Overview
Internal hemorrhoids are inside the rectum and may bleed without pain. External hemorrhoids are under the skin around the anus and can itch or hurt.
A blood clot in an external hemorrhoid causes a sudden, painful, hard lump.
Symptoms
Common signs:
- Blood when wiping or on toilet paper
- Pain, itching, or swelling at the bottom
Less common
- A lump near the anus
- Mucus or leaking
When to get medical care
Causes
Pressure on the veins from straining, constipation, diarrhea, pregnancy, heavy lifting, or sitting a long time.
Does it spread or run in families?
- It isn't contagious. You can't catch it from someone else.
Who is more likely to get it
- Constipation
- Pregnancy
- Low-fiber diet
- Older age
Possible complications
- Anemia: Rarely, from long-term bleeding
- Anal fissure
Diagnosis
A healthcare professional looks and may do a gentle exam.
Questions you may be asked
- Bowel habits
- Bleeding and how much
The exam
An exam of the anus, sometimes with a gloved finger.
Tests
Tests, if needed:
- Anoscopy: A short tube to look inside.
- Colonoscopy: If bleeding needs more checking, especially over 45.
Treatment
Most improve in a week with home care.
Self-care
- Eat more fiber and drink water: soft stools mean less straining
- Don't strain or sit on the toilet a long time
- Take warm sitz baths: 10 to 15 minutes a few times a day
- Pat clean with wet wipes or a peri bottle
Medicines
Medicines that may help:
| Medicine | Helps with | Good to know |
|---|---|---|
| Creams and pads | Itching and pain | Use steroid creams for only a week unless told. |
| Fiber and stool softeners | Softer stools |
OwieClear doesn't give doses: follow the label or your healthcare professional. Medicine names here are examples, not a full list.
Procedures like rubber band ligation or surgery help hemorrhoids that keep bleeding or hurting.
Prevention
To prevent them:
- Eat 25 to 30 grams of fiber a day
- Drink water
- Go when you feel the urge
Which doctor treats this
- Start with your primary care provider (family doctor or internist).
- They may send you to a gastroenterologist or a colon and rectal surgeon.
Back to school, work, or sports
- Most people keep up normal school and work. Rest when you need to.
Children, pregnancy, and older adults
- Pregnancy: Common late in pregnancy and after birth.
Pregnancy and breastfeeding
- If you're pregnant or planning to be, tell your prenatal provider about this condition.
- Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
- Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
- Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.
Outlook
Hemorrhoids usually get better, but can come back.
Myths and facts
Myth: Hemorrhoids only happen to older adults.
Fact: They're common in pregnancy and with straining at any age.
Getting ready for your visit
Bring a list of your symptoms and medicines.
Questions to ask
- Do I need a colonoscopy?
- What procedures can help?
Research studies
Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.
Sources
Last updated 2026-11-12.