Hemorrhoids
Hemorrhoids are swollen blood vessels in and around the anus and lower rectum. They are very common and can cause bright red bleeding, itching, discomfort, or a lump that bulges out. VidaVascular evaluates hemorrhoid symptoms and offers Hemorrhoid Artery Embolization (HAE), a minimally invasive, nonsurgical option for bleeding internal hemorrhoids that have not improved with conservative care.
Many people feel embarrassed to talk about hemorrhoids, so they put off getting help. Hemorrhoids are a normal part of anatomy that only become a problem when they swell or bleed, and there are many ways to treat them. This page explains the types of hemorrhoids, what symptoms to watch for, and how they are diagnosed and treated.
What are hemorrhoids?
Everyone has hemorrhoidal tissue. These cushions of blood vessels help with bowel control. Hemorrhoids become a problem when the tissue swells, stretches, or slips out of place (1).
- Internal hemorrhoids form inside the rectum. They are usually painless but often bleed, and they may prolapse (bulge out through the anus)
- External hemorrhoids form under the skin around the anus. They can itch or hurt, and a blood clot inside one (thrombosed hemorrhoid) can cause sudden, sharp pain
Internal hemorrhoids are often graded from I to IV based on how much they prolapse, which helps guide treatment.
What are the symptoms of hemorrhoids?
Common symptoms include:
- Bright red blood on toilet paper, on the stool, or in the toilet bowl
- Itching or irritation around the anus
- Discomfort, aching, or pain, especially when sitting
- A lump or swelling near the anus
- Tissue that bulges out during bowel movements and may go back in on its own or need to be pushed back
- Mucus leakage or a feeling of incomplete emptying
What causes hemorrhoids, and who is at risk?
Hemorrhoids are linked to increased pressure in the lower rectum (1). Common contributing factors include:
- Straining during bowel movements
- Chronic constipation or diarrhea
- Sitting on the toilet for long periods
- A low-fiber diet
- Pregnancy
- Aging, as supporting tissues weaken
- Heavy lifting
How are hemorrhoids diagnosed?
Diagnosis starts with a conversation about your symptoms and an exam. Your provider may recommend:
- A visual exam and a digital rectal exam
- Anoscopy, a quick in-office look inside the anal canal
- Colonoscopy or sigmoidoscopy in some cases, particularly with rectal bleeding, to rule out other causes
Rectal bleeding is not always caused by hemorrhoids. Conditions such as anal fissures, inflammatory bowel disease, polyps, and colorectal cancer can also cause bleeding, so it should always be evaluated.
What are the treatment options for hemorrhoids?
Most people start with conservative care and move to other options if symptoms continue (2):
- Diet and habit changes, such as more fiber and water, avoiding straining, and limiting time on the toilet
- Over-the-counter care, such as creams, stool softeners, and warm sitz baths
- Office procedures, such as rubber band ligation, sclerotherapy, or infrared coagulation
- Hemorrhoid Artery Embolization (HAE), a minimally invasive procedure that reduces blood flow to internal hemorrhoids through a small puncture in the wrist or groin, without cutting the anal tissue
- Surgery, such as hemorrhoidectomy, for large or severe hemorrhoids
HAE is generally best suited to bleeding internal hemorrhoids. It is not a good fit for every case, such as severe prolapse, external hemorrhoids, or anal fissures. Our team will explain whether it may fit your situation.
When to seek emergency care
Call 911 or go to the nearest emergency room if you have any of the following:
- Heavy rectal bleeding or bleeding that will not stop
- Dizziness, lightheadedness, or fainting with rectal bleeding
- Black, tarry, or maroon-colored stools
- Severe anal pain with fever
Why see VidaVascular for hemorrhoid symptoms?
If bleeding or discomfort keeps coming back despite home care, you deserve a clear explanation of your options. At VidaVascular, your evaluation is guided by our board-certified vascular and interventional radiologist and clinical team. We talk through your symptoms respectfully and privately, explain the options that make sense for you, including nonsurgical ones, and give you clear next steps.
Care is available at our offices in Oxon Hill, MD, Springfield, VA, and White Plains, MD.
Your VidaVascular Care Team
Your evaluation and treatment are guided by our board-certified vascular and interventional radiologist and clinical team.
Where to Get Care for Hemorrhoids
Choose the office that is most convenient for you. All locations share one phone number for scheduling.
Frequently Asked Questions About Hemorrhoids
Is rectal bleeding always from hemorrhoids?
No. Hemorrhoids are a common cause of bright red bleeding, but other conditions can cause bleeding too, including anal fissures, polyps, inflammatory bowel disease, and colorectal cancer. Any rectal bleeding should be checked by a healthcare provider.
Can hemorrhoids be treated without surgery?
Often, yes. Many people improve with diet changes and home care. Office procedures and Hemorrhoid Artery Embolization (HAE) are other nonsurgical options for some types of hemorrhoids. Our team will explain which options fit your situation.
Does insurance cover my visit?
VidaVascular accepts most major insurance providers. Coverage varies by plan and procedure, so please call us to confirm whether your specific plan is covered. Insurance information.
How do I schedule an appointment?
Call (866) 800-2346 or request an appointment online. Our offices are open Monday through Thursday, 8 AM to 5 PM, and Friday, 8 AM to 3 PM.
References
- Lohsiriwat, V. (2012). Hemorrhoids: From basic pathophysiology to clinical management. World Journal of Gastroenterology, 18(17), 2009–2017.
- Davis, B. R., Lee-Kong, S. A., Migaly, J., Feingold, D. L., & Steele, S. R. (2018). The American Society of Colon and Rectal Surgeons clinical practice guidelines for the management of hemorrhoids. Diseases of the Colon & Rectum, 61(3), 284–292.
Ready to Talk About Your Hemorrhoid Symptoms?
Schedule an evaluation with our team. We’ll explain your options clearly and help you decide what fits your goals.