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