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Internal Hemorrhoids: Understanding, Managing, and Finding Relief

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Hello there! As a gastroenterologist, I feel like I'm in a unique position to shed some light on a common condition that affects many individuals: hemorrhoids. Whether you're experiencing discomfort or seeking knowledge about this condition, this blog post aims to provide you with a comprehensive understanding of internal hemorrhoids; including their symptoms, underlying causes, and available treatment options. So, let's dive in!

What are Internal Hemorrhoids?

Hemorrhoids, also known as "piles", are swollen blood vessels located in the lower rectum or anus. They can cause discomfort, pain, and sometimes bleeding during bowel movements. Hemorrhoids can be internal, occurring inside the rectum, or external, forming around the anus.

Symptoms of Hemorrhoids:

  1. Itching or irritation around the anus

  2. Pain or discomfort during bowel movements

  3. Bleeding after passing stool (bright red blood on toilet paper or in the toilet bowl)

  4. Swelling or a lump near the anus

  5. Leakage of feces (in severe cases)

Pathophysiology of Hemorrhoids (or, "why do they happen?"):

Hemorrhoids develop due to increased pressure on the blood vessels in the rectum and anus. This increased pressure can be caused by various factors, including:

  1. Straining during bowel movements: Pushing too hard when passing stool can put excessive pressure on the blood vessels.

  2. Chronic constipation or diarrhea: Irregular bowel habits can contribute to the development of hemorrhoids by causing repeated stress on the rectal area.

  3. Prolonged sitting or standing: Spending long periods in a sitting or standing position can hinder proper blood circulation, leading to the formation of hemorrhoids.

  4. Obesity: Being overweight or obese increases the pressure on the veins in the lower rectum and anus, making hemorrhoids more likely to occur.

  5. Pregnancy: Hormonal changes and increased pressure on the pelvic region during pregnancy can cause hemorrhoids.

Treatment Options for Hemorrhoids (or, "How Do I Get Rid of Them?"):

1. Lifestyle Modifications:

  • Dietary changes: Including high-fiber foods (fruits, vegetables, whole grains) in your diet can soften stools, making them easier to pass and reducing strain on the rectal area.

  • Adequate hydration: Drinking plenty of water helps maintain soft stools, preventing constipation.

  • Regular exercise: Engaging in physical activity improves bowel function and helps regulate bowel movements.

  • Avoiding prolonged sitting or standing: Taking breaks and moving around can alleviate pressure on the rectal area.

2. Over-the-Counter (OTC) Medications:

  • Topical creams or ointments: These products contain ingredients that soothe the affected area, reducing itching and discomfort.

  • Oral pain relievers: Non-prescription pain relievers, such as acetaminophen or ibuprofen, can provide temporary relief from hemorrhoid-related pain.

3. Medical Procedures:

  • Rubber band ligation: My professional favorite. In this procedure, a small rubber band is placed around the base of an internal hemorrhoid, cutting off its blood supply. The hemorrhoid then shrinks and the extra tissue falls off typically within a week.

  • Sclerotherapy: A chemical solution is injected into the hemorrhoid, causing it to shrink over time.

  • Infrared coagulation: Heat is applied to the hemorrhoidal tissue, causing it to shrink and recede.

  • Hemorrhoidectomy: This surgical procedure involves the removal of hemorrhoids using a scalpel or laser. It is typically reserved for severe or recurring cases.


Hemorrhoids are a common condition that can cause discomfort, pain, and occasional bleeding during bowel movements. By understanding the symptoms and underlying causes of hemorrhoids, you can take steps to manage and alleviate the associated discomfort. Lifestyle modifications, such as increasing fiber intake, staying hydrated, and regular exercise, can play a significant role in preventing and managing hemorrhoids. Over-the-counter medications and medical procedures are also available for symptomatic relief and in more severe cases.

Remember, if you experience persistent or severe symptoms, it's essential to consult with a healthcare professional, such as Dr. Stuart Akerman, who can provide an accurate diagnosis and recommend appropriate treatment options. Dr. Akerman specializes in hemorrhoid treatment in Dallas, Plano, and Frisco, TX.

Stay informed, take care of your digestive health, and remember that you don't need to suffer from hemorrhoids.


DISCLAIMER: Please note that this blog is intended for Informational Use only and is not intended to replace personal evaluation and treatment by a medical provider. The information provided on this website is not intended as a substitute for medical advice or treatment. Please consult your doctor for any information related to your personal care.


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