What Are Hemorrhoids? Causes, Symptoms and Types
If you’ve just noticed bleeding, itching or a lump near your anus and typed “what are hemorrhoids” into your phone at midnight, you’re not alone — most adults will deal with this at some point. Hemorrhoids are swollen blood vessels in and around the anal canal. Everyone has these vascular cushions; the problem starts when they become enlarged and inflamed, usually from repeated straining or prolonged pressure.
Read this first if you’re bleeding. Hemorrhoids are the most common cause of bright red rectal bleeding, but they’re not the only cause. Colorectal cancer can produce the same symptom. If you have bleeding that hasn’t been examined by a doctor, a change in your bowel habits lasting more than a couple of weeks, unexplained weight loss, or a family history of bowel cancer, get it checked before assuming it’s “just hemorrhoids.”
What causes hemorrhoids
The anal cushions swell when pressure in that area builds up repeatedly. The usual drivers:
- Straining on the toilet — from constipation, or from sitting too long even when stool is soft
- Chronic constipation or diarrhea — both involve extra pressure and irritation
- Pregnancy and childbirth — increased pelvic pressure and hormonal changes
- Low-fiber diets — harder stool means more straining
- Sitting for long periods — desk jobs, long drives
- Heavy lifting — repeated Valsalva-type straining
- Aging — the tissue supporting the cushions weakens over time
Internal vs external hemorrhoids
The distinction is about location, and it changes what you’ll feel. Internal hemorrhoids form inside the rectum, above the point where pain nerves are dense, so they’re usually painless — the main sign is bright red blood on the paper or in the bowl. They can prolapse (push through the anus) in more advanced cases. External hemorrhoids form under the skin around the anus, where nerve endings are plentiful, so they’re the ones that hurt, itch and can swell into a visible lump. A hemorrhoid can also be a mix of both.
Common symptoms
| Symptom | More typical of |
|---|---|
| Painless bright red bleeding | Internal |
| A lump you can feel near the anus | External (or prolapsed internal) |
| Itching or irritation | External |
| Pain, especially sitting | External, or thrombosed |
| Mucus discharge | Internal, prolapsing |
| A hard, sudden, very painful lump | Thrombosed external — see a doctor promptly |
How hemorrhoids are graded
Doctors grade internal hemorrhoids I to IV based on how much they prolapse — grade I doesn’t prolapse at all, grade IV stays prolapsed permanently. The grade matters because it decides treatment: grade I–II usually responds to fiber, fluids and habit changes; grade III–IV generally needs a procedure. If you want the detail, see our full breakdown of hemorrhoid grades 1 to 4.
What actually helps
For most mild-to-moderate cases, the first-line approach is unglamorous and well-supported: more fiber, more water, less straining, less time on the toilet, and a warm sitz bath when it flares. That’s also the substance behind most over-the-counter programs and guides in this space — we go through one of the better-known ones in our Hemorrhoids Healing Protocol review, including who it actually suits and who should skip it.
Frequently Asked Questions
Are hemorrhoids dangerous?
Usually not, but they’re not something to self-diagnose indefinitely. Get any new rectal bleeding checked by a doctor at least once, so you know for certain what you’re dealing with.
Do hemorrhoids ever need surgery?
Most don’t. Surgery or banding is reserved for grade III–IV hemorrhoids or cases that haven’t responded to conservative measures — see our guide on hemorrhoid surgery cost and recovery for what that involves.
Can hemorrhoids go away without treatment?
Mild ones often settle down on their own once the triggering pressure eases, though they tend to recur if the underlying habits don’t change. We cover this in more depth separately.
What’s the difference between a hemorrhoid and a fissure?
They’re commonly confused because both cause pain and bleeding, but they’re different structures with different treatments. See hemorrhoids vs anal fissures.
Who is more likely to get hemorrhoids?
People who strain on the toilet regularly, sit for long stretches, are pregnant or postpartum, or eat a low-fiber diet are all at higher risk. Age also plays a role.
What to Read Next
- Internal vs External Hemorrhoids: The Difference
- Hemorrhoid Grades 1 to 4 Explained
- What Does a Hemorrhoid Look Like?
- More in Hemorrhoid Basics
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Sources and further reading
General background on hemorrhoids from public health sources:
