Hemorrhoids: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Hemorrhoids?
Hemorrhoids are often evaluated by a primary care doctor. For more care, you may see a gastroenterologist (a digestive system doctor). You may also see a colorectal surgeon (a surgeon for the colon, rectum, and anus). A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What are hemorrhoids?
Hemorrhoids, also called piles, are swollen and inflamed veins around your anus or in your lower rectum. There are two types.
- External hemorrhoids form under the skin around the anus.
- Internal hemorrhoids form in the lining of the anus and lower rectum.
Hemorrhoids are common in both men and women. They affect about 1 in 20 Americans, and about half of adults older than age 50 have them.
Symptoms
The symptoms depend on which type you have. With external hemorrhoids, you may have:
- Anal itching.
- One or more hard, tender lumps near your anus.
- Anal pain, especially when sitting.
Too much straining, rubbing, or cleaning around your anus may make symptoms worse. For many people, the symptoms of external hemorrhoids go away within a few days.
With internal hemorrhoids, you may have:
- Bleeding from your rectum. You may see bright red blood in your stool, on toilet paper, or in the toilet bowl.
- Prolapse, which is a hemorrhoid that has fallen through your anal opening.
Internal hemorrhoids are usually not painful unless they are prolapsed. A blood clot can form in an external hemorrhoid. A sore on an external hemorrhoid can also become infected.
Causes and who gets it
Hemorrhoids happen when there is too much pressure on the veins around the anus. Causes include:
- Straining during bowel movements.
- Sitting on the toilet for long periods of time.
- Chronic constipation or diarrhea.
- A low-fiber diet.
- Weakening of the supporting tissues in your anus and rectum, which can happen with aging and pregnancy.
- Lifting heavy objects often.
How doctors diagnose it
Your provider will ask about your medical history and do a physical exam. Often providers can diagnose external hemorrhoids by looking at the area around your anus.
To check for internal hemorrhoids, the provider does a digital rectal exam. The provider inserts a lubricated, gloved finger into the rectum to feel for anything that is not normal. The provider may also do a procedure called an anoscopy to check for internal hemorrhoids.
Bleeding from the rectum has other possible causes, such as Crohn's disease, ulcerative colitis, colorectal cancer, and anal cancer. That is why it is important to find the cause of any bleeding.
Treatment
You can most often treat hemorrhoids at home. Helpful steps include:
- Eating foods that are high in fiber.
- Taking a stool softener or a fiber supplement.
- Drinking enough fluids every day.
- Not straining during bowel movements.
- Not sitting on the toilet for long periods of time.
- Taking over-the-counter pain relievers.
- Sitting in a tub of warm water, called a sitz bath, several times a day to ease pain.
Over-the-counter hemorrhoid creams, ointments, or suppositories (medicines you insert into your rectum) may relieve mild pain, swelling, and itching of external hemorrhoids. Follow up with your doctor if they do not help after 1 week. Also call if they cause side effects, such as dry skin around your anus or a rash.
Most prolapsed internal hemorrhoids go away without at-home treatment. However, severely prolapsed or bleeding internal hemorrhoids may need medical treatment.
Doctors can treat hemorrhoids with procedures. Office treatments include rubber band ligation, sclerotherapy, infrared photocoagulation, and electrocoagulation. These cause scar tissue to form. This cuts off the blood supply and usually shrinks the hemorrhoid.
In rubber band ligation, a doctor places a special rubber band around the base of the hemorrhoid. Only a doctor should do this. You should never try it yourself.
A doctor, most often a surgeon, may do a hemorrhoidectomy. This removes large external hemorrhoids and prolapsing internal hemorrhoids that do not respond to other treatments. You get anesthesia for this surgery.
When to see a doctor
See your health care provider if you still have symptoms after 1 week of at-home treatment. See your provider if you have any bleeding from your rectum. Hemorrhoids are a common cause of bleeding, but other conditions can also cause it.
Call 911 or go to the emergency room if you have bleeding that will not stop or you faint.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type of doctor can examine you and talk with you about home care. They can also refer you to a specialist if you need a procedure or surgery.
Common questions
Can hemorrhoids be treated at home?
Yes, most often they can. Eating foods high in fiber, drinking enough fluids, and not straining during bowel movements all help. Warm baths called sitz baths and over-the-counter pain relievers can ease pain.
Is rectal bleeding always caused by hemorrhoids?
No. Hemorrhoids are a common cause of rectal bleeding, but Crohn's disease, ulcerative colitis, colorectal cancer, and anal cancer can also cause it. Your provider can find the cause.
Can I put a rubber band on a hemorrhoid myself?
No. Rubber band ligation is a procedure that only a doctor should perform. You should never try it yourself.
Sources
- MedlinePlus - Hemorrhoids
- NIDDK - Definition & Facts of Hemorrhoids
- NIDDK - Treatment of Hemorrhoids
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
