Hemorrhoids (you may have heard them called “piles”) are swollen blood vessels inside and around the anus and lower rectum. They become enlarged, inflamed, and painful. They may feel itchy or bleed.

They are common when there’s pressure on the rectal area (like being pregnant or overweight) and as you get older. They can develop from pushing and straining, for example, from chronic constipation or giving birth.

Hemorrhoids usually aren’t serious, but they can affect your quality of life. They may lead to infections.

Anal bleeding and irritation can be a sign of a more serious problem like Crohn’s disease, ulcerative colitis, or cancer. That’s why it’s crucial to have a doctor check out your symptoms. 

Doctors classify hemorrhoids by noting where the swollen veins develop. Symptoms can vary, depending on what type you have. 

The different types are:

• External: These form on the outside of your body, under the skin around your anus. The anus is where your food waste leaves the body. Symptoms include itching and pain, with hard, tender lumps near your anus.
• Internal: These form inside your body, in the lining of the anus and lower rectum. They usually aren’t painful. Symptoms include itching, mucus discharge, and bright red blood on your stool, toilet paper, or toilet bowl.
• Prolapsed: Doctors use this term when the swollen veins bulge out of your anus. Symptoms include bleeding and pain. 

For many people, a few simple lifestyle changes can help hemorrhoid symptoms improve. Your doctor may recommend drinking more water, eating a high-fiber diet, or using stool softeners, fiber supplements, or hemorrhoid creams.

If your symptoms don't improve after about a week or keep coming back, it's time to see a doctor. We start with the least invasive treatment options and recommend additional care based on your symptoms.

Pelvic floor therapy

If diet changes aren't enough, pelvic floor therapy may help relieve symptoms and prevent hemorrhoids from returning. The pelvic floor is the group of muscles that supports your pelvic organs and bowel.

Our pelvic floor physical therapists can teach you exercises to strengthen these muscles. Pelvic floor therapy may be especially helpful after childbirth.

Minimally invasive procedures

If you have internal hemorrhoids or more severe symptoms, your doctor may refer you to a colorectal surgeon. They may recommend one of these minimally invasive procedures:

• Electrocoagulation: An electric current cuts off the hemorrhoid's blood supply, causing it to shrink
• Infrared photocoagulation: Infrared light is used to cut off the blood supply to an internal hemorrhoid so it shrinks
• Sclerotherapy: A chemical solution is injected into the hemorrhoid, creating scar tissue that cuts off its blood supply
• Rubber band ligation: A small rubber band is placed around the base of an internal hemorrhoid, cutting off its blood supply so it dries up and falls off

Surgery

For larger or more complex hemorrhoids, surgery may be the best option. Under anesthesia, a colorectal surgeon may use a stapling procedure to remove internal hemorrhoids or reposition a prolapsed hemorrhoid and secure it in place.