Hemorrhoids are swollen blood vessels located in the anal canal or around the anus, resulting from the enlargement of anal cushions that help control bowel movements. They are fairly common and generally not harmful but can cause discomfort.

The main signs and symptoms of hemorrhoids include rectal bleeding, itching, and pain, and bleeding is typically bright red and painless. Symptoms can vary based on the type of hemorrhoid; external hemorrhoids are painful and visible, whereas internal hemorrhoids are often painless and not visible unless prolapsed.

Hemorrhoids are diagnosed through a physical exam, which may include an examination of the anus and rectum, a digital rectal exam, or the use of an endoscope for internal hemorrhoids. Internal hemorrhoids are graded based on their degree of prolapse, ranging from Grade I (painless swelling) to Grade IV (prolapsed and irreducible).

Initial treatment for hemorrhoids focuses on lifestyle changes to reduce constipation, such as increasing fiber and fluid intake, and over-the-counter creams and prescription medications can provide temporary relief. For more severe cases, nonsurgical and surgical options may be considered, though they carry risks of recurrence and pain.

Fiber supplementation, especially with psyllium, helps alleviate hemorrhoid symptoms and bleeding by softening the stool and reducing irritation. Similarly, bioflavonoid supplementation, particularly micronized purified flavonoid fraction, has been shown to effectively reduce bleeding and overall symptoms.

A high-fiber diet and adequate fluid intake are recommended for managing and preventing hemorrhoids. Although spicy foods have been associated with a higher risk, no causal link has been established.

Sitz baths are commonly recommended for hemorrhoids and offer soothing relief despite limited evidence for pain or healing benefits. Pelvic floor physiotherapy may help with recurrent hemorrhoids that are related to pelvic floor dysfunction.

Hemorrhoids are believed to occur when the connective tissues in the anal cushion weaken, leading to enlarged and displaced blood vessels, often due to increased abdominal pressure or shear forces.