Everyone has hemorrhoids! But not everyone has pain. When should you see your doc?

March 18, 2024 Swedish Health Team


In this article: 

  • Hemorrhoids are small veins around your anus. They keep your body from releasing stool and gas unintentionally.

  • Everyone has hemorrhoids. They are a normal part of the human body.

  • A colon and rectal surgeon answers common hemorrhoid-related questions and explains when it’s time to call your doctor.

Hemorrhoids may not be a “proper” conversation at the average dinner party, but there's a good chance that every adult at the table has personal experience with the topic.

“Hemorrhoids are actually a normal part of our anatomy,” says Lindsay A. Sceats, M.D., MS. “Everyone has hemorrhoids!”

Dr. Sceats is a colon and rectal surgeon at the Swedish Colon and Rectal Clinic. We talked to her to get answers to some of your most common hemorrhoid-related questions.

Q & A with Dr. Sceats

Q: What are hemorrhoids? What causes them? Where do they come from?

A: Hemorrhoids are small veins around the anus. There are hemorrhoids on the inside of the anus as well as on the outside. Their job is to keep us from leaking gas or stool when we don’t intend to.

That being said, when most people say, ‘I have hemorrhoids,’ they typically mean that they have hemorrhoids that are causing them problems. This happens when the hemorrhoids have become too swollen and full of blood. It is usually related to straining while on the toilet.

Q: Who is at increased risk of getting hemorrhoids?

A: Hemorrhoids become enlarged with repetitive straining. That means that any ongoing diarrhea or constipation can lead to hemorrhoid problems. Pregnancy, childbirth and even weightlifting are also common causes of worsening hemorrhoid symptoms because they are situations that result in straining or pushing.

Q: Are hemorrhoids a risk to your health? Can you damage your health if you ignore them?

A: Hemorrhoids are not typically dangerous. When internal hemorrhoids become enlarged, they can cause painless, bright red bleeding seen on the toilet paper, in the toilet bowl or on the stool itself. This can be alarming and is a reason why people come to their doctor for hemorrhoids. In rare cases, long-term bleeding from hemorrhoids can result in anemia. If you are noticing bright red bleeding with bowel movements, it is a good idea to be checked by a doctor to make sure there are no other, more dangerous, causes of bleeding.

External hemorrhoids may look like extra skin or tissue around the outside of the anus. These can become swollen, painful, and sometimes bleed. If there is a lot of excess skin, some people may find it hard to thoroughly cleanse themselves after a bowel movement. Many people are bothered by this extra tissue and come to see a colorectal surgeon to discuss surgery to remove it.

Q: When is it time to talk to your doctor?

A: If you notice recurrent bright red bleeding with bowel movements, it’s a good idea to see your doctor to get evaluated for hemorrhoids. Your doctor may order different tests to check for other causes of bleeding.

Consistent pain, aching or a dull pressure in the anal area during or after bowel movements are other symptoms that might prompt you to see your doctor.

If you develop severe pain and a swollen grape-like lump around your anus, you may have a thrombosed hemorrhoid, which means that a blood clot has formed in the hemorrhoid. You should see a doctor sooner rather than later if this happens, as we may be able to do procedures to help ease the pain, which is often quite severe.

Q: How can hemorrhoids be prevented?

A: The best way to prevent problems related to hemorrhoids is to improve the quality of your bowel movements to avoid straining. For many people, improving fiber and water intake can significantly reduce the symptoms they experience from their hemorrhoids.

Fiber acts as a sponge to hold water into the stool. Fiber helps bulk up stools that are too loose and boosts water retention in stools that are too hard. You should aim for about 25-30 grams of fiber per day. It can be hard to do this with a typical Western diet, which is why taking a fiber supplement is often helpful.

I tell my patients that water is equally as crucial as fiber. You want to poop out a wet sponge, not a dry sponge. It’s important to drink at least 64 ounces of water or non-caffeinated/non-alcoholic beverages per day.

It’s also important to limit toilet time as much as possible. Spend two minutes or less on the toilet. If you can’t go in that time period, get up and come back. No 30-minute marathons in the bathroom. There is a better time to finish a chapter book or check your stock accounts!

Q: How are hemorrhoids treated?

A: Treatment for hemorrhoids depends on how many symptoms they are causing and whether the hemorrhoids are internal or external.

For many people, increasing their fiber and water intake and decreasing the amount of time spent on the toilet can improve the symptoms they are experiencing. For internal hemorrhoids, we can perform office procedures such as rubber band ligation or sclerotherapy to decrease the amount of bleeding from hemorrhoids. For very large internal hemorrhoids or for external hemorrhoids, surgery may be the most effective treatment.

Your physician can help you determine the best care to address your individual needs.

Learn more and find a provider

Swedish offers a full range of procedures for hemorrhoids – from office-based procedures to surgeries to remove the hemorrhoids themselves or decrease their blood flow. Contact the Swedish Colon and Rectal Clinic for more information about our advanced care options.

Whether you require an in-person visit or want to consult a doctor virtually, you have options. Contact Swedish Primary Care to schedule an appointment with a primary care provider. You can also connect virtually with your provider to review your symptoms, provide instruction and follow up as needed. And with Swedish ExpressCare Virtual you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections and more. You can use our provider directory to find a specialist or primary care physician near you.

Information for patients and visitors

Related resources

Keep your colon healthy to help prevent disease

24 hours to better gut health

Nutrition is your secret weapon for good gut health

This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.

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