Worried about your symptoms?
Start the Hemorrhoid test with our free AI Symptom Checker.
This will help us personalize your assessment.
By starting the symptom checker, you agree to the Privacy Policy and Terms of Use
Hemorrhoids
Painful anus
Bleeding from anus
Blood in stool
A lump at the anal opening
Rectal pain
Rectal bleeding
Not seeing your symptoms? No worries!
Commonly known as piles, hemorrhoids are swollen areas around the anus where feces are excreted from the body. They can form inside or outside the anus, often due to excessive straining or poor blood flow, and may result in painless bleeding.
Your doctor may ask these questions to check for this disease:
Piles can initially be treated with simple home remedies like increasing fiber intake and using sitz baths. Other options include creams, procedures like rubber band application, and surgeries.
Reviewed By:
Carlos Cuenca, MD (General Surgery)
Dr. Cuenca graduated from Rutgers New Jersey Medical School. He is currently a categorical surgical resident at UC Davis Health.
Aiko Yoshioka, MD (Gastroenterology)
Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.
Content updated on Mar 31, 2024
Following the Medical Content Editorial Policy
Was this page helpful?
We would love to help them too.
With a free 3-min Hemorrhoid quiz, powered by Ubie's AI and doctors, find possible causes of your symptoms.
This questionnaire is customized to your situation and symptoms, including the following personal information:
Biological Sex - helps us provide relevant suggestions for male vs. female conditions.
Age - adjusts our guidance based on any age-related health factors.
History - considers past illnesses, surgeries, family history, and lifestyle choices.
Your symptoms

Our AI

Your report

Your personal report will tell you
✔ When to see a doctor
✔︎ What causes your symptoms
✔︎ Treatment information etc.
See full list
Q.
Still Hurting? Why Hemorrhoids Persist and Medical Treatment Next Steps
A.
Persistent hemorrhoids often linger because the underlying drivers are still there, including constipation and straining, chronic diarrhea, prolonged sitting, pregnancy, large or thrombosed hemorrhoids, or misdiagnosis and incorrect self treatment; there are several factors to consider, so see below to understand more. Next steps range from fiber and hydration, sitz baths, short term topical relief, and better bathroom habits to office procedures like rubber band ligation, infrared coagulation, or sclerotherapy, with surgery for severe or recurrent cases; urgent signs like heavy or ongoing bleeding, black stools, severe pain, fever, weight loss, or no improvement after a week mean you should seek care promptly. See complete details below to choose the right path for you.
References:
* Jacobs D. Hemorrhoids. N Engl J Med. 2023 Apr 6;388(14):1314-1323. doi: 10.1056/NEJMcp2207010. PMID: 37018365.
* Rivard K, Padmanabhan A, Al-Hammadi H, Safar B, Lightner A, Steele SR, Rafferty JF. Clinical Practice Guidelines for Hemorrhoidal Disease: The American Society of Colon and Rectal Surgeons (ASCRS) Revised 2023. Dis Colon Rectum. 2024 Jan 1;67(1):15-32. doi: 10.1097/DCR.0000000000002951. PMID: 38101479.
* Alonso-Coello P, Castillejo MM, Garcia-Ruiz A. Advances in non-operative management of hemorrhoids. World J Gastroenterol. 2021 May 28;27(20):2568-2580. doi: 10.3748/wjg.v27.i20.2568. PMID: 34168434; PMCID: PMC8184519.
* Pescatori M, Stipa F. When conservative treatment fails: What's next for hemorrhoids? Tech Coloproctol. 2023 May;27(5):377-384. doi: 10.1007/s10151-023-02808-x. PMID: 37000305.
* Rubbini M, Rubbini M. Hemorrhoidal disease: A review of current management options. Acta Biomed. 2019 Apr 23;90(2):223-232. doi: 10.23750/abm.v90i2.7214. PMID: 31059432; PMCID: PMC6530058.
Q.
Rectal Pain? Why Your Body Has Hemorrhoids Symptoms & Medical Next Steps
A.
Rectal pain and hemorrhoid symptoms are common and treatable, usually caused by increased pressure from constipation, straining, pregnancy, low fiber, or prolonged sitting, and they often improve with fiber, fluids, sitz baths, and over the counter creams. There are several factors to consider, including red flags like new or heavy bleeding, severe or worsening pain, black stools, dizziness, or symptoms lasting more than a week, which need medical evaluation and may point to conditions other than hemorrhoids. See below for complete guidance on causes, home relief, when to see a doctor, and office or surgical treatments.
References:
* Agbo S, Nzeukou T. Hemorrhoids: Pathophysiology and medical treatment. World J Gastroenterol. 2023 Apr 14;29(14):2100-2108. doi: 10.3748/wjg.v29.i14.2100. PMID: 37190011; PMCID: PMC10167683.
* Gallo G, Martellucci J, Sturiale A, Clerico G, Curro G, Da Silva G, Di Tanna GL, Dodi G, El Zalabany T, Giuratrabocchetta S, Litta F, Pescatori M, Piccirillo V, Trompetto M, Valente M, Grossi U. Consensus statement of the Italian Society of Colorectal Surgery (SICCR): management of hemorrhoidal disease. Tech Coloproctol. 2020 Jan;24(1):15-22. doi: 10.1007/s10151-019-02130-y. Epub 2019 Nov 19. PMID: 31745771; PMCID: PMC6954209.
* Davis BR, Lee-Kong SA, Friel JC, Stewart DB, Fleshner PR, Mutch MG, Margolin DA. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Hemorrhoids. Dis Colon Rectum. 2018 Mar;61(3):284-292. doi: 10.1097/DCR.0000000000000938. PMID: 29420423.
* Jacobs D, Ambesh P, Kella D. Hemorrhoids: A review. World J Clin Cases. 2017 Nov 16;5(11):389-397. doi: 10.12998/wjcc.v5.i11.389. PMID: 29181404; PMCID: PMC5690989.
* Sneider EB, Maykel JA. Diagnosis and Management of Hemorrhoids. Surg Clin North Am. 2016 Oct;96(5):1123-33. doi: 10.1016/j.suc.2016.06.003. PMID: 27693903.
Q.
What Are Hemorrhoids? Why Your Body Is Hurting & Medically Approved Next Steps
A.
Hemorrhoids are swollen veins in the rectum or anus, internal or external, that commonly cause bright red bleeding, itching, swelling, and pain; they are usually not dangerous, but persistent, heavy, or unusual bleeding and severe pain need medical attention. Medically approved next steps include more fiber and fluids, avoiding straining, warm sitz baths, short-term OTC treatments, and if symptoms persist, office procedures or surgery; there are several factors to consider, including pregnancy, risks, and red flags, so see the complete guidance below to choose the right next steps.
References:
* Rivadeneira F, Esparza R, Rivadeneira A, et al. New Insights into Hemorrhoidal Disease. Diagnostics (Basel). 2021 Nov 3;11(11):2013. doi: 10.3390/diagnostics11112013. PMID: 34829373; PMCID: PMC8616788.
* Gaj MA, Gaj Z, Bartoń P, et al. Hemorrhoids - a disease with various therapeutic options: a narrative review. Ann Agric Environ Med. 2023 Jun 19;30(2):292-297. doi: 10.26444/aaem/165561. PMID: 37375685.
* Sanchez C, Chinn BT. Hemorrhoids: Diagnosis and Treatment. Clin Colon Rectal Surg. 2022 Mar;35(2):100-108. doi: 10.1055/s-0041-1736340. Epub 2022 Mar 23. PMID: 35345638; PMCID: PMC8944517.
* Altomare DF, Binda GA, Canuti M. Haemorrhoids: a review of their aetiology, symptomatology and treatment. Ann Gastroenterol. 2013;26(3):214-9. PMID: 23890947; PMCID: PMC3780360.
* Lohsiriwat V. Hemorrhoids: from basic pathophysiology to clinical management. World J Gastroenterol. 2012 May 7;18(17):2009-17. doi: 10.3748/wjg.v18.i17.2009. PMID: 22563187; PMCID: PMC3342595.
Q.
Preparation H Not Working? Why Your Hemorrhoids Persist + Medical Next Steps
A.
If Preparation H is not helping, there are several factors to consider: it relieves itching and swelling but does not fix root causes like constipation or straining, and ongoing symptoms can signal a higher grade or thrombosed hemorrhoid, incorrect use, or a different diagnosis. See below to understand more. Next steps range from 25 to 38 grams of daily fiber with good hydration, limiting toilet time and straining, and warm sitz baths, to medical treatments like prescription topicals or rubber band ligation, with urgent care for heavy or ongoing bleeding, severe pain, black stools, or new bleeding after 45. Important details that can guide your next move are outlined below.
References:
* Lohsiriwat V. Hemorrhoids: from management to prevention. World J Gastroenterol. 2012 May 7;18(17):2009-17. doi: 10.3748/wjg.v18.i17.2009. PMID: 22563187; PMCID: PMC3342594.
* Madoff RD, Fleshman JW, Becker JM, et al. American Society of Colon and Rectal Surgeons Clinical Practice Guideline for the Management of Hemorrhoids. Dis Colon Rectum. 2018 Mar;61(3):284-292. doi: 10.1097/DCR.0000000000000931. PMID: 29420422.
* Rubbini M, Neri A. Hemorrhoidectomy: a comprehensive review of current techniques and outcomes. Acta Biomed. 2019 Feb 19;90(1):159-172. doi: 10.23750/abm.v90i1.8152. PMID: 30860473; PMCID: PMC6503223.
* Davis BR, Lee-Kong SA. Hemorrhoids: An Update on Management. Curr Gastroenterol Rep. 2021 Jun 25;23(7):15. doi: 10.1007/s11894-021-00810-7. PMID: 34170366.
* Longo A, Barone M, Cincione I, Di Lena M, Iannello A, Cirocchi R, Arezzo A, Del Vecchio C. Updates on Clinical Practice Guidelines for Hemorrhoids: A Systematic Review. Front Surg. 2022 Jul 26;9:925828. doi: 10.3389/fsurg.2022.925828. PMID: 35957138; PMCID: PMC9361730.
Q.
Hemorrhoid Pain? Why It Won’t Heal & Medically Approved Next Steps
A.
There are several factors to consider: hemorrhoid pain that is not healing is usually driven by ongoing straining or constipation, chronic diarrhea, a thrombosed or prolapsed hemorrhoid, persistent irritation, or a different diagnosis, and although many settle within days to a few weeks, others require specific treatment. Medically approved next steps include more fiber and fluids, brief toilet time, warm sitz baths, short courses of topical creams, better bathroom habits, and NSAIDs if appropriate, with prompt medical review for heavy bleeding, severe or lasting pain, fever, black stools, or no improvement after 1 to 2 weeks; see below for complete details and procedure options that may change your next steps.
References:
* Mott T, Latimer K, Edwards C. Hemorrhoids: Diagnosis and Management. Am Fam Physician. 2018 Feb 1;97(3):172-179. PMID: 29431940.
* Davis BR, Lee-Kong SA. Hemorrhoids: An Overview of the Current Guidelines and the Latest Management. Clin Colon Rectal Surg. 2018 Sep;31(5):346-352. doi: 10.1055/s-0038-1667104. Epub 2018 Sep 12. PMID: 30206410; PMCID: PMC6128033.
* Sun Z, Migaly J. Review of Hemorrhoid Disease: Presentation and Management. Clin Colon Rectal Surg. 2019 Nov;32(6):443-449. doi: 10.1055/s-0039-1694765. Epub 2019 Nov 20. PMID: 31777412; PMCID: PMC6875883.
* Rakinic J, Sirianni A. Hemorrhoids. Clin Colon Rectal Surg. 2021 Mar;34(2):80-87. doi: 10.1055/s-0041-1726053. Epub 2021 Mar 22. PMID: 33767606; PMCID: PMC8004193.
* Gallo G, Monteforte P, Pescatori M, Di Tanna GL, Piloni V. The Italian Society of Colorectal Surgery (SICCR) consensus statement on the management of hemorrhoidal disease. Tech Coloproctol. 2023 Apr;27(4):259-270. doi: 10.1007/s10151-023-02758-1. Epub 2023 Feb 11. PMID: 36767931; PMCID: PMC9919532.
Q.
Sitting on Glass? Why Your Hemorrhoids Swell & Steps to Heal
A.
Hemorrhoids swell when pressure builds in rectal veins from straining, constipation or diarrhea, prolonged sitting on the toilet, pregnancy, obesity, aging, or heavy lifting, and the sharp “sitting on glass” pain often comes from an inflamed or thrombosed external hemorrhoid. Most improve with fiber and hydration to soften stool, limiting toilet time, warm sitz baths, short-term topical relief, gentle hygiene, and reducing sitting pressure with regular activity; there are several factors to consider, so see below for key red flags that may change your next steps and the in-office treatments available if home care does not help.
References:
* Menteş BB, Yılmaz G, Menteş A. Current Insights in Hemorrhoidal Disease Management. J Clin Med. 2022 Nov 22;11(23):6911. doi: 10.3390/jcm11236911. PMID: 36498616; PMCID: PMC9738914.
* Jacobs D, Amodeo L, Khoury T, Grewal R. Hemorrhoids: An Updated Overview. Dig Dis Sci. 2021 Nov;66(11):3799-3807. doi: 10.1007/s10620-021-06977-z. Epub 2021 Apr 19. PMID: 33876307.
* Gallo G, Valerio M, Bottini C, Sturiale A, Clerico G, Magrini S, Bianco F, Sforza D, Pescatori M, Trompetto M. Hemorrhoidal disease: From basic proctology to new clinical approaches. World J Gastroenterol. 2020 Nov 28;26(44):6919-6931. doi: 10.3748/wjg.v26.i44.6919. PMID: 33328795; PMCID: PMC7711478.
* Pigot F. Treatment Options for Hemorrhoidal Disease: A Review. J Clin Med. 2022 Oct 13;11(20):6046. doi: 10.3390/jcm11206046. PMID: 36294371; PMCID: PMC9606456.
* Quijano M, Ruiz-Tovar J, Die Trill M. Hemorrhoidal disease: current concepts. Cir Esp. 2015 Mar;93(3):149-55. doi: 10.1016/j.ciresp.2014.07.016. Epub 2014 Sep 10. PMID: 25217462.
Q.
Hemorrhoids in Women: Relief, Causes & Your Vital Next Steps
A.
Hemorrhoids are swollen veins in the rectum or anus that are especially common in women during pregnancy, after vaginal delivery, and with constipation or straining, with other contributors like low fiber, prolonged sitting, and aging. Most cases improve with fiber and hydration, avoiding straining and long toilet time, warm sitz baths, cold compresses, and short-term over the counter creams or suppositories. Rectal bleeding should never be ignored, so seek care for heavy or persistent bleeding, severe pain, or symptoms that do not improve, especially if you are over 45 or have a family history of colon cancer; there are several factors to consider, and the complete next steps and important details are outlined below.
References:
* Ismaeel A, Al-Thani H, Al-Thani M, et al. Hemorrhoids during pregnancy: Pathophysiology, prevalence, and management considerations. BMC Gastroenterol. 2023 Feb 1;23(1):31. doi: 10.1186/s12876-023-02640-5. PMID: 36725946; PMCID: PMC9892900.
* Lohsiriwat V. Risk factors for symptomatic hemorrhoids: A systematic review and meta-analysis. Ann Coloproctol. 2021 Feb;37(1):1-12. doi: 10.3393/ac.2020.00685.0007. Epub 2021 Feb 28. PMID: 33621931; PMCID: PMC7931327.
* Garg P, Singh P, Garg M. Hemorrhoids: An Updated Review on Etiopathogenesis, Diagnosis, and Management. Ann Coloproctol. 2023 Dec;39(6):639-650. doi: 10.3393/ac.2023.00445. PMID: 38167389; PMCID: PMC10762397.
* Giani S, Zampino MG, D'Orazio B. Management of Hemorrhoids. JAMA. 2024 Jan 16;331(3):266. doi: 10.1001/jama.2023.23847. PMID: 38227092.
* Chang L, Tang B, Yang C, et al. Nonsurgical Treatment for Hemorrhoids. Clin Colon Rectal Surg. 2017 Dec;30(5):343-349. doi: 10.1055/s-0037-1606132. PMID: 29184518; PMCID: PMC5701880.
Q.
When to see a doctor for hemorrhoids?
A.
Mild hemorrhoids often improve with home care, but see a doctor if you have heavy or recurrent bleeding, severe pain that doesn’t respond to treatment, a non‑reducible or very tender lump, fever or pus, dizziness/shortness of breath, a change in bowel habits, or symptoms lasting more than 7–10 days. People over 40–50 or with anemia, unexplained weight loss, a family history of colon cancer, liver disease, use of blood thinners, or immunosuppression should be evaluated sooner—there are several factors to consider; see details below to guide your next steps.
References:
Practice Parameters Committee of the American College of Gastroenterology. (2003). American College of Gastroenterology practice guidelines on the manag… Am J Gastroenterol, 12916420.
Castera L, Forns X, & Alberti A. (2008). Non-invasive evaluation of liver fibrosis using transient elast… J Hepatol, 18280353.
D'Amico G, Garcia-Tsao G, & Pagliaro L. (2006). Natural history and prognostic indicators of survival in cirrhosis: a systematic… Hepatology, 16805403.
Q.
What do hemorrhoids look like and what are the causes?
A.
Hemorrhoids are swollen veins in the rectum or anus, often caused by straining during bowel movements, constipation, or prolonged sitting.
References:
Oberi IA, Omar Y, Alfaifi AJ, Ayoub RA, Ajeebi Y, Moafa SH, et al. (2023). Prevalence of Hemorrhoids and Their Risk Factors Among .... Cureus, 37885500.
https://pubmed.ncbi.nlm.nih.gov/37885500/
Shafik A. (1981). Urethral discharge, constipation, and hemorrhoids. New .... Urology, 7269018.
https://pubmed.ncbi.nlm.nih.gov/7269018/
Quijano CE, & Abalos E. (2005). Conservative Management of Symptomatic and/or .... The Cochrane database of systematic reviews, 16034920.
Our symptom checker AI is continuously refined with input from experienced physicians, empowering them to make more accurate diagnoses.

“World’s Best Digital
Health Companies”
Newsweek 2024

“Best With AI”
Google Play Best of 2023

“Best in Class”
Digital Health Awards 2023 (Quarterfinalist)

Which is the best Symptom Checker?
Ubie’s symptom checker demonstrated a Top-10 hit accuracy of 71.6%, surpassing the performance of several leading symptom checkers in the market, which averaged around 60% accuracy in similar assessments.
Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Lohsiriwat V. Treatment of hemorrhoids: A coloproctologist's view. World J Gastroenterol. 2015 Aug 21;21(31):9245-52. doi: 10.3748/wjg.v21.i31.9245. PMID: 26309351; PMCID: PMC4541377.
https://www.wjgnet.com/1007-9327/full/v21/i31/9245.htmTalaie R, Torkian P, Moghadam AD, Tradi F, Vidal V, Sapoval M, Golzarian J. Hemorrhoid embolization: A review of current evidences. Diagn Interv Imaging. 2022 Jan;103(1):3-11. doi: 10.1016/j.diii.2021.07.001. Epub 2021 Aug 27. PMID: 34456172.
https://www.sciencedirect.com/science/article/abs/pii/S2211568421001704?via%3Dihub