Hemorrhoids are remarkably common — nearly three-quarters of adults will deal with them at some point — yet they’re a condition many people are reluctant to talk about with their doctor. The result? Unnecessary discomfort and, occasionally, delayed diagnosis of something more serious. Let’s clear the air.
What Are Hemorrhoids?
Think of hemorrhoids as small cushions of tissue and blood vessels inside and around your anal canal. Everyone has them — they’re a normal part of your body. They only become a problem when they get swollen, irritated, or start to bleed.
There are two types:
Internal hemorrhoids form inside your rectum (the end of your digestive tract).
You usually can’t see or feel them, and they’re often painless. Sometimes they can
slip outside the body — doctors call this “prolapse.” There are four levels, from
mild (just a little swollen) to severe (permanently sticking out).
External hemorrhoids form just outside your anal opening, under the skin. This
skin has a lot of nerve endings, which is why external hemorrhoids can be
painful, itchy, and uncomfortable. Sometimes a blood clot can form inside one,
causing sudden, sharp pain.
Most Common Causes and Risk Factors
Hemorrhoids flare up when there’s too much pressure on the blood vessels in your lower digestive tract.
The most common reasons this happens:
- Straining hard when you have a bowel movement
- Being constipated (hard stools) or having frequent diarrhea
- Sitting on the toilet for a long time
- Not eating enough fiber or drinking enough water
- Being pregnant (the baby puts pressure on those blood vessels)
- Being overweight
- Getting older (the tissue weakens over time — most common in people ages 45–65)
- Lifting heavy objects regularly
- A family history of hemorrhoids
Home Treatments That Actually Help
The good news is that most mild hemorrhoids can be managed at home. Here’s what actually works:
Eat more fiber. This is the single most effective thing you can do. Fiber softens your stool so you don’t have to strain. Aim for 25–35 grams per day. Good sources include fruits, vegetables, beans, oats, and fiber supplements like Metamucil or Citrucel.
Drink more water. 6–8 glasses a day helps fiber do its job and keeps stools soft.
Take warm sitz baths. Sit in a few inches of warm water in your tub (or a special sitz bath basin) for 10–15 minutes, 2–3 times a day. This relaxes the muscles, eases pain, and reduces swelling.
Use over-the-counter creams or pads. Products with hydrocortisone or witch hazel (like Preparation H or Tucks pads) can help with itching and swelling. Don’t use steroid creams for more than one week at a time — they can thin the skin.
Try a stool softener. Products like Colace can make bowel movements easier during a flare-up.
Don’t sit on the toilet too long. Keep bathroom visits under 5 minutes. Sitting too long increases pressure.
What Does NOT Work (and Why)
Harsh wiping. Scrubbing with dry toilet paper makes things worse. Use moist, alcohol-free wipes or a bidet instead.
Most “miracle cure” supplements. Many products are heavily marketed but have little real proof behind them. Don’t waste money on anything that promises to “eliminate” hemorrhoids fast.
Essential oils or home remedies like apple cider vinegar. Putting these on sensitive skin around your bottom can cause painful burns and irritation. Avoid them.
Ignoring the problem. Hemorrhoids don’t just disappear on their own — especially if you’re still straining or eating a low-fiber diet. Without changing the habits that caused them, symptoms will keep coming back or get worse.
When to See a Doctor
Don’t wait too long to make an appointment. You should be evaluated by a physician if you notice:
Any rectal bleeding — even a small amount of blood on the toilet paper or in the bowl. This should never be assumed to be “just hemorrhoids” without a doctor checking.
Tissue that sticks out and won’t go back in on its own
Sudden severe pain — this can mean a blood clot has formed, which may need to be treated quickly
Symptoms that don’t improve after one week of home treatment
Feeling unusually tired or weak — ongoing bleeding can cause anemia (low iron), which drains your energy
Any new symptoms if you’re 45 or older — bleeding or changes in your bowel habits at this age should always be checked out to rule out colon cancer
Office-Based Treatments at Palmetto GI
Most hemorrhoids — even moderate to severe ones — can be treated right in the office. No hospital stay or general anesthesia needed.
Rubber band ligation (most common): A tiny rubber band is placed around the base of the hemorrhoid. It cuts off the blood supply, and the hemorrhoid shrinks and falls off within about a week. This works for most people and has about an 80% success rate. You might feel some pressure or mild discomfort, but it’s usually quick.
Sclerotherapy (injection): A doctor injects a small amount of a chemical solution directly into the hemorrhoid, causing it to shrink. It’s nearly painless and a good option if you’re on blood thinners or have smaller hemorrhoids.
Infrared coagulation: A small probe uses heat to shrink the hemorrhoid. Quick, with very little discomfort. Best for smaller internal hemorrhoids.
Surgery (for the most severe cases): If office treatments haven’t worked, or if hemorrhoids are very large, surgery may be needed. Recovery takes 1–3 weeks. This is only recommended when other options have been exhausted.
Why You Should Never Assume Rectal Bleeding Is "Just Hemorrhoids"
This is the most important point of all.
Seeing blood when you go to the bathroom can be alarming — and your first instinct might be to brush it off as hemorrhoids. But rectal bleeding is a symptom, not a diagnosis. Several serious conditions can cause the exact same symptom, including:
- Colon cancer (one of the most common cancers in the U.S. — often causes rectal bleeding before any other symptoms appear)
- Precancerous polyps (growths that can be removed before they ever turn into cancer — but only if found in time)
- Anal fissures (small tears that need a different treatment than hemorrhoids)
- Inflammatory bowel disease like Crohn’s or colitis
- Anal cancer
A GI doctor can tell the difference with a simple exam. The danger is assuming it’s nothing and waiting — because with colon cancer, finding it early makes an enormous difference in treatment and survival.
Bottom line: if you see blood, get it checked. It’s a quick visit that could save your life.
Schedule your colonoscopy
Rectal bleeding or persistent discomfort should always be evaluated by a professional. Dr. Derek Feussner at Palmetto GI specializes in hemorrhoid evaluation and treatment. Schedule a consultation — it’s more straightforward than you think.
