What are hemorrhoids?

Hemorrhoids, also called piles, are tissues found in the anus and rectum. Within these tissues are blood vessels that can become swollen and irritated, causing the condition we know as "hemorrhoids." This inflammation of the vessels can happen just inside the rectum (internal hemorrhoids) or just outside (external hemorrhoids). In some cases, an internal hemorrhoid protrudes through the anus (prolapsed hemorrhoid).

Some of the causes of hemorrhoids may be straining too hard while having bowel movements or straining while lifting something heavy. Pregnant women are more prone to hemorrhoids because of the extra pressure of the baby's weight on the rectum and anus.

Symptoms of hemorrhoids

Hemorrhoids are a common condition that most people will have at some point in their lives. Because one of the symptoms is rectal bleeding, however, it's always a good idea to let your doctor know what you're experiencing so that he or she can rule out other more serious conditions. You may also have symptoms such as:

  • Itching around the anus
  • Soreness and tenderness in the anal area
  • Small bumps (swollen tissue) that you can feel around the anus
  • Pain during bowel movements
  • Blood spotting on toilet tissue (painless bleeding)

In most cases, hemorrhoids go away on their own with over-the-counter medications and anti-itch creams. You may also benefit from drinking more water and eating high-fiber foods to ensure your stool (bowel) stays soft and passes easily.

Diagnosis and testing of hemorrhoids

If you decide to see your doctor about your symptoms, your doctor will review your medical history and perform a physical exam that may include a digital rectal exam. If additional testing is needed, your doctor may recommend sigmoidoscopy or anoscopy. In rare cases, hemorrhoids may require surgery such as transanal hemorrhoidal dearterialization or cryosurgery, which are less invasive procedures than traditional hemorrhoidectomy (surgical removal of hemorrhoids).



Cryotherapy is used for removal of abnormal cells, such as basal cell carcinoma, and internally for cancerous and precancerous cells of the prostate and cervix.

Transanal Hemorrhoidal Dearterialization

THD is usually an outpatient procedure that involves indentifying the arteries that are sending blood to the swollen areas and cutting off that blood supply with a clip or ligature.



Main Line Health gastroenterology works to resolve digestive issues and GI conditions. Find the right solution for your digestive conditions at one of our Philadelphia locations.