If you've recently discovered you have hemorrhoids, you're certainly not alone. Hemorrhoids affect approximately 50% of adults by the age of 50, making them one of the most common health concerns in Australia. Despite their prevalence, many people feel embarrassed to discuss hemorrhoids or seek treatment, often suffering in silence when effective relief is readily available.

This comprehensive guide will walk you through everything you need to know about hemorrhoids, from understanding what they are and why they develop, to exploring the full range of treatment options available to you. Whether you're dealing with your first hemorrhoid flare-up or looking for better management strategies, this information will empower you to take control of your comfort and health.

What Are Hemorrhoids?

Hemorrhoids, also known as piles, are swollen blood vessels located in and around the rectum and anus. Everyone has hemorrhoidal tissue as part of their normal anatomy, these cushions of tissue contain blood vessels, muscle, and elastic fibres. Problems arise when these tissues become swollen and inflamed, causing discomfort and other symptoms.

There are two main types of hemorrhoids, classified by their location:

• Internal hemorrhoids develop inside the rectum, above the dentate line. They typically cannot be seen or felt and usually don't cause pain because this area has few pain-sensing nerves. However, they may cause painless bleeding during bowel movements.
• External hemorrhoids form under the skin around the anus. Because this area has many pain-sensing nerves, external hemorrhoids can be quite painful, especially if a blood clot forms within them (thrombosed hemorrhoid).

Common Causes and Risk Factors

Understanding what causes hemorrhoids is the first step toward prevention and effective treatment. Hemorrhoids develop when there is increased pressure on the blood vessels in the rectal area. Several factors can contribute to this pressure:

Straining During Bowel Movements

The most common cause of hemorrhoids is straining during bowel movements. When you strain, you increase pressure in the veins of the rectum and anus. This is often linked to constipation, but it can also occur with chronic diarrhoea or spending too long sitting on the toilet.

Dietary Factors

A diet low in fibre can lead to hard, difficult-to-pass stools, increasing the likelihood of straining. Insufficient water intake compounds this problem by making stools even harder. Australians are recommended to consume 25-30 grams of fibre daily, but many fall short of this goal.

Pregnancy and Childbirth

Pregnancy increases the risk of hemorrhoids due to the growing uterus putting pressure on pelvic veins, hormonal changes that relax blood vessel walls, and the straining that occurs during childbirth. Many women develop hemorrhoids during their third trimester or during labour.

Sedentary Lifestyle

Prolonged sitting, whether at a desk job or during long commutes, can increase pressure on the rectal veins. Regular physical activity helps promote healthy bowel function and reduces hemorrhoid risk.

Recognising Hemorrhoid Symptoms

Hemorrhoid symptoms vary depending on the type and severity of the hemorrhoids. Being able to recognise these symptoms helps you seek appropriate treatment and know when to consult a healthcare professional.

Common Symptoms Include:

• Rectal bleeding: Bright red blood on toilet paper, in the toilet bowl, or coating the stool. This is the most common symptom of internal hemorrhoids.
• Itching and irritation: The anal area may feel itchy due to mucus secretion or skin irritation.
• Pain or discomfort: Especially with external hemorrhoids or thrombosed hemorrhoids.
• Swelling: A lump or swelling around the anus.
• Feeling of incomplete evacuation: A sensation that the bowel hasn't fully emptied.

Treatment Options Available

The good news is that most hemorrhoids can be effectively treated with over-the-counter remedies and lifestyle modifications. Here's an overview of the treatment options available:

Topical Treatments

Hemorrhoid creams, ointments, and suppositories are the first-line treatment for most people. These products contain various active ingredients that target different symptoms:

• Hydrocortisone: Reduces inflammation and itching
• Lidocaine: Provides local anaesthesia for pain relief
• Phenylephrine: Shrinks blood vessels to reduce swelling
• Witch hazel: Natural astringent with soothing properties

Home Remedies

Several home remedies can provide significant relief:

• Sitz baths: Sitting in warm water for 15-20 minutes several times daily
• Cold compresses: Can help reduce swelling of external hemorrhoids
• High-fibre diet: Softens stools and reduces straining
• Adequate hydration: Helps maintain soft, easy-to-pass stools

Medical Procedures

For hemorrhoids that don't respond to conservative treatment, several medical procedures are available:

• Rubber band ligation: A rubber band is placed around the base of an internal hemorrhoid to cut off its blood supply
• Sclerotherapy: A chemical solution is injected to shrink the hemorrhoid
• Infrared coagulation: Heat is used to shrink hemorrhoid tissue
• Hemorrhoidectomy: Surgical removal of severe hemorrhoids

When to Seek Medical Help

While most hemorrhoids can be managed at home, certain situations require professional medical attention. Consult a healthcare provider if you experience:

• Symptoms that persist beyond one week of home treatment
• Severe pain, especially with external hemorrhoids
• Heavy or persistent bleeding
• Signs of infection such as fever or pus
• Changes in bowel habits
• Any rectal bleeding if you're over 40

Taking the First Steps

If you're dealing with hemorrhoids for the first time, start with these practical steps:

1. Increase your fibre intake gradually to 25-30 grams daily
2. Drink at least 8 glasses of water per day
3. Use an over-the-counter hemorrhoid cream for symptom relief
4. Take warm sitz baths for 15-20 minutes, 2-3 times daily
5. Avoid straining during bowel movements
6. Don't delay when you feel the urge to go

Remember, hemorrhoids are a common, treatable condition. With the right approach, you can find relief and prevent future flare-ups. If you're unsure which treatment option is right for you, our product finder quiz can help you identify the best hemorrhoid cream for your specific symptoms.