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Hemorrhoids

Hemorrhoids are common — and they’re nothing to be embarrassed about. If symptoms like bleeding, pain, or irritation aren’t getting better with diet changes or medicine, hemorrhoid removal may help.

At UVA Health, our surgeons take a careful, step-by-step approach. We focus on finding the real cause of your symptoms and start with the least invasive treatment possible.

What Are Hemorrhoids?

Hemorrhoids are normal veins inside and around the anus. Everyone has them. Problems happen when these veins become enlarged or irritated.

Types of Hemorrhoids

The type of hemorrhoid depends on where the swollen vein forms.

Internal Hemorrhoid

An internal hemorrhoid develops inside the rectum. Because they’re deeper in the body, internal hemorrhoids usually aren’t painful. However, they can cause bleeding, especially during bowel movements.

External Hemorrhoid

An external hemorrhoid forms under the skin around the anus (the opening where stool leaves the body). External hemorrhoids are more likely to cause symptoms you can feel, such as itching, discomfort, or pain. They may also bleed. You can often see or feel an external hemorrhoid as a lump near the anus.

Prolapsed Hemorrhoid

A prolapsed hemorrhoid happens when an internal hemorrhoid stretches and bulges outside the anus. Prolapsed hemorrhoids may cause pain, irritation, or bleeding.

Thrombosed Hemorrhoid

A thrombosed hemorrhoid happens when a blood clot forms inside an external hemorrhoid. This can cause sudden, severe pain and swelling. The area may look purple or blue. While painful, this type of clot stays in the hemorrhoid and does not travel to other parts of the body.

Hemorrhoid Symptoms

Hemorrhoids may cause:

  • Bright red blood on toilet paper or in the bowl
  • Pain or discomfort around the anus
  • Itching or irritation
  • A feeling of pressure or fullness
  • Tissue that bulges out during a bowel movement
  • Trouble getting clean after using the bathroom

What Causes Hemorrhoids?

Hemorrhoids can be more common in those who:

  • Have chronic, irregular bowel movements
  • Have been through pregnancy and childbirth
  • Struggle with excessive weight gain or obesity
  • Have jobs requiring daily or frequent heavy lifting

Symptoms can come and go. Many people feel better with simple changes — but some need medical treatment.

When Should You See a Doctor?

You should schedule a visit if you have:

  • Bleeding that keeps coming back
  • Pain that doesn’t improve
  • Symptoms that interfere with daily life
  • A new or worsening lump near the anus

Bleeding isn’t always from hemorrhoids. Other conditions — including anal fissures, infections, or colorectal cancer — can cause similar symptoms. The only way to know for sure is to get checked.

How Hemorrhoids Are Diagnosed

Many people assume they have hemorrhoids — but symptoms can overlap with other conditions.

Your provider will:

  • Ask detailed questions about your symptoms and bowel habits
  • Perform a physical exam
  • Decide if more testing, such as a colonoscopy, is needed

Hemorrhoid Treatment

Treatment usually starts with:

  • Increasing fiber intake
  • Drinking more water
  • Using fiber supplements
  • Limiting time on the toilet
  • Avoiding straining or pushing
  • Being physically active to improve circulation

Many symptoms improve within weeks once habits change.

Nonsurgical Hemorrhoid Removal

If symptoms don’t improve, we may recommend an office-based treatment called banding.

Hemorrhoid Banding

  • Used for internal hemorrhoids
  • Performed in the office
  • A small rubber band cuts off blood flow to the hemorrhoid
  • The hemorrhoid shrinks and falls off

This treatment is quick and doesn’t require anesthesia.

Surgical Hemorrhoid Removal

Surgery is usually recommended when:

  • Symptoms are severe
  • Other treatments haven’t worked
  • Large hemorrhoids cause ongoing pain or bleeding

What to Know About Surgery

  • Hemorrhoid surgery is effective
  • Recovery can be uncomfortable
  • Pain and swelling are common for several weeks

Recovery & Healing

You may experience:

  • Pain or soreness
  • Swelling
  • Light bleeding

Your care team will help you:

  • Manage pain safely
  • Keep stools soft
  • Reduce the risk of hemorrhoids coming back

Gastrointestinal & Digestive Health