Approved Doctor(s) ; Nathaly P. Llore , Kevin T. Behm • Jan 11, 2022

Table of contents

30 Second Summary

  • Hemorrhoids are a condition caused by swollen veins in the lowest part of the anus and rectum, similar to varicose veins.
  • It occurs in two types: internal and external.
  • Hemorrhoids can be treated with lifestyle changes, medication and surgery.
  • It is a condition with a high risk of recurrence.

What is hemorrhoids?

The health problem called hemorrhoids is the swelling of the veins in the lower part of the anus and rectum. Hemorrhoids, which look like varicose veins, can develop in the rectum and around the anus. There are a wide variety of treatment methods for hemorrhoids. However, a significant proportion of patients achieve hemorrhoid relief with home remedies and lifestyle changes.

The problem of hemorrhoids, which is quite common in both men and women, affects half of the population over the age of 50. Pressure on the blood vessels in the lower part of the anus and rectum for any reason causes hemorrhoids to occur. Pregnancy and childbirth are therefore among the most common causes of hemorrhoids.

Diagnostic criteria for hemorrhoids

Hemorrhoids are a health problem that is usually consulted to a doctor with the appearance of blood in the stool. However, blood in the stool can be a sign of many health problems, especially digestive disorders and colorectal cancer. For this reason, the diagnosis is confirmed when the doctor orders some tests after performing a physical examination.

Physical examination

During the physical examination, specialists check the anus and rectum. This check looks for swollen blood vessels in the specified areas.

Digital rectal examination

In this examination, the finger is inserted into the rectum to examine the inside of the rectum and look for swollen blood vessels or structural abnormalities.


To visualize internal hemorrhoids, a hollow and lighted tube is inserted into the anus and examined.


It is another test performed with a lighted tube inserted into the anus. It is among the methods used for visualization of internal hemorrhoids.


This test, which checks a portion of the large intestine, can help identify factors that cause abdominal pain, diarrhea, abnormal growths and constipation. In this test, a short, flexible and lighted tube is inserted into the large intestine through the rectum. The device then blows air into the large intestine, causing it to swell and allowing a clearer view of the inside. It is also possible to take a biopsy sample in this procedure.


In a colonoscopy test, all parts of the large intestine are visualized. This allows you to check for swelling, redness, sores or bleeding in any part of the large intestine. It is also possible to take a biopsy sample during this procedure.

Symptoms of hemorrhoids

Symptoms of hemorrhoids vary between people. Among the most common symptoms are the following:

  • Itching
  • Bright red blood in the stool, on toilet paper or in the toilet bowl
  • Swelling around the anus
  • Pain around the anus
  • Hard lump around the anus
  • Irritation around the anus

Symptoms of internal hemorrhoids

Internal hemorrhoids cannot be seen from the outside with the naked eye. Among the symptoms it causes are the following:

  • Experiencing painless bleeding during bowel movements. This is why small amounts of bright red blood can be seen in the toilet or on toilet paper.
  • When hemorrhoids enter through the anal opening, there is pain and irritation.

Symptoms of external hemorrhoids

Symptoms caused by hemorrhoids around the anus and under the skin include the following:

  • Bleeding
  • Itching in the anal area
  • Swelling around the anus
  • Irritation in the anal area
  • Agri
  • Discomfort

Causes of hemorrhoids

Among the causes of hemorrhoids are the following:

  • Prolonged constipation or diarrhea
  • Frequent straining during bowel movements
  • Advanced age
  • Pregnancy
  • Family history of hemorrhoids
  • Anal intercourse
  • Eating a low-fiber diet

In addition to these reasons, hemorrhoids are more common in people with certain risk factors. These risk factors include the following:

  • Between 45 and 65 years of age
  • Sitting on the toilet for too long
  • Being over the ideal weight
  • Performing tasks such as heavy lifting

Why does hemorrhoids occur in women?

Although hemorrhoids are a problem that can be seen in people of all ages and genders, they are more common especially in the third period of pregnancy. Among the reasons why it is more common during this period of pregnancy are the following:

  • Increased blood flow to the pelvic area
  • Increased pressure from an expanding uterus and growing baby
  • Constipation due to pregnancy hormones causing slow bowel movements
  • Extra straining due to hard stools
  • Rising progesterone hormones cause the walls of blood vessels to dilate and swell more easily

Women who have hemorrhoid problems before pregnancy are more likely to experience this problem during pregnancy.

How to prevent hemorrhoids during pregnancy?

Hemorrhoids are a common problem during pregnancy due to significant changes in the body. For this reason, pregnant women should pay attention to some points. Measures that can be taken to prevent hemorrhoids include the following:

  • Determining a diet with a high fiber content
  • When the need to go to the toilet is felt, this need should not be delayed
  • Not sitting on the toilet longer than necessary
  • Taking fiber supplements from a doctor in case of constipation
  • Synthetic vitamins, especially iron, cause constipation. Therefore, prefer food-based supplements during pregnancy.
  • Exercise should be continued until the end of pregnancy in consultation with your doctor.
  • Doing Kegel exercises will strengthen the muscles in the rectal area.
  • Do not sit or stand still for long periods of time.
  • Drink plenty of fluids, especially water.
  • To reduce pressure in the rectal area, you should lie on your side while sleeping, watching TV or resting.

How to treat hemorrhoids during pregnancy?

Among the treatments that women who have hemorrhoids during pregnancy can apply are the following.

  • Applying an ice compress to the affected area
  • Sitting in warm water several times a day.
  • Use a hemorrhoid pillow.
  • Applying witch hazel pads to the affected area. Witch hazel pads help reduce swelling with their cooling effect.
  • Wet or dry baking soda can be applied to the area to reduce itching.
  • Coconut oil helps to relieve inflammation. Pure aloevera gel can also be used for this purpose.
  • Thick, soft and odorless toilet paper should be used to prevent further irritation of the affected area.
  • Acupuncture can help with treatment.

Hemorrhoids (hemorrhoids) treatment methods

Among the criteria considered when planning hemorrhoid treatment are the following.

  • Age and general health status of the patient
  • Clinical presentation of the disease
  • Which form of hemorrhoids are found
  • Patient response to medication, treatment and therapies
  • Whether the situation will worsen

The basis of hemorrhoid treatment is to reduce symptoms. Recommendations for reducing the severity of symptoms include flour.

  • Sitting in the bathtub in plain, warm water several times a day
  • Using hemorrhoid creams or suppositories
  • Applying ice compresses to reduce swelling

In addition, health professionals may recommend dietary changes to patients to facilitate defecation. The softer consistency of the stool will allow defecation without difficulty during bowel movements. This reduces the pressure on hemorrhoids. For this, foods containing more fiber should be added to the diet. For this, the foods that patients should definitely add to their diets include the following.

  • Vegetables
  • Fruits
  • Whole grains

In addition, the doctor may recommend the use of fiber supplements to further soften the stool. In cases where these methods are not sufficient, surgery is recommended.

Hemorrhoid cream

One of the most commonly used methods in hemorrhoid treatment is hemorrhoid creams. You should first get information from your doctor about how and how often to use these creams. While some of the creams are sold with prescription, some of them are available without a prescription. The most accurate information on how to use the cream can be obtained from your doctor and the package leaflet. In addition, the points you should pay attention to in hemorrhoid cream applications include the following.

  • Before using the cream, the application area should be cleaned with soap and warm water.
  • The application area should be rinsed well.
  • The cream should then be applied to the problem area.
  • These creams, which should generally be applied in the morning and evening, are recommended to be applied especially after bowel movements.
  • For application to the lower part of the anus, the applicator head must be used.

Side effects of hemorrhoid creams

Hemorrhoid creams usually do not have serious side effects. However, if an unexpected situation is encountered, then a doctor should be consulted as soon as possible. Apart from this, the side effects of hemorrhoid creams include the following.

  • Mild burning
  • Slight stinging

In case of the following side effects, you should consult a doctor immediately.

  • Rapid and/or irregular heartbeat
  • Severe headache
  • Irritability
  • Tremor
  • Sleep problems

There is also a risk of serious allergic reactions to hemorrhoid creams. Symptoms of an allergic reaction include the following:

  • Rash
  • Itching
  • Swelling, especially in the face and tongue area
  • Dizziness
  • Shortness of breath

In addition, the doctor should be informed if you have any of the following diseases:

  • Diabetes
  • Heart diseases
  • High blood pressure
  • Overactive thyroid gland
  • Difficulty urinating due to obstruction

Hemorrhoid surgery

There are different surgical methods used in the treatment of hemorrhoids. These methods include the following:

  • Thanks to the rubber band ligation, which cuts off the blood circulation to the hemorrhoid, hemorrhoids disappear within a few days. The elastic band is placed around the base of the hemorrhoid.

  • The process of applying a chemical solution around the blood vessels to shrink hemorrhoids is called sclerotherapy.

  • Electrical coagulation method, also called infrared photo-coagulation, which uses infrared rays to burn hemorrhoid tissue, is another surgical method.

  • Surgical procedures that provide permanent removal of hemorrhoids are hemorrhoidopexy and hemorrhoidectomy.

Side effects of hemorrhoid surgery

As with any surgery, some side effects and complications are possible after hemorrhoid surgery. Among the side effects that can be seen in hemorrhoidectomy are the following.

  • After surgery, patients feel pain in their anal area and this shadow is extremely sensitive. For this reason, patients should rest and move as little as possible in the first few weeks after surgery. During this process, precautions should be taken especially to ensure that the stool is not hard. Hard defecation will cause the pain to increase. Warm water baths can be used to reduce complaints. In addition, hemorrhoid pillows should be used to reduce the pressure on the anal area.

  • Minor bleeding, especially after surgery, is to be expected. Blood can be seen especially in underwear and feces. The bleeding should stop within 48 or 72 hours after surgery. However, if the bleeding is serious, you should see a doctor immediately. In addition, the doctor should be informed about the formation of a clot unless otherwise instructed.

  • Infection is seen as a risk in all surgical procedures. After hemorrhoid surgery, the risk of infection increases due to the passage of feces through the surgical site. Therefore, all symptoms that may be caused by infection, from general signs of infection such as fever to specific signs of infection such as abscesses, should be carefully monitored.

  • Fecal incontinence is also among the side effects seen in patients after hemorrhoid surgery. This condition usually resolves spontaneously during the healing process. However, if fecal incontinence persists after the recovery period, it is necessary to inform the doctor.

  • Severe constipation is highly likely after hemorrhoid surgery. Constipation is expected due to the narrowing of the anal canal and damage to the tissues located there. In addition, patients' fear of bowel movements after surgery can also cause constipation. It is rare for feces to get stuck in the anal canal and become hard feces after surgery. For this reason, it is rarely necessary to pass stool.

Benefits of hemorrhoid surgery

Among the benefits of hemorrhoid surgery, first of all, is the rapid improvement of the pain of the patients. Patients are treated with surgery and do not experience the symptoms again. However, the recovery period after surgery may take several weeks. Another advantage of hemorrhoid surgery is that a single operation is sufficient in cases with multiple hemorrhoids.

What are the complications of hemorrhoid surgery?

Complications that can be seen after hemorrhoid surgery include the following.

  • Recurrence of hemorrhoids
  • Bloating
  • Delayed wound healing
  • Anal canal rupture
  • Urinary retention
  • Difficulty urinating
  • Hypertrophic anal papilla
  • Rectal prolapse
  • Intestinal obstruction

Complications that can be seen in surgeries performed under general anesthesia include the following.

  • Allergic reactions
  • Breathing difficulties
  • Deep vein thrombosis in the leg or pelvis
  • Pulmonary embolism in the lungs

Life after hemorrhoid surgery

Patient care after hemorrhoid surgery has a great impact on recovery. For this reason, it is necessary to learn in detail from the doctor what to pay attention to and what to do after the operation.


Among the activities that patients can do after surgery are the following.

  • Patients need to rest for 24 hours before resuming normal activities.
  • Patients should start walking as soon as possible after surgery. Walking is supportive for bowel movements.
  • Only activities that can be tolerated should be carried out. Patients should avoid exerting themselves.
  • Patients should not lift heavy objects until complete recovery is achieved.


After the operation, the medications prescribed by the doctor should be used as recommended by the doctor.

  • Antibiotics are prescribed to prevent possible infections. Antibiotic schedules must be observed.
  • Painkillers are prescribed for pain control. Painkillers should also be used as recommended by the doctor. Otherwise there is a risk of addiction.
  • In addition, experts may recommend stool softeners.


Patients should pay attention to their diet after surgery to facilitate defecation.

  • After the surgery, it is necessary to start feeding with clear liquids to prevent nausea, vomiting and constipation. The day after the operation, you can return to a normal diet.
  • You should drink at least 8 glasses of water a day.
  • Fiber intake should be increased.
  • Foods that cause constipation such as dairy products and red meat should not be consumed. Sugary foods and processed foods should also be avoided.

The healing process of hemorrhoids

Recovery after hemorrhoidectomy surgery can be a challenging process. Depending on the scope of the treatment and the methods applied, the healing process can take between 1 and 6 weeks. What is important here is the number and size of hemorrhoids removed.

It is possible for patients to experience severe pain in the first week after surgery. These pains start to subside by the end of the first week. But 4. It lasts until next week.

After surgery, patients should especially pay attention to constipation. Because hard stools and straining cause skin irritation. Soft bowel movements after surgery are considered an indication that the healing is progressing properly.

After hemorrhoid surgery, patients usually return to their normal lives within 2 to 3 weeks. After surgery In the 2nd week, they can start light exercises that do not involve lifting weights. Although recovery can take up to a month, patients At week 3, they can return to work.

What should patients with hemorrhoids pay attention to?

Among the points that people with hemorrhoids should pay attention to are the following:

  • People with hemorrhoids should avoid spice consumption
  • They should limit salt intake and avoid excessively salty foods.
  • They should prefer foods rich in fiber.
  • They should take the medication prescribed by their doctor regularly.
  • Patients should consume at least 2 to 3 liters of water during the day.
  • They should avoid canned food.
  • They should limit carbohydrate-heavy foods such as rice and pasta.
  • Red meat consumption should be avoided during treatment.
  • Patients need to sit on the toilet for a long time.
  • They should regularly consume olive oil foods.
  • They should not drink alcohol.
  • They should reduce the amount of tea, coffee and cola they consume during the day as much as possible.

Types of hemorrhoids

Hemorrhoids are a health problem that can occur inside or outside the rectum. For this reason, it is divided into three.

Internal hemorrhoids

It is a type of hemorrhoids caused by swelling of the veins in the rectum. The rectum is the part of the large intestine that connects to the anus. People with internal hemorrhoids may experience bleeding. However, these bleedings usually do not cause pain.

External hemorrhoids (hemorrhoids)

It occurs as a result of swelling of the blood vessels under the skin around the anus. External hemorrhoids, which sometimes bleed, can also cause pain and itching. In some cases it is filled with clotted blood. This is not dangerous, but it can cause pain and swelling.

Prolapsed hemorrhoids (hemorrhoids)

Prolapsed hemorrhoids can be seen in both internal and external hemorrhoids. With prolapsed hemorrhoids, the blood vessels stretch and bulge out of the anus. Bleeding and pain may occur.

Thrombosed hemorrhoids (hemorrhoids)

Thrombosed hemorrhoids, also known as clotted hemorrhoids, are one of the types of external hemorrhoids. Clots the size of a chickpea are formed due to bleeding in the cushion structures at the entrance to the anus. Within hours, these clots cause patients to feel severe pain. There is also stiffness, swelling and tightness.

In thrombosed hemorrhoids, patients feel very severe pain, especially in the first 2 to 3 days. This pain can prevent patients from sitting or even sleeping. Urgent intervention is required during this time. This intervention, which is performed under local anesthesia, takes 2 to 3 minutes and the clot is removed. Although it is an operation that does not require hospitalization, patients are provided to relax.

Patients who do not seek emergency care within the first 3 days are not subjected to surgical intervention. Instead, supportive intervention is used to dissolve the clot and relieve the pain.

Stages of hemorrhoids

When we talk about the stages of hemorrhoids, internal hemorrhoids should come to mind. Because internal hemorrhoids are divided into 4 stages.

Stage 1 hemorrhoids

Although this stage is the first stage of hemorrhoids, no findings are found during palpation. For this reason, anoscopy or rectoscopy imaging may be required during diagnosis.

Stage 1 hemorrhoids (hemorrhoids) symptoms

In this stage, hemorrhoids are seen at the level of the rectum in the last part of the large intestine. Hemorrhoids in the first stage may cause bleeding but do not go outside the anus.

Stage 2 hemorrhoids

In people with second stage hemorrhoids, hemorrhoid packets begin to come out of the anus. It is especially common after prolonged constipation, diarrhea and lifting heavy objects. However, the protrusion of the breasts is temporary. For this reason, after a while it retracts into the anus on its own.

Stage 2 hemorrhoids (hemorrhoids) symptoms

Patients with second stage hemorrhoids may occasionally complain of pain.

Stage 3 hemorrhoids

The most prominent feature of this stage is the hemorrhoid nozzles that come out after defecation. These nipples that come out of the anus can be pushed into the anus by the patient or the doctor.

3rd stage hemorrhoids (hemorrhoids) symptoms

At this stage, patients complain of pain and bleeding, as well as wetness in the anus. Patients may also experience itching.

Stage 4 hemorrhoids

In the fourth stage, which is the last stage of hemorrhoid disease, the hemorrhoid nozzles are completely outside. It does not enter the anus with manual pushing. During the examination, if the doctor does not see any other symptoms, a visual examination is sufficient. If the patient has severe pain during the examination, pushing the breasts back is not attempted.

Stage 4 hemorrhoids (hemorrhoids) symptoms

In this stage, all symptoms of hemorrhoids are observed.

What is good for hemorrhoid pain?

The methods that can help treat hemorrhoids differ according to the level of hemorrhoids. However, it is essential to lead an active lifestyle and consume foods rich in fiber. Apart from this, the methods that will be good for hemorrhoid pain include the following:

  • Consuming soup regularly
  • Drinking herbal tea in the morning on an empty stomach
  • Consuming carob
  • Regular consumption of yogurt
  • Consume plenty of vitamin-rich foods
  • Avoiding carbonated and fermented foods
  • Being at an ideal weight
  • Consume at least 8 glasses of water a day

Hemorrhoid bleeding

Although hemorrhoid bleeding causes patients to experience anxiety, it is not always a condition that requires medical intervention. However, if the bleeding is persistent, the blood is dark in color and patients experience severe pain, they should consult a doctor.

A high-fiber diet and sufficient water consumption during the day reduce the risk of bleeding due to hemorrhoids.

How many days does hemorrhoid bleeding last?

How long hemorrhoid bleeding lasts varies according to the characteristics of the patients. However, patients should see a doctor if the bleeding lasts longer than a week.

Is hemorrhoid bleeding harmful?

The bright red color of hemorrhoidal bleeding is usually nothing to be afraid of. In addition, patients are advised to consult a doctor immediately if bleeding continues for a long time, if they feel severe pain or if the blood is dark red in color.

Does the external hemorrhoid (hemorrhoid) breast go away on its own?

As long as there is no clotting and pain in external hemorrhoids, no special treatment is required. In a significant proportion of cases of external hemorrhoids, it heals spontaneously within a few days. However, if external hemorrhoids persist, patients may experience discomfort, pain and itching. In this case, it will be sufficient for patients to resort to some methods that they can apply at home. If clots develop in the external hemorrhoid, surgery may be recommended.

Hemorrhoids (hemorrhoids) nutrition

There is a close relationship between hemorrhoid disease and nutrition. For this reason, patients should pay attention to the foods they consume and do not consume in their diet. However, foods that are generally useful for hemorrhoids may not be good for some patients. For this reason, the doctor should be consulted and the relationship between nutrition and hemorrhoid complaints should be closely monitored. In general, the following are among the foods that are good for hemorrhoids:

  • Foods rich in vitamin A: these include watermelon, broccoli, peas, potatoes, pumpkin, carrots, leeks, grapefruit, melon and parsley.

  • Foods rich in vitamin B: citrus fruits, bananas, whole grains, barley, millet, turkey meat, tuna, avocados, beans and millet.

  • It is recommended to consume foods rich in vitamin C. However, this food should be consumed with caution by patients with rectal burning. These foods include lemons, raspberries, kiwi, strawberries, red and green peppers, pineapple, rose hips, lettuce, arugula, oranges, parsley.

  • Foods rich in vitamin E include anchovies, salmon, tuna, pumpkin, olive oil, beets, walnuts, hazelnuts, pumpkin seeds, sunflower seed oil and almonds.

  • The cereals recommended for patients to consume include wheat, oats, corn, bran and brown rice.

  • It is also recommended that patients eat dried fruits that are rich in fiber, such as raisins, dried apricots, prunes and sultanas.

  • Hemorrhoid patients should include fruit in their diet. It is recommended to consume fruits with the peel. Recommended fruits include apples, bananas, figs, peaches, melons, cherries, grapes, pears, apricots and plums.

  • Vegetables that should be included in the diet of hemorrhoids patients include lettuce, tomatoes, celery, cucumber, parsley, green peppers, mushrooms and onions.

What is a hemorrhoid cushion?

Hemorrhoid pillows in the form of donuts are frequently preferred by hemorrhoid patients. However, for most patients, using a hemorrhoid cushion is not the right decision. Because hemorrhoid cushions cannot provide enough support. Although these pillows relieve the pain and itching of patients with inflamed hemorrhoids for a short time, it is necessary to prefer sofas and beds where full support will be provided for rest.

Types of hemorrhoid pillows

The most commonly used type of hemorrhoid pillow is the donut-shaped one. These pillows, which look like the letter O and are empty in the middle, are also called ring pillows. The purpose of these pillows is to relieve the hemorrhoid area of the patients from pressure and thus relieve the patients. The hemorrhoid area remains empty due to the hollow center. However, the surrounding cushion tissue does not provide enough support for the hip.

Apart from donut-shaped pillows, there are also hemorrhoid pillows that look like normal pillows. These pillows gently support the hemorrhoid area and provide better support than donut pillows. However, it is not efficient enough on soft levels such as a sofa or a bed.

Who should not use a hemorrhoid pillow?

Hemorrhoid pillows can provide relief for some patients. However, it is not recommended for all hemorrhoid patients. Especially if there is hemorrhoidal prolapse, it causes patients to experience more problems in the long term. The healing process takes longer after using the pillow.

Will hemorrhoids go away on their own?

Hemorrhoids are usually a health problem that does not require any treatment and passes on its own. Bleeding and pain due to hemorrhoids can last up to a week. In case of these symptoms, the following methods can be tried.

  • Over-the-counter creams containing hydrocortisone and lidocaine can be applied to the affected area.
  • More water consumption is recommended.
  • Dietary fiber consumption should be increased. For this, it is recommended to consume at least 35 g of fiber during the day.
  • Warm sitz baths can be applied for 10-20 minutes a day.
  • Non-steroidal anti-inflammatory drugs can be used to relieve pain and inflammation.
  • Avoid hard blows when cleaning the anus after defecation. It is recommended to use wet wipes or wash with water.

What is a hemorrhoid eruption?

If a blood clot forms inside the hemorrhoid, the internal pressure increases and it thromboses. This excessive pressure causes the blood clot to burst and patients experience severe pain.

Burst hemorrhoids cause bright red blood to appear as a result of bowel movements. This condition is also called ruptured hemorrhoids. Symptoms of hemorrhoidal rupture are as follows:

  • Severe pain, swelling and irritation around the anus
  • Palpable painful swelling in the anal opening
  • Persistent rectal bleeding

The difference between hemorrhoids and anal fissure

Although both hemorrhoids and anal fissures have similar symptoms such as pain and itching, they are two different problems. Swollen veins cause hemorrhoids, while anal fissures are caused by tears in the lining of the anus.

What other conditions have symptoms similar to those of hemorrhoids?

Some gastrointestinal disorders can cause the symptoms of hemorrhoids. Some of these problems are extremely dangerous and life-threatening. Other health problems that may show symptoms similar to bleeding and other hemorrhoid symptoms include the following.

  • Colon cancer
  • Ulcerative colitis
  • Crohn's disease
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