What Are Hemorrhoids? Plus Tips On Prevention & Management

A woman in discomfort sits on a toilet.

It is estimated that 75% of Americans will experience hemorrhoids at some point in their lives.

Hemorrhoids are a common yet often misunderstood condition that can cause significant discomfort. It is estimated that 75% of Americans will experience hemorrhoids at some point in their lives (1). This article describes what hemorrhoids are and what can cause them as well as provides prevention and management techniques—conventional and holistic.

Hemorrhoids

Hemorrhoids, also known as piles, are swollen veins located around the lower rectum or anus. Hemorrhoids can develop inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids). They can result from increased pressure in the lower rectal area, leading to swelling, discomfort, and sometimes bleeding during bowel movements (1). Understanding what hemorrhoids are is the first step toward effectively managing this condition and alleviating stigmas associated with it.

Symptoms

Both internal and external hemorrhoids can present symptoms, though external hemorrhoids tend to be more obvious and uncomfortable. Hemorrhoids can also become thrombosed, which means that a blood clot forms inside the hemorrhoid. Each type of hemorrhoid has distinct symptoms that will help you know which type you may be dealing with.

Internal Hemorrhoids

  • Small amount of bright red bleeding during bowel movements: You may notice a small amount of blood on the toilet paper when you wipe or a small drop or two in the toilet.

  • An internal hemorrhoid may push through the anal opening during a bowel movement: This is called a prolapsed or protruding hemorrhoid, which can be painful.

External Hemorrhoids

  • A lump around the anus.

  • Pain or discomfort.

  • Mucus: This can irritate the skin and cause itchiness.

Thrombosed Hemorrhoids

  • Can be very painful.

  • Lump near the anus will be discolored and look dark blue or purple.

When To See A Doctor

While rectal bleeding is a symptom of hemorrhoids, it can also be a symptom of more serious conditions like rectal or anal cancer. If your hemorrhoids do not improve with homecare within a week, or you have a large amount of rectal bleeding, it is important to speak with your doctor to rule out other conditions and to discuss a treatment plan.

Common Causes Of Hemorrhoids

Hemorrhoids occur under increased pressure in the rectal and anal areas. This can occur due to the following conditions (2):

  • Diet low in fiber

  • Straining during bowel movements

  • Chronic constipation or diarrhea

  • Prolonged sitting, especially on the toilet (all that bathroom scrolling might not be harmless after all!)

A woman sits on the toilet while looking at her phone.

Who Is At Risk Of Hemorrhoids?

Although hemorrhoids are extremely common and affect most people at some point in their lives, there are certain populations who are at higher risk.


People who are overweight or pregnant are at a higher risk, simply because the extra weight places increased pressure in the rectal area. Additional factors at play during pregnancy include higher progesterone levels, which allow for tissues and veins to relax and swell more easily (3). During pregnancy we also naturally have more blood flow to the pelvic region.


Elderly people tend to be more prone to hemorrhoids because of the weakening of the connecting tissues in the rectal area that happens with age (3).


There is some evidence that there is a link between poor cardiovascular health and hemorrhoids (4). If the circulatory system is not working optimally, there may be increased pressure in the veins in the rectal area, which can play a part in the development of hemorrhoids.


If you are interested in cardiovascular & circulation support you may like Cardio Complete™. Our convenient capsules contain flavonoids, co-factors, & antioxidants that support the heart and overall cardiovascular health. 

Is It Possible To Avoid Hemorrhoids?

Maintaining rectal health largely involves maintaining a lifestyle that minimizes the risk factors mentioned above. This can be done through the following approaches:

1. Healthy Diet

Focusing on hydration and incorporating fiber-rich foods into your diet to soften stools and reduce straining during bowel movements is foundational for maintaining rectal health.


2. Bowel Regularity

If you are struggling with constipation, getting back to bowel regularity will be an important step to take. Along with the dietary approach described above, some supplements including magnesium and certain herbal formulations can be helpful. Probiotic supplementation helps maintain a diverse microbiome.


3. Regular Exercise

Regular physical activity helps maintain bowel regularity (5) and a healthy circulatory system.

A pregnant woman sits on an exercise ball while doing stretches.

4. Good Bathroom Habits

It is advisable to use the bathroom as soon as you feel the urge and to avoid prolonged sitting on the toilet. Using a Squatty Potty is helpful for many as it puts the body in a position that allows for easier bowel emptying with less straining.

How Are Hemorrhoids Treated?

Once hemorrhoids develop, several treatment options are available, ranging from home remedies to medical interventions. 

Topical Care

Topical care is an effective way to provide immediate symptom management. A sitz bath  can be a great way to soothe discomfort, and we recommend following it up with our Relieve & Restore Hem Balm. This botanical balm contains witch hazel, which is an astringent that calms itchiness and swelling (6). Other key nutrients include calendula, St. John's wort, and white oak bark. A beeswax and coconut oil base helps this ointment stay put for prolonged action.


Additional topical care techniques include using gentle wet wipes, tucks, or a bidet after bowel movements to keep things clean without further irritating the area with dry wiping. Medicated topical creams and suppositories like Preparation H™ contain the active ingredients phenylephrine, which temporarily narrows the blood vessels, and pramoxine, which is a temporary local anesthetic. These creams may provide temporary symptom relief.


To learn how to prepare a sitz bath, see: How To Prepare An Herbal Sitz Bath For Hemorrhoid Or Postpartum Care

Herbal Remedies

Herbal care is a great way to manage the temporary discomfort associated with minor hemorrhoids. Outside of using herbs in topical treatments, like sitz baths and balms, some herbs can be taken orally to manage discomfort from the inside out. Stone Root is well known by herbalists to be supportive of the maintenance of strong healthy veins, and literature from as early as the 1800s describes its use for managing hemorrhoid symptoms (7). Marshmallow root is a mucilaginous herb that coats the digestive tract (8), helping to prevent irritation and contributing to maintaining bowel regularity. Plantain has a mild astringent effect (9) that is considered by herbalists to be soothing for hemorrhoids. These key herbs and more are featured in our Hem Your Rhoids™ glycerite.

Treatment Of Persistent Or Severe Hemorrhoids

If home care is insufficient for keeping hemorrhoids at bay, your doctor may recommend medical intervention, such as rubber band ligation or sclerotherapy, which can be effective for persistent hemorrhoids. In severe cases, surgical options like hemorrhoidectomy may be considered. Your doctor will guide you on understanding these options and when they are necessary.

Summary

Hemorrhoids are swollen veins in the lower rectum or anus that roughly 75% of Americans will experience at some point in their lives. They are usually not serious, but they can be extremely uncomfortable. Hemorrhoids arise from heightened pressure in the rectal area due to various factors, including straining during bowel movements, chronic constipation or diarrhea, and prolonged sitting. 


Certain populations, such as those who are overweight, pregnant, elderly, or with poor cardiovascular health, may be more susceptible to hemorrhoids. To prevent hemorrhoids, lifestyle adjustments like increasing dietary fiber, staying hydrated, engaging in regular exercise, and developing good bathroom practices are recommended. For those already dealing with hemorrhoids, home remedies such as sitz baths, herbal balms, and herbal remedies can be very effective. In some cases, medical treatments, like rubber band ligation or surgery, may be required.

References:

  1. Lohsiriwat V. (2015). Treatment of hemorrhoids: A coloproctologist's view. World journal of gastroenterology, 21(31), 9245–9252. https://doi.org/10.3748/wjg.v21.i31.9245

  2. Mayo Clinic. (2018). Hemorrhoids - Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268

  3. De Marco, S., & Tiso, D. (2021). Lifestyle and Risk Factors in Hemorrhoidal Disease. Frontiers in surgery, 8, 729166. https://doi.org/10.3389/fsurg.2021.729166

  4. Chang, S. S., Sung, F. C., Lin, C. L., & Hu, W. S. (2017). Association between hemorrhoid and risk of coronary heart disease: A nationwide population-based cohort study. Medicine, 96(31), e7662. https://doi.org/10.1097/MD.0000000000007662

  5. Tantawy, S. A., Kamel, D. M., Abdelbasset, W. K., & Elgohary, H. M. (2017). Effects of a proposed physical activity and diet control to manage constipation in middle-aged obese women. Diabetes, metabolic syndrome and obesity : targets and therapy, 10, 513–519. https://doi.org/10.2147/DMSO.S140250

  6. Piazza, S., Martinelli, G., Magnavacca, A., Fumagalli, M., Pozzoli, C., Terno, M., Canilli, L., Angarano, M., Maranta, N., Dell'Agli, M., & Sangiovanni, E. (2022). Unveiling the Ability of Witch Hazel (Hamamelis virginiana L.) Bark Extract to Impair Keratinocyte Inflammatory Cascade Typical of Atopic Eczema. International journal of molecular sciences, 23(16), 9279. https://doi.org/10.3390/ijms23169279

  7. Shoemaker J. V. (1887). Collinsonia Canadensis. British medical journal, 2(1396), 712–713. https://doi.org/10.1136/bmj.2.1396.712

  8. Mohiuddin A. K. (2019). Alternative Treatments for Minor GI Ailments. Innovations in pharmacy, 10(3), 10.24926/iip.v10i3.1659. https://doi.org/10.24926/iip.v10i3.1659 (Retraction published Innov Pharm. 2020 Feb 25;11(1):)
  9. Najafian, Y., Hamedi, S. S., Farshchi, M. K., & Feyzabadi, Z. (2018). Plantago major in Traditional Persian Medicine and modern phytotherapy: a narrative review. Electronic physician, 10(2), 6390–6399. https://doi.org/10.19082/6390

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