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Hemorrhoids: Inside and Outside

Hemorrhoids, also known as “piles,” are swollen veins that form inside and outside of your anus. They can be uncomfortable, causing symptoms like pain, anal itching, and rectal bleeding. However, they are a common issue, affecting an estimated 1 in 20 Americans, particularly those between 45 and 65 years of age. Hemorrhoids are merely enlarged veins in a sensitive area.


What Causes Hemorrhoids?

Hemorrhoids develop when the venous drainage of the anus is altered, causing the venous plexus and connecting tissue to dilate. This creates an outgrowth of anal mucosa from the rectal wall. Factors that can increase the risk of developing hemorrhoids include being overweight, pregnant, eating a low-fiber diet, suffering from chronic constipation or diarrhea, regularly lifting heavy objects, and spending too much time sitting on the toilet.

Types of Hemorrhoids

Hemorrhoids can occur inside or outside of your rectum.

 -Internal hemorrhoids form inside your rectum and are usually painless. They may bleed but often don't cause discomfort unless they prolapse, meaning they stretch and bulge outside of your anus.

 -External hemorrhoids form underneath the skin around your anus and can be itchy and painful. Sometimes, they can fill with blood that can clot, resulting in pain and swelling.


Diagnosing Hemorrhoids

The diagnosis of hemorrhoids is based on symptoms and a physical exam. Your doctor might be able to see external hemorrhoids. Diagnosing internal hemorrhoids might include an examination of your anal canal and rectum. This could involve a digital exam, where your doctor inserts a gloved, lubricated finger into your rectum to feel for anything unusual, such as growths.


Treatment Options

Treatment for hemorrhoids varies depending on their severity. Home remedies can often relieve the mild pain, swelling, and inflammation of hemorrhoids. These include eating highfiber foods, using topical treatments, soaking regularly in a warm bath, and taking oral pain relievers. If your hemorrhoids produce only mild discomfort, your doctor might suggest over- the-counter creams, ointments, suppositories, or pads. These products contain witch hazel, hydrocortisone, and lidocaine, which can temporarily relieve pain and itching.

Your doctor might recommend one of the other minimally invasive procedures for persistent bleeding or painful hemorrhoids. These treatments can be done in your doctor's office or another outpatient setting and don't usually require anesthesia. We have had good success with the O’Regan Hemorrhoidal Banding procedure for internal hemorrhoids.

In severe or recurring cases, surgery might be needed. Hemorrhoid removal, or hemorrhoidectomy, is the most effective and complete way to treat painful or frequent hemorrhoids.



Preventing hemorrhoids primarily involves avoiding strain and maintaining a healthy lifestyle. This includes eating a high-fiber diet, drinking plenty of water, exercising regularly, and avoiding sitting for long periods. Remember, if you're experiencing symptoms of hemorrhoids, it's important to consult with a healthcare provider to get a proper diagnosis and treatment plan.

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Center For Digestive Health & Nutrition

725 Cherrington Parkway • Moon Township, PA 15108 412.262.1000 • • IG: @thedigestivetract

The Center for Digestive Health & Nutrition is a private medical practice comprised of experienced Gastroenterologists, Nurse Practitioners, and staff members dedicated to preventing and treating digestive disorders. Our physicians have been serving the needs of those in Western Pennsylvania and surrounding areas since 1977, having cared for tens of thousands of individuals with digestive problems. Our mission is to deliver high-quality gastroenterology services efficiently and cost-consciously. We realize the very sensitive nature of GI illness and understand the necessity to provide our services in an environment that stresses patient privacy and confidentiality and where patient satisfaction is the goal. Appointments can be conveniently scheduled online via our website above. Learn more about digestive issues on Instagram @thedigestivetract

DISCLAIMER : The information on this website is to provide general information. The information on this website does NOT reflect definitive medical advice, and self-diagnoses should not be made based on information obtained online. It is important to consult a physician for a consultation and examination regarding ANY and ALL symptoms or signs as they may signify a serious illness or condition. An accurate diagnosis and treatment plan should only be made by a qualified doctor to exclude a serious condition.

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