Nine out of ten people living in the United States will get hemorrhoids at some time in their lives; five out of ten people develop them sometime before their fiftieth birthday. The person suffering from hemorrhoids, or piles as they are sometimes called, will notice the symptoms long before a physician finds them during a routine physical.

Perhaps the patient will find bright red blood in his stool, in the toilet, or on the toilet paper. The toilet paper and his underwear may show signs of mucous excretions. He may squirm when seated because of anal itching, burning, or pain. He might feel a sensitive lump of swollen tissue around the anal opening.

Hemorrhoids can be internal or external. Internal hemorrhoids can not be seen because they are in the upper portion of the anal canal or further up in the rectum, the last eight inches of the intestine. Their presence is often detected by mucous and blood excreted during bowel movements. External hemorrhoids can be seen through a physical exam. They appear as bluish-colored hard lumps around the anal opening. The bluish tinge is from the swollen varicose veins that supply blood to the hemorrhoids. When a hemorrhoid is irritated, the hue will become dull red.

Pregnant women and the elderly can be prone to develop hemorrhoids. People who do not exercise regularly, sit for long periods of time, engage in anal intercourse, or have long-term diarrhea or constipation can also get hemorrhoids.

Hemorrhoids are classified into four levels of severity. First degree hemorrhoids have not prolapsed, or been forced out of the rectum by the strain of a bowel movement. Their presence is indicated by mucous or blood. A second degree hemorrhoid has prolapsed but retracts back into the rectum by itself. Third degree hemorrhoids are prolapsed and must be manually pushed back into the anal cavity. Fourth degree hemorrhoids involve prolapsed tissue which can not be pushed back. A blood clot, or thrombosis, may develop or the hemorrhoid may become strangulated.

Physicians recommend home treatments in all but the most severe cases. Using ice packs, taking acetaminophen or aspirin, and soaking in warm water for ten minutes at a time several times a day reduces swelling. During bowel movements, every effort should be made to refrain from straining. Afterward, thoroughly clean the anal area with medicated pads or damp toilet paper. Pat the area; do not rub or wipe. Apply petroleum jelly and topical creams to prevent mucous from irritating the hemorrhoid. Wear loose fitting clothing and cotton underwear. Reduce constipation by taking stool softening pills or water soluble fiber supplements. Lifestyle changes should be made to prevent hemorrhoids from reoccurring. Increase dietary fiber and fluids, especially water, exercise, and take off excess weight.

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