher in the digestive tract
- You are over 40 and experiencing rectal bleeding for the first time
Medical procedures for hemorrhoids range from minimally invasive options like rubber band ligation and sclerotherapy to surgical hemorrhoidectomy for severe cases. Your doctor will recommend the best approach based on the type and severity.
Track Your Patterns with Flushy
Prevention starts with awareness. Flushy helps you log every bowel movement — including stool type, color, and tags like fiber intake, hydration, and stress — so you can spot the patterns that lead to problems before they escalate. Tracking your habits consistently is one of the simplest steps you can take toward better digestive health.
This article is for informational purposes only and does not constitute medical advice. Consult a healthcare professional for personalized guidance.