Hemorrhoids: Reducing the Pain and Discomfort What are hemorrhoids? Hemorrhoids are swollen veins in your rectum or anus. The type of hemorrhoid you have depends on where it occurs. Internal hemorrhoids involve the veins inside your rectum. Internal hemorrhoids usually don't hurt but they may bleed painlessly. Sometimes, an internal hemorrhoid may stretch down until it bulges outside your anus. This is called a prolapsed hemorrhoid. A prolapsed hemorrhoid will go back inside your rectum on its own, or you can gently push it back inside. External hemorrhoids involve the veins outside the anus. They can be itchy or painful and can sometimes crack and bleed. If a blood clot forms, you may feel a tender lump on the edge of your anus. You may see bright red blood on the toilet paper or in the toilet after a bowel movement. What causes hemorrhoids? One of the main causes is straining when you're trying to have a bowel movement. This may happen if you're constipated or if you have diarrhea. It may also happen if you sit on the toilet too long. Who gets hemorrhoids? Just about everyone has hemorrhoids at some time. But some things may make you more likely to get them. People whose parents had hemorrhoids may be more likely to get them. Pregnant women often get hemorrhoids because of the strain from carrying the baby and from giving birth. Being very overweight, or standing or lifting too much can make hemorrhoids worse. Should I see my doctor? See your doctor if you notice bleeding to make sure the cause is hemorrhoids and not some other problem. What can I do about hemorrhoids? Preventing constipation Include more fiber in your diet. Fresh fruits, leafy vegetables, and whole-grain breads and cereals are good sources of fiber. Drink plenty of fluids (except alcohol). Eight glasses of water a day is ideal. Exercise regularly. Avoid laxatives except bulk-forming laxatives such as Fiberall, Metamucil, etc. Other types of laxatives can lead to diarrhea, which can worsen hemorrhoids. When you feel the need to have a bowel movement, don't wait too long to use the bathroom. Constipation is a main cause of hemorrhoids. See the box above for some tips on preventing constipation. In the meantime, you can follow the tips in the box below to reduce the pain caused by hemorrhoids. Don't use hemorrhoid medicine without talking to your family doctor first. Relieving the pain Take warm soaks 3 or 4 times a day. Clean your anus after each bowel movement by patting gently with moist toilet paper or moistened pads such as baby wipes. Use ice packs to relieve swelling. Use acetaminophen (Tylenol), ibuprofen (Motrin) or aspirin to help relieve pain. Apply a cream that contains witch hazel to the area or use a numbing ointment. Creams that contain hydrocortisone can be used for itching or pain. Will I need surgery? Most painful hemorrhoids stop hurting on their own in 1 to 2 weeks. If yours keep causing problems, talk with your doctor about your options. Rubber band ligation can be used to treat internal hemorrhoids. It involves placing a small rubber band around the base of the hemorrhoid. This stops the flow of blood to the area and the hemorrhoid withers away. Internal hemorrhoids can also be destroyed by injecting them with chemicals or by burning them. A hemorrhoidectomy (surgical removal of the hemorrhoid) may be needed if internal hemorrhoids are prolapsed or very large.