WHAT YOU NEED TO KNOW:

What are hemorrhoids? Hemorrhoids are swollen blood vessels inside your rectum (internal hemorrhoids) or on your anus (external hemorrhoids). Sometimes a hemorrhoid may prolapse. This means it extends out of your anus.

What increases my risk for hemorrhoids?

• Pregnancy or obesity
  
  
• Straining or sitting for a long time during bowel movements
  
  
• Liver disease
  
  
• Weak muscles around the anus caused by older age, rectal surgery, or anal intercourse
  
  
• A lack of physical activity
  
  
• Chronic diarrhea or constipation
  
  
• A low-fiber diet

What are the signs and symptoms of hemorrhoids?

• Pain or itching around your anus or inside your rectum
  
  
• Swelling or bumps around your anus
  
  
• Bright red blood in your bowel movement, on the toilet paper, or in the toilet bowl
  
  
• Tissue bulging out of your anus (prolapsed hemorrhoids)
  
  
• Incontinence (poor control over urine or bowel movements)

How are hemorrhoids diagnosed? Your healthcare provider will ask about your symptoms, the foods you eat, and your bowel movements. He will examine your anus for external hemorrhoids. You may need the following:

• A digital rectal exam is a test to check for hemorrhoids. Your healthcare provider will put a gloved finger inside your anus to feel for the hemorrhoids.
  
  
• An anoscopy is a test that uses a scope (small tube with a light and camera on the end) to look at your hemorrhoids.

How are hemorrhoids treated? Treatment will depend on your symptoms. You may need any of the following:

• Medicines can help decrease pain and swelling, and soften your bowel movement. The medicine may be a pill, pad, cream, or ointment.
  
  
• Procedures may be used to shrink or remove your hemorrhoid. Examples include rubber-band ligation, sclerotherapy, and photocoagulation. These procedures may be done in your healthcare provider's office. Ask your healthcare provider for more information about these procedures.
  
  
• Surgery may be needed to shrink or remove your hemorrhoids.

How can I manage my symptoms?

• Apply ice on your anus for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel before you apply it to your anus. Ice helps prevent tissue damage and decreases swelling and pain.
  
  
• Take a sitz bath. Fill a bathtub with 4 to 6 inches of warm water. You may also use a sitz bath pan that fits inside a toilet bowl. Sit in the sitz bath for 15 minutes. Do this 3 times a day, and after each bowel movement. The warm water can help decrease pain and swelling.
  
  
• Keep your anal area clean. Gently wash the area with warm water daily. Soap may irritate the area. After a bowel movement, wipe with moist towelettes or wet toilet paper. Dry toilet paper can irritate the area.

How can I help prevent hemorrhoids?

• Do not strain to have a bowel movement. Do not sit on the toilet too long. These actions can increase pressure on the tissues in your rectum and anus.
  
  
• Drink plenty of liquids. Liquids can help prevent constipation. Ask how much liquid to drink each day and which liquids are best for you.
  
  
• Eat a variety of high-fiber foods. Examples include fruits, vegetables, and whole grains. Ask your healthcare provider how much fiber you need each day. You may need to take a fiber supplement.
  
  
• Exercise as directed. Exercise, such as walking, may make it easier to have a bowel movement. Ask your healthcare provider to help you create an exercise plan.
  
  
• Do not have anal sex. Anal sex can weaken the skin around your rectum and anus.
  
  
• Avoid heavy lifting. This can cause straining and increase your risk for another hemorrhoid.

When should I seek immediate care?

• You have severe pain in your rectum or around your anus.
  
  
• You have severe pain in your abdomen and you are vomiting.
  
  
• You have bleeding from your anus that soaks through your underwear.

When should I contact my healthcare provider?

• You have frequent and painful bowel movements.
  
  
• Your hemorrhoid looks or feels more swollen than usual.
  
  
• You do not have a bowel movement for 2 days or more.
  
  
• You see or feel tissue coming through your anus.
  
  
• You have questions or concerns about your condition or care.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.