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Hemorrhoids: patterns and care

Added · 23 February 2026 ·How we create our content

At a glance

Hemorrhoids — sometimes called piles — are swollen blood vessels in and around the anus and lower rectum. They are extremely common. Most adults will experience them at some point.

Hemorrhoids can be internal (inside the rectum, where you cannot see or feel them) or external (under the skin around the anus). Sometimes internal hemorrhoids push through the anal opening, which is called prolapse.

This page covers what people commonly experience, what tends to help or make things worse, and when to seek care.

Internal vs external

Internal hemorrhoids are inside the rectum. People often do not feel them directly. Common signs include:

  • Painless bleeding during bowel movements — bright red blood on toilet paper or dripping into the toilet
  • A feeling of fullness or incomplete evacuation
  • Tissue that may bulge out during straining and either retracts on its own or needs to be gently pushed back

External hemorrhoids are under the skin around the anus. People commonly describe:

  • A noticeable lump or swelling near the anus
  • Itching or irritation in the anal area
  • Discomfort or aching, especially when sitting
  • Tenderness when wiping

Some people have both types at the same time.

Common patterns people report

  • Symptoms that come and go in flare-ups, sometimes triggered by diet, stress, or changes in routine
  • Bleeding that is painless (often internal) or accompanied by discomfort (often external)
  • Itching that is persistent and frustrating
  • A feeling of pressure or heaviness in the rectal area
  • Symptoms that worsen with prolonged sitting or straining
  • Anxiety about whether the bleeding could be something more serious

What tends to help

  • Fiber and hydration — softening stools is one of the most consistently reported helpful changes. People commonly try psyllium husk, fruits, vegetables, and increased water intake.
  • Sitz baths — warm water soaks for 10 to 15 minutes, particularly after bowel movements. Many people find this soothing for both pain and itching.
  • Avoiding straining — not forcing bowel movements and limiting time on the toilet.
  • Gentle cleaning — using water or unscented wipes rather than dry toilet paper, and patting rather than rubbing.
  • Movement — light physical activity and avoiding prolonged sitting.
  • Over-the-counter topical treatments — some people find temporary relief from creams or suppositories. Talk to your doctor or pharmacist about what may be appropriate for you.

What tends to make things worse

  • Constipation and straining during bowel movements
  • Sitting on the toilet for extended periods (scrolling on your phone counts)
  • Heavy lifting without proper breathing technique
  • Low fiber diet and dehydration
  • Ignoring the urge to go, leading to harder stools
  • Excessive wiping or using rough toilet paper
  • Spicy foods and alcohol (some people report these as triggers)

Talking to your doctor

If you are considering seeing a doctor, it can help to note:

  • When symptoms started and how often they occur
  • Whether you have noticed bleeding and what it looks like
  • Any lumps or swelling you have felt
  • What you have already tried
  • Whether symptoms are getting better, stable, or worse
  • Your usual bowel habits and any recent changes

Many people feel embarrassed discussing these symptoms. Doctors see hemorrhoids regularly and can help you find relief.

If you experience severe pain, heavy bleeding, fever, or symptoms that concern you, seek medical care.

When to seek care

If you experience any of the following, seek urgent medical care:

  • Heavier or persistent bleeding that does not settle
  • Severe pain that is not relieved by over-the-counter measures
  • A hard, painful lump near the anus that appeared suddenly
  • Symptoms that have not improved after two weeks of self-care
  • Fever alongside anal or rectal symptoms
  • Any rectal bleeding if you are over 40 or have a family history of colorectal conditions

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