3 Out of 4 People Deal With Hemorrhoids—And Might Not Even Know It

Hemorrhoids sound scary. Scary enough that if you had them, you’d know—right? Not quite, says Niket Sonpal, MD, an internist and gastroenterologist in New York City. Forty percent of people with hemorrhoids have no symptoms at all. But what causes hemorrhoids and what it’s like to have them?

“Hemorrhoids are enlarged or swollen veins in the lower rectum. They are normal blood vessels which become aggravated and inflamed,” says Dr. Sonpal. “Hemorrhoids are common, occurring in both men and women. Although hemorrhoids do not usually cause serious health problems, they can be annoying and uncomfortable. The development of symptomatic hemorrhoids has been associated with advancing age, diarrhea, pregnancy, pelvic tumors, prolonged sitting, straining, and chronic constipation.”

In the United States, Dr. Sonpal says the most common cause of hemorrhoids is constipation and hard stools.

“The main reason why hemorrhoids are so common in the U.S. is primarily due to our diets,” he says. “The American diet is high in meat and low in fiber, which yields to constipation, straining, and long episodes of sitting in the bathroom.”

Foods that help you poop:

Dr. Sonpal says the most common symptoms of hemorrhoids can include painless rectal bleeding, anal itching, tissue bulging around the anus, and in some rare cases leakage of feces or difficulty cleaning after a bowel movement. “If severe pain occurs this may be a thrombosed hemorrhoid and a doctor should be seen immediately,” he says.

To diagnose hemorrhoids, your doctor will need to do a physical exam.

“Your doctor will examine your rectum and anus and may insert a gloved finger into the rectum,” says Dr. Sonpal. “If there is bleeding, testing should include a procedure that allows your healthcare provider to look inside the anus, called anoscopy, or colon, called sigmoidoscopy or colonoscopy.”

If you have hemorrhoids, changing what you eat can help.

“Initial treatment is with dietary management consisting of adequate oral fluid, stool softeners, and lots of fiber intake,” he says. “Fiber and more water is the best thing you can do right up front.”

Additionally, cooling products like sitz baths or the new Preparation H Soothing Relief Cleansing and Cooling Wipes ($16) and itch relievers like the Preparation H Soothing Relief Anti-Itch Cream ($7) can relieve discomfort. Dr. Sonpal says topical steroids can also help to shrink hemorrhoids.

“If these measures fail, there are endoscopic treatments like rubber band ligation or infrared treatment,” says Dr. Sonpal. “If this fails, then surgery may be needed.”

If you think you may have hemorrhoids, don’t hesitate to check in with your doctor.

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