What Are Hemorrhoids? (Ultimate Guide 2025)
What Are Hemorrhoids? Your Complete 2025 Guide
Hemorrhoids, also known as piles, are swollen and inflamed veins in the lower rectum and anus. They’re one of the most common medical conditions worldwide — affecting an estimated 75% of adults at some point in their lives.
Despite how common they are, many people suffer in silence due to embarrassment. But here’s the truth: hemorrhoids are not a sign of poor hygiene or moral failure — they’re a normal anatomical response to pressure.
This guide will explain:
- What hemorrhoids really are (anatomy included)
- The 3 main types — and how to tell them apart
- What causes them (it’s not just toilet habits)
- Who’s at risk — and why
- How to know if it’s hemorrhoids or something more serious
- Prevention and when to see a doctor
Anatomy: Where Hemorrhoids Form
Your body has a network of blood vessels around the anus and lower rectum called “hemorrhoidal plexus.” These vessels help with stool control and cushioning during bowel movements.
When pressure increases — from straining, pregnancy, or prolonged sitting — these veins can stretch, bulge, or swell. That’s when they become “hemorrhoids.”
📍 Internal hemorrhoids: Form above the dentate line (inside the rectum) — usually painless.
📍 External hemorrhoids: Form below the dentate line (under the skin) — often painful.
📍 Thrombosed hemorrhoids: A blood clot forms inside — sudden, severe pain.
📌 Note: Everyone has hemorrhoidal tissue — it only becomes a “hemorrhoid” when it’s swollen or symptomatic.
The 3 Types of Hemorrhoids (With Symptoms)
1. Internal Hemorrhoids
Located inside the rectum. Often painless because there are few pain-sensing nerves here.
Symptoms:
- Bright red blood on toilet paper or in the bowl
- Prolapse (tissue that bulges out during bowel movements — may retract on its own or need to be pushed back)
- Feeling of fullness or pressure
Grading (Goligher System):
- Grade I: No prolapse — just bleeding
- Grade II: Prolapses during straining, but retracts on its own
- Grade III: Prolapses and must be pushed back manually
- Grade IV: Permanently prolapsed — cannot be pushed back
2. External Hemorrhoids
Located under the skin around the anus. Painful because this area is rich in nerve endings.
Symptoms:
- Pain or discomfort, especially when sitting
- Itching or irritation
- Swelling or lump near the anus
- Bleeding (less common than internal)
3. Thrombosed Hemorrhoids
A blood clot forms inside an external hemorrhoid. This is the most painful type.
Symptoms:
- Sudden, severe pain
- Hard, bluish lump near the anus
- Swelling and inflammation
- May rupture and bleed
🚨 Seek immediate care if: You have severe pain + a hard lump — it may need drainage. Don’t try to pop it yourself.
What Causes Hemorrhoids? (It’s Not Just Toilet Time)
Many people think hemorrhoids are caused by sitting too long on the toilet — and while that can contribute, it’s rarely the only cause.
Common Causes:
- Straining during bowel movements (due to constipation or hard stools)
- Chronic diarrhea (frequent bowel movements irritate the area)
- Pregnancy (increased pressure from the uterus + hormonal changes)
- Obesity (extra abdominal pressure)
- Heavy lifting (increases intra-abdominal pressure)
- Low-fiber diet (leads to harder stools → more straining)
- Prolonged sitting (office jobs, long drives)
- Age (tissues weaken over time)
- Genetics (some people inherit weaker vein walls)
📌 Myth Buster: Spicy food does NOT cause hemorrhoids — but it can irritate existing ones.
Who Gets Hemorrhoids? (Risk Factors)
Hemorrhoids can affect anyone — but some groups are at higher risk:
| Group | Why |
|---|---|
| Pregnant women | Uterine pressure + progesterone relaxing veins |
| Adults 45–65 | Weaker supportive tissues |
| Office workers / drivers | Prolonged sitting |
| Weightlifters / laborers | Frequent straining |
| People with chronic constipation | Straining damages veins |
| Those with low-fiber diets | Hard stools → straining |
Hemorrhoids vs. Other Conditions
Rectal bleeding or pain doesn’t always mean hemorrhoids. It could be:
- Anal fissure — a small tear in the lining (sharp pain during bowel movements)
- Anal fistula — an infected tunnel from the anus to the skin (pus, swelling)
- Colorectal cancer — persistent bleeding, weight loss, change in bowel habits
- Proctitis — inflammation of the rectum (often from IBD or infection)
🚨 Red Flags — See a Doctor Immediately If You Have:
- Dark red or black stool (may indicate upper GI bleed)
- Unexplained weight loss
- Persistent bleeding for >1 week
- Lump that doesn’t go away
- Family history of colorectal cancer
Can Hemorrhoids Go Away on Their Own?
Yes — mild hemorrhoids often resolve within a few days to a week with:
- Increased fiber and water intake
- Sitz baths
- OTC creams or suppositories
- Avoiding straining
But: If they’re Grade III/IV or thrombosed — they may need medical intervention.
✅ Tip: Start with conservative treatment for 7 days. If no improvement — consult a doctor.
Prevention: How to Avoid Hemorrhoids
You can’t always prevent them — but you can drastically reduce your risk:
- Eat 25–35g of fiber daily (fruits, veggies, whole grains, psyllium)
- Drink 8+ glasses of water (softens stool)
- Don’t delay bowel movements (ignoring urges leads to harder stool)
- Avoid straining (if it doesn’t come easily, get up and try later)
- Exercise regularly (even walking 30 min/day helps)
- Avoid prolonged sitting (get up every 30–60 min)
- Use a footstool (squatting position reduces straining)
When to See a Doctor
Don’t suffer in silence. See a healthcare provider if:
- Bleeding lasts more than a week
- Pain interferes with daily life
- You feel a lump that won’t go away
- You’re over 45 and have new rectal bleeding (to rule out cancer)
- Home treatments aren’t working
💡 Pro tip: Ask for a proctologist or colorectal surgeon — they specialize in this area.
FAQs About Hemorrhoids
Are hemorrhoids contagious?
No. Hemorrhoids are swollen blood vessels — not caused by viruses or bacteria. You cannot catch them from toilet seats, towels, or other people.
Can hemorrhoids turn into cancer?
No — hemorrhoids do not become cancerous. However, rectal bleeding can be a symptom of colorectal cancer. Never ignore persistent bleeding, especially if you’re over 45 or have a family history.
Can you pop a hemorrhoid?
No — and you should never try. Popping can cause infection, severe bleeding, or scarring. Thrombosed hemorrhoids should be drained by a doctor in sterile conditions.
Do only older people get hemorrhoids?
No — while more common after 45, young adults and even teenagers can get them, especially with constipation, pregnancy, or heavy lifting.
Can stress cause hemorrhoids?
Indirectly — stress can lead to constipation or diarrhea, which can trigger hemorrhoids. Stress also causes muscle tension, including in the pelvic floor.
Are hemorrhoids dangerous?
Rarely. Most are harmless and resolve on their own. But severe bleeding can lead to anemia, and thrombosed hemorrhoids can cause intense pain requiring urgent care.
Can I exercise with hemorrhoids?
Yes — walking, swimming, and yoga are great. Avoid heavy lifting or cycling (pressure on the area) until symptoms improve.
Key Takeaways
- Hemorrhoids are swollen veins — not a moral failing or hygiene issue.
- There are 3 types: internal (painless, bleeding), external (painful, lump), thrombosed (clot, severe pain).
- Causes include straining, pregnancy, sitting, low fiber — not just “bad habits.”
- Prevention is possible with diet, hydration, and movement.
- Don’t ignore red flags — bleeding + age + weight loss = see a doctor.
- Most resolve at home — but know when to seek help.
🩺 Reviewed by: Hemorrhoid Care Hub Medical Review Team
📅 Last reviewed: September 1, 2025
ℹ️ Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a healthcare provider for diagnosis and treatment.