Hemorrhoids risk factors: straining, constipation, age and pregnancy

What hemorrhoids are

Hemorrhoids, also called piles, are swollen and inflamed veins around your anus or in your lower rectum (NIDDK). The two types are external hemorrhoids, which form under the skin around the anus, and internal hemorrhoids, which form in the lining of the anus and lower rectum (NIDDK).

Hemorrhoids are a type of varicose vein (MedlinePlus).

Hemorrhoids are common in both men and women and affect about 1 in 20 Americans. About half of adults older than age 50 have hemorrhoids (NIDDK).

Who is more likely to get hemorrhoids

You are more likely to get hemorrhoids if you (NIDDK):

• strain during bowel movements
• sit on the toilet for long periods of time
• have chronic constipation or diarrhea
• eat foods that are low in fiber
• are older than age 50
• are pregnant
• often lift heavy objects

What causes hemorrhoids

Hemorrhoids happen when there is too much pressure on the veins around the anus (MedlinePlus). The causes of hemorrhoids include (NIDDK):

• straining during bowel movements
• sitting on the toilet for long periods of time
• chronic constipation or diarrhea
• a low-fiber diet
• weakening of the supporting tissues in your anus and rectum that happens with aging
• pregnancy
• often lifting heavy objects

MedlinePlus notes that weakening of the supporting tissues in your anus and rectum can happen with aging and pregnancy (MedlinePlus).

Symptoms

The symptoms of hemorrhoids depend on the type you have (NIDDK). With external hemorrhoids, you may have anal itching, one or more hard, tender lumps near your anus, and anal ache or pain, especially when sitting. Too much straining, rubbing, or cleaning around your anus may make your symptoms worse. For many people, the symptoms of external hemorrhoids go away within a few days (NIDDK).

With internal hemorrhoids, you may have bleeding from your rectum (bright red blood on stool, on toilet paper, or in the toilet bowl after a bowel movement) or a hemorrhoid that has fallen through your anal opening, called prolapse. Internal hemorrhoids that are not prolapsed most often are not painful. Prolapsed internal hemorrhoids may cause pain and discomfort (NIDDK).

Complications

Complications of hemorrhoids can include (NIDDK):

• blood clots in an external hemorrhoid
• skin tags, extra skin left behind when a blood clot in an external hemorrhoid dissolves
• infection of a sore on an external hemorrhoid
• strangulated hemorrhoid, when the muscles around your anus cut off the blood supply to an internal hemorrhoid that has fallen through your anal opening
• anemia

When to see a doctor

You should seek a doctor's help if you still have symptoms after 1 week of at-home treatment or have bleeding from your rectum (NIDDK).

Not every anal symptom is caused by a hemorrhoid. Bleeding from your rectum may be a sign of bowel diseases such as Crohn's disease, ulcerative colitis, or cancer of the colon or rectum (NIDDK). MedlinePlus adds that other conditions that can cause bleeding include Crohn's disease, ulcerative colitis, colorectal cancer, and anal cancer, so it's important to see your provider to find the cause of the bleeding (MedlinePlus).

To find out if you have hemorrhoids, your health care provider will ask about your medical history and do a physical exam, will do a digital rectal exam to check for internal hemorrhoids, and may do procedures such as an anoscopy (MedlinePlus).

Lowering your chances

You can help prevent hemorrhoids by (NIDDK):

• eating foods that are high in fiber
• drinking water or other nonalcoholic liquids each day as recommended by your health care professional
• not straining during bowel movements
• not sitting on the toilet for long periods of time
• avoiding regular heavy lifting

You can most often treat hemorrhoids at home. If at-home treatments don't help, you may need a medical procedure, and in severe cases, you may need surgery (MedlinePlus).

Common questions

Are hemorrhoids more common with age?

Yes. Being older than age 50 is on NIDDK's list, and about half of adults older than age 50 have hemorrhoids (NIDDK).

Can pregnancy cause hemorrhoids?

Pregnancy is one of the causes of hemorrhoids that NIDDK lists (NIDDK).

Is rectal bleeding always from hemorrhoids?

No. Hemorrhoids are a common cause of bleeding, but other conditions can also cause bleeding, so it's important to see your provider to find the cause (MedlinePlus).