About this condition
Haemorrhoidal disease involves enlarged vascular cushions inside the anal canal or externally. It can cause bleeding, itching, a feeling of lumps or discomfort, but similar symptoms are not always due to haemorrhoids.
What you should know
Internal and external haemorrhoids differ in location and presentation. Painless bright bleeding is more typical of internal disease; a painful external lump may be thrombosed. Constipation, straining and spending a long time on the toilet can contribute.
Symptoms and reasons for assessment
Symptoms may include bright-red blood after a bowel movement, itching, mucus, protruding tissue and discomfort. Internal haemorrhoids can prolapse without marked pain. Heavy bleeding or a change in bowel habits merits further assessment.
Other possible explanations
Anal fissures, inflammation, rectal polyps and other bowel disorders may also cause bleeding and pain. Even when haemorrhoids are found, the clinician must consider whether they explain all symptoms. Online self-diagnosis is unreliable.
How the condition is assessed
Assessment includes a history and inspection, with digital rectal examination and anoscopy where appropriate. Family history, age, repeated bleeding or altered bowel habits may prompt examination of the large bowel.
Treatment and follow-up options
Common first steps include sufficient dietary fibre and fluid and avoiding straining. Depending on the findings, local medication, outpatient procedures or surgery may be considered. Banding, laser and other techniques are not the best option for every case.
When urgent care is needed
Heavy or persistent bleeding, large clots, dizziness or fainting require emergency assessment. Increasing pain with fever may indicate infection rather than uncomplicated haemorrhoids. Call 103 for a life-threatening situation.
Related health information
Bleeding during bowel movements; Lump near the anus; Anal fissure.
Signs and symptoms
Diagnosis and tests
Care and treatment approaches
When to seek urgent care
Frequently asked questions
Can haemorrhoids be cured using only ointment?
Ointments may ease symptoms, but treatment depends on the type and severity found at examination.
Does existing haemorrhoidal disease explain all rectal bleeding?
No. The presence of haemorrhoids does not prove that they are the source of blood.
Does everyone need laser treatment or surgery?
No. Conservative care is often considered first, while procedures have specific indications.
Information sources
Medical source links used when preparing this article.
Important information
A medical consultation is needed for diagnosis and treatment recommendations.
Self-treatment can be harmful to your health.
