Hemorrhoids are common and most settle with simple changes. Here are the six symptoms to check, and the one sign that is never assumed to be a hemorrhoid.
Hemorrhoids are swollen veins in and around the anus, and most cases settle with changes you can make at home. Six symptoms point at them.
Pressure is the mechanism. Straining, long sitting on the toilet, constipation, low fiber, pregnancy and frequent heavy lifting all raise pressure in those veins until they swell.
Below are the six symptoms, the fiber and fluid targets that actually change things, and the one sign that always goes to a doctor. That last one is the reason this article exists.
Six symptoms that point at a hemorrhoid
Internal and external hemorrhoids feel different from each other.
NIDDK separates them (NIDDK). Internal ones usually cause no pain and show up as bleeding. External ones itch, ache and can be felt. Cleveland Clinic adds two further forms.
- Bright red blood after a bowel movement. NIDDK describes it on the stool, on the toilet paper or in the bowl. This is the usual sign of an internal hemorrhoid, and it is also the sign that gets checked by a doctor.
- Itching around the anus. NIDDK lists anal itching first among external hemorrhoid symptoms. Cleveland Clinic describes itchiness and irritation in the same area.
- One or more hard, tender lumps. NIDDK describes hard, tender lumps near the anus. Cleveland Clinic says they feel sore or tender to the touch.
- An ache or pain when sitting. NIDDK names an anal ache or pain, especially when sitting. Cleveland Clinic lists pain when sitting among its symptoms too.
- A lump that comes through the opening. NIDDK calls this a prolapsed hemorrhoid, an internal one that has fallen through the anal opening. Cleveland Clinic says it may bleed or hurt.
- A painful purple or blue lump. Cleveland Clinic describes a thrombosed hemorrhoid, where a blood clot forms inside an external one. It is typically painful and the lump looks purple or blue.
Most of this settles. NIDDK says external hemorrhoid symptoms often go away within a few days. Cleveland Clinic says pain and bleeding may last one week or slightly longer.
What actually helps at home, with the numbers
The home plan is unglamorous and it works.
Cleveland Clinic puts most adults at 25 to 38 grams of fiber a day, with more water (Cleveland Clinic). It adds a warm sitz bath of 10 to 20 minutes a day. It also names over the counter products with witch hazel, lidocaine or hydrocortisone.
Harvard Health adds the habit most people skip. Go when you feel the urge rather than waiting, because delaying backs the stool up and that is what raises the pressure and the straining.
Two more come from Harvard Health (Harvard Health). A 20 minute sitz bath after each bowel movement, plus two or three more through the day. Then brisk walking for 20 to 30 minutes a day, which stimulates bowel function.
Gradually increase your intake to 25 to 30 grams of fiber per day. Also, increase your fluid intake.
Keep the plan with you
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⬇ Download your plan (PDF)Why any bleeding gets looked at by a doctor
This is the part of the article that matters most.
NIDDK says bleeding from the rectum may be a sign of bowel diseases including Crohn's disease, ulcerative colitis or colorectal cancer. Cleveland Clinic says other gastrointestinal disorders cause rectal bleeding and symptoms like hemorrhoids, and that some of those disorders are life threatening.
There is a second trigger. NIDDK says to see a doctor if symptoms have not improved after a week of home treatment. Cleveland Clinic adds worsening symptoms, and symptoms that get in the way of daily life or sleep.
Cleveland Clinic names more reasons to call rather than wait. Abdominal pain, chronic constipation or diarrhoea, fever and chills, nausea and vomiting, and severe rectal bleeding with pain.
Three things people get wrong about hemorrhoids
Three beliefs about hemorrhoids cause real delay.
Bleeding is always a hemorrhoid. It is not, and this is the one that costs the most. NIDDK says rectal bleeding may be a sign of bowel disease, including colorectal cancer. Cleveland Clinic says some of the other causes are life threatening. Bleeding is checked, not assumed.
Pushing harder gets it over with. Straining during bowel movements is one of the causes NIDDK lists, along with long sitting on the toilet and chronic constipation. Softening the stool with fiber and fluid is the fix, not more effort.
There is nothing to do but wait. Cleveland Clinic lists sitz baths, fiber, fluid, laxatives or fiber supplements, moist paper and over the counter products. If those are not enough it lists rubber band ligation, sclerotherapy and surgery.
To your health,
Ageless Coach
Age Strong. Live Long.
This article is education, not medical advice. Rectal bleeding is never assumed to be a hemorrhoid. NIDDK says bleeding from the rectum may be a sign of bowel disease, including Crohn's disease, ulcerative colitis or colorectal cancer, and Cleveland Clinic says some of the other causes are life threatening. Any rectal bleeding gets looked at by a doctor.