Hemorrhoids – Symptoms, Causes, and Treatment Options

Overview of Hemorrhoids

Hemorrhoids are a very common condition that affects millions of people worldwide. They occur when the veins in your lower rectum or anus become swollen and inflamed, similar to varicose veins in the legs. Hemorrhoids may be internal (inside the rectum) or external (under the skin around the anus).

Prevalence is high—studies suggest that about 1 in 2 adults over the age of 50 will experience hemorrhoids at some point in life (Sun & Migaly, 2016, Clin Colon Rectal Surg, doi:10.1055/s-0035-1568144).

Daily life can be significantly affected by hemorrhoids:

• Work: Sitting for long hours may worsen symptoms, causing discomfort during office tasks.
• Sport: High-impact exercise or heavy lifting can trigger or aggravate flare-ups.
• Sleep: Pain and itching may make it harder to fall asleep or stay asleep.
• Relationships: Embarrassment or discomfort can reduce intimacy and social confidence.
• Mental health: Chronic pain or bleeding may increase anxiety and stress about your health.

Hemorrhoids are not life-threatening, but they can mimic more serious conditions like anal fissures, colorectal cancer, or inflammatory bowel disease (IBD), which is why proper diagnosis is essential.

Symptoms of Hemorrhoids

The main symptoms of hemorrhoids depend on whether they are internal or external, but both types can cause significant discomfort.

What are the main symptoms of hemorrhoids?

• Bleeding: Bright red blood on toilet paper or in the bowl after bowel movements is common.
• Itching and irritation: Especially around the anus.
• Pain or discomfort: External hemorrhoids can be very painful, particularly if a blood clot forms (thrombosed hemorrhoid).
• Swelling or lumps: You may feel a tender lump around the anus.
• Mucus leakage: Sometimes accompanied by a feeling of incomplete evacuation.

How severe can hemorrhoid symptoms get?

• Mild cases may cause occasional itching or minor bleeding.
• Moderate cases often include discomfort during bowel movements and daily activities.
• Severe cases can involve constant pain, large lumps, or heavy bleeding, sometimes requiring urgent medical care.

Functional impact of hemorrhoids

• Work performance: Sitting at a desk may become uncomfortable.
• Sports and fitness: Running, cycling, or lifting weights may aggravate symptoms.
• Sleep quality: Nighttime itching or pain can disrupt rest.
• Relationships: Embarrassment about bleeding or discomfort may affect intimacy.
• Mood and mental health: Persistent pain can cause frustration, anxiety, or even depressive symptoms.

Red flag symptoms (see a doctor immediately)

• Large amounts of blood in stool
• Severe, persistent pain
• Black or tarry stools (may indicate bleeding higher in the digestive tract)
• Rapidly enlarging lump around the anus

Causes and Risk Factors for Hemorrhoids

Hemorrhoids are caused by increased pressure in the rectal veins, which leads them to swell. Multiple lifestyle and health factors can contribute.

What are the most common causes of hemorrhoids?

• Chronic constipation or diarrhea: Straining during bowel movements is a leading factor.
• Prolonged sitting: Especially on the toilet, which increases rectal pressure.
• Pregnancy: Hormonal changes and increased pressure from the uterus can lead to hemorrhoids.
• Obesity: Extra abdominal pressure may stress rectal veins.
• Heavy lifting: Repeated straining can worsen symptoms.
• Low-fiber diet: Leads to hard stools and more straining.

Who is at higher risk of hemorrhoids?

• Adults aged 45–65 (most common age group).
• Pregnant women (up to 35% experience hemorrhoids).
• People with sedentary jobs or lifestyles.
• Athletes who perform heavy lifting or high-impact sports.
• Individuals with a family history of hemorrhoids.

Comparison with other conditions

Unlike anal fissures, which cause sharp pain during bowel movements, hemorrhoid pain is often dull and throbbing. Compared to rectal prolapse, hemorrhoids typically involve smaller tissue protrusions and less severe functional disruption.

Reference: Sun, Z., & Migaly, J. (2016). Review of hemorrhoid disease: Presentation and management. Clin Colon Rectal Surg, 29(1), 22–29. doi:10.1055/s-0035-1568144

Diagnosis, Recovery, and Management of Hemorrhoids

Hemorrhoids can often be self-diagnosed based on symptoms, but a proper clinical evaluation is important to rule out more serious conditions. Recovery timelines vary by severity, and treatment focuses on reducing symptoms, preventing recurrence, and improving quality of life.

Diagnosis of Hemorrhoids

Hemorrhoids are diagnosed through a clinical evaluation that includes a discussion of your symptoms, a physical examination, and sometimes specialized tests.

How do doctors test for hemorrhoids?

Most cases of hemorrhoids can be identified with a simple physical exam. A doctor will:

• Ask about your symptoms: such as bleeding, pain, itching, or swelling.
• Perform a visual inspection: External hemorrhoids are often visible as swollen lumps.
• Conduct a digital rectal exam (DRE): The doctor inserts a gloved, lubricated finger into the rectum to check for internal hemorrhoids, polyps, or other abnormalities.

For internal hemorrhoids, further tests may be recommended:

• Anoscopy: A small, lighted tube allows the doctor to see inside the rectum.
• Sigmoidoscopy or colonoscopy: These may be ordered if you have persistent bleeding or are over age 50, to rule out colorectal cancer or inflammatory bowel disease.

How are hemorrhoids different from other conditions?

Hemorrhoid symptoms can mimic other digestive conditions:

• Anal fissures cause sharp pain during bowel movements, unlike the dull ache of hemorrhoids.
• Rectal prolapse involves more significant tissue protrusion.
• Colon cancer may also cause bleeding, but it is usually darker and accompanied by other systemic symptoms like weight loss.

This is why seeing a doctor is important if you experience bleeding—to confirm the diagnosis and exclude more serious issues.

Recovery & Prognosis of Hemorrhoids

The recovery timeline for hemorrhoids depends on whether they are mild, moderate, or severe.

How long does it take for hemorrhoids to heal?

• Mild cases: Small hemorrhoids may resolve in a few days with home care, especially if constipation is managed.
• Moderate cases: Symptoms may take 1–2 weeks to improve with conservative treatments such as sitz baths, topical creams, and dietary changes.
• Severe or thrombosed hemorrhoids: May take 2–4 weeks to resolve, and sometimes require medical procedures.

What affects long-term outcomes?

• Recurrence risk: High if constipation, poor diet, or prolonged sitting are not addressed.
• Age: Older adults may heal more slowly due to decreased tissue elasticity.
• Pregnancy: Symptoms often improve after childbirth but may return with future pregnancies.

Decision pathway: if/then logic

• If symptoms are mild: Home remedies such as increased fiber, hydration, and warm baths are often enough.
• If symptoms are moderate: A doctor may recommend topical medications or office procedures like rubber band ligation.
• If symptoms are severe or persistent: Surgical options may be considered, such as hemorrhoidectomy or stapled hemorrhoidopexy.

Impact on daily life and return to activities

• Work: Most people with mild hemorrhoids can continue working, though sitting may be uncomfortable. Severe cases may require time off after a procedure.
• Sports: Light activity is usually safe, but heavy lifting and straining should be avoided during recovery.
• Long-term lifestyle: Prevention is key—healthy diet, hydration, and regular exercise reduce recurrence risk.

Reference: Sun, Z., & Migaly, J. (2016). Review of hemorrhoid disease: Presentation and management. Clin Colon Rectal Surg, 29(1), 22–29. doi:10.1055/s-0035-1568144

Management of Hemorrhoids

Managing hemorrhoids involves relieving symptoms, preventing recurrence, and supporting overall digestive health.

What’s the best way to manage hemorrhoids at home?

Self-care strategies are often effective for mild to moderate cases:

• High-fiber diet: Eat fruits, vegetables, whole grains, and legumes.
• Hydration: Drinking enough water helps soften stools.
• Avoid straining: Don’t sit on the toilet for long periods.
• Sitz baths: Soaking in warm water for 10–15 minutes reduces pain and swelling.
• Topical relief: Creams or ointments with hydrocortisone or witch hazel may ease irritation.

Step-by-step self-help tips

1. Increase fiber gradually (20–30 g daily) to prevent bloating.
2. Drink at least 6–8 glasses of water per day.
3. Exercise regularly (walking, swimming, or yoga) to improve circulation.
4. Practice good toilet habits—go when you feel the urge, don’t delay.
5. Use cushions when sitting for long periods.
6. Avoid heavy lifting that increases abdominal pressure.

Medical and procedural management

• Office treatments: Rubber band ligation, sclerotherapy, and infrared coagulation shrink hemorrhoids.
• Surgery: Reserved for severe or recurring hemorrhoids.
• Lifestyle coaching: Long-term changes in diet, activity, and posture help prevent recurrence.

Community and social supports

Support groups, online communities, and patient education resources can help reduce stigma and provide reassurance that hemorrhoids are common and treatable.

Multidisciplinary Coordinated Care for Hemorrhoids at CARESPACE

At CARESPACE, hemorrhoid care goes beyond symptom relief. Our multidisciplinary team combines medical, therapeutic, and lifestyle-based approaches to provide comprehensive, personalized support that helps you heal faster and lowers the chance of recurrence.

How does CARESPACE treat hemorrhoids differently?

Most standard care for hemorrhoids focuses only on symptom management—like creams, medications, or procedures. At CARESPACE, your care plan is built by a team of professionals working together, addressing not just the physical problem but also the underlying causes and lifestyle factors that can trigger or worsen hemorrhoids.

This team-based approach means your physiotherapist, nutritionist, massage therapist, psychotherapist, and other providers collaborate on your recovery. That coordination helps you:

• Get faster symptom relief.
• Prevent flare-ups and recurrence.
• Build sustainable habits that support long-term health.

Coordinated physical care for hemorrhoids

CARESPACE integrates multiple physical health services to reduce pain, improve circulation, and prevent re-injury.

• Physiotherapy: Gentle pelvic floor and core exercises can ease strain during bowel movements and reduce rectal pressure.
• Massage therapy: Targeted massage may release surrounding muscle tension and improve blood flow, supporting healing.
• Chiropractic care: Posture and spinal alignment adjustments may reduce sitting discomfort and pelvic pressure.
• Kinesiology & fitness training: Guided, low-impact exercise builds circulation and strength while avoiding movements that worsen hemorrhoids.

By combining these approaches, CARESPACE helps you not only recover but also adapt your daily movements to minimize flare-ups.

Nutrition, naturopathy, and digestive health support

Diet and digestion are central to both treating and preventing hemorrhoids. CARESPACE’s registered nutritionists and naturopathic doctors provide strategies that:

• Increase fiber intake gradually to avoid bloating.
• Balance hydration for softer, easier bowel movements.
• Identify trigger foods that worsen constipation or irritation.
• Recommend natural remedies like soothing herbal options when appropriate.

Instead of leaving you on your own with generic advice, our team helps you implement practical, real-life changes that fit your lifestyle and preferences.

Mental health and lifestyle support for hemorrhoids

Hemorrhoids can affect more than your body—they can impact your sleep, stress levels, and confidence. At CARESPACE, we recognize this mind-body connection.

• Psychotherapy & coaching: Helps you manage stress, anxiety, or embarrassment related to hemorrhoids. Stress can worsen symptoms, so building coping skills is key.
• Sleep support: Insomnia or discomfort during rest can be addressed with relaxation strategies and lifestyle coaching.
• Habit-building: Counselors and coaches guide you in forming routines for exercise, diet, and stress management that reduce recurrence.

Why does a team approach help hemorrhoids recover faster?

When you’re treated by a single provider, you may only get relief for one part of the problem. At CARESPACE, your hemorrhoid care moves through phases with coordinated support:

1. Acute phase: Reduce swelling and discomfort with massage, sitz bath guidance, and topical relief.
2. Subacute phase: Strengthen pelvic support muscles, improve digestion with tailored nutrition, and learn better bathroom habits.
3. Maintenance phase: Ongoing lifestyle coaching, ergonomic support for sitting at work, and relapse-prevention strategies to avoid recurrence.

This comprehensive approach ensures you’re not just treating the hemorrhoids—you’re addressing root causes and building resilience for the future.

The CARESPACE advantage in hemorrhoid care

What makes CARESPACE unique is how all your providers work together. Instead of isolated appointments, your physiotherapist can communicate with your nutritionist, who can coordinate with your psychotherapist, ensuring your care is personalized, consistent, and seamless.

The benefits for you include:

• Faster pain relief and shorter recovery times.
• Fewer flare-ups due to proactive prevention strategies.
• Improved quality of life through better digestion, less stress, and healthier habits.
• Confidence knowing you have a whole team supporting you.

Related Conditions, FAQs, and Disclaimer for Hemorrhoids

Related Conditions for Hemorrhoids

Hemorrhoids often share symptoms with other anorectal and digestive conditions, which is why proper evaluation is important. For example, anal fissures can also cause bleeding and sharp pain during bowel movements, while anal fistulas may cause persistent discomfort, drainage, or swelling. Rectal prolapse can mimic the sensation of tissue bulging out of the anus, similar to advanced hemorrhoids. Inflammatory conditions such as ulcerative colitis or Crohn’s disease may also present with rectal bleeding, making them easy to confuse with hemorrhoids.

Constipation, irritable bowel syndrome (IBS), and chronic straining due to pelvic floor dysfunction can overlap with hemorrhoid symptoms as well. Because these conditions can appear similar, it’s best to get a professional evaluation to ensure you receive the right care.

Looking for information on a different condition? Visit our full Conditions List.