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If you’re experiencing severe abdominal pain, fever, or heavy bleeding, call 911.

Hemorrhoids

Hemorrhoids Explained

Hemorrhoids are very common and can be internal (inside the rectum) or external (under the skin around the anus). Straining, constipation, pregnancy, prolonged sitting, and aging can contribute. Many people improve with conservative treatment, but persistent or severe symptoms may benefit from in-office procedures such as rubber band ligation (banding) or, more rarely, surgery.

Symptoms

Symptoms can range from small amounts of bright red blood on the toilet paper to painful swelling or tissue that protrudes during bowel movements.

Symptoms include:
Bright red blood on toilet paper or in the toilet bowl
Itching or irritation in the anal area
Pain or discomfort, especially when sitting or during bowel movements
A lump or swelling around the anus
Tissue that protrudes (prolapses) from the anus

When to call

Call the office if you have recurrent or persistent rectal bleeding, painful hemorrhoids, prolapsing tissue, or symptoms not relieved by home care.

Seek emergency care for heavy rectal bleeding, dizziness, fainting, or severe anal pain with fever or inability to pass stool or gas.

Evaluation & Tests
Management & Treatment

Evaluation aims to confirm hemorrhoids and rule out other causes of rectal bleeding. This may involve a visual and digital exam, anoscopy, and sometimes colonoscopy, especially if bleeding is unexplained or you are due for colon cancer screening.

Review of symptoms, bowel habits, and history of constipation or straining
Physical and rectal exam; anoscopy for internal hemorrhoids
Colonoscopy when age, risk factors, or symptoms suggest other causes
Assessment of severity and impact on quality of life

Treatment includes addressing constipation and straining, topical relief, and sitz baths. For persistent or significantly symptomatic internal hemorrhoids, rubber band ligation is a common and effective in-office procedure.

Increase fiber and fluids to soften stools and reduce straining
Sitz baths, topical creams, or suppositories for symptom relief
Rubber band ligation (banding) for appropriate internal hemorrhoids
Other procedures or surgery for large, recurrent, or complicated hemorrhoids
Long-term bowel habit changes to prevent recurrence
This information is for general educational purposes only and is not a diagnosis or personalized medical advice. It does not replace a visit with your own healthcare provider. Always follow the specific recommendations given by your medical team. If you have urgent or worsening symptoms, contact your provider or seek emergency care right away.

At-a-glance

Rectal bleeding

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Information on this website is for education only and not a substitute for medical advice.

If you’re experiencing an emergency, call 911.
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