Hemorrhoid 101

By March 17, 2022November 7th, 2022Blogs

Hemorrhoid 101

Hemorrhoids are very common and rarely life-threatening, but having this condition can absolutely impact your quality of life. Hemorrhoids are also called piles, but in either case, this is a condition in which the veins in the lowest part of the rectum and anus are swollen and bulge.

Let’s break things down so you can understand what’s going on—and how you can find relief.

Types of Hemorrhoids

Internal Hemorrhoids

Internal Hemorrhoids rarely cause discomfort because they lie inside the rectum. However, straining during bowel movements can cause irritation and bleeding. You may realize you have internal hemorrhoids if you notice blood in your stool or on the toilet paper after you wipe.

Tissue may also bulge outside your anal opening; in this case, the hemorrhoid has prolapsed. Internal hemorrhoids can be classified by the degree of prolapse. There is no prolapse in Grade One, while Grade Two involves prolapse that goes back in on its own. With Grade Three, prolapse can be pushed by the patient. Grade Four is the most painful level where the prolapse cannot be pushed back.

External Hemorrhoids

External hemorrhoids occur under the skin around the anus opening. As it exists externally, there is a visible lump outside the anus. External hemorrhoids can cause constant and severe pain, bleeding, itching and swelling.

Thrombosed Hemorrhoids

A thrombosed external hemorrhoid occurs when a blood clot forms in the skin overlying the outside of the anus. Thrombosed internal hemorrhoids develop in the lower rectum and are far less common than thrombosed external hemorrhoids. Thrombosed hemorrhoids can cause inflammation, lumps around the anus, swelling and intense pain.

Causes of Hemorrhoids

Hemorrhoids can develop for various reasons, but some factors that increase your risk of hemorrhoids include:

  • Straining – Straining during bowel movement puts excess pressure on veins, causing them to become swollen and inflamed. Constipation makes passing stool difficult, which leads to the tendency to strain.
  • Sitting on the toilet too long – Sitting on the toilet for a prolonged period increases the pressure on the veins in the anus, affecting blood flow. As a result, the blood pools within the vessels, leading to inflammation and hemorrhoid development.
  • Diarrhea and irregular bowel patterns – Spending too much time on the toilet due to irregular and frequent bowel patterns put excessive strain on the anus. Diarrhea can also worsen existing hemorrhoids.
  • Obesity – Excess weight puts pressure on the veins in the anus when you’re sitting down and even more when you’re sitting on the toilet.
  • Repeated heavy lifting – When you hold your breath and strain when you lift heavy weights, the air you force down when you grunt can increase pressure on your internal organs. This, combined with the movement of squatting and lifting, causes the veins near the rectum to swell.
  • Pregnancy – An expanding uterus and growing baby put pressure on the veins that run through the anus. Pregnancy also causes increased blood flow to the pelvic area and constipation.

Exams to Diagnosis Hemorrhoids

Doctors use several tests to determine which type of hemorrhoid you have and the best treatment method. These exams include:

  • Anoscopy
  • Colonoscopy
  • Digital exam
  • Sigmoidoscopy


Prolapsed hemorrhoids often return to normal on their own, but you may need at-home remedies, medication or surgery if your hemorrhoid does not improve.

For more on hemorrhoid prevention, diagnosis and treatment, contact Gastro MD. We are a cutting-edge clinical gastroenterology practice that sets the standard in digestive health care.