Hemorrhoids or hemorrhoids are swelling or inflammation of the blood vessels at the end of the large intestine (rectum) and anus. This condition is caused by increased pressure in the blood vessels around the anus. One of them is pushing too hard.

Hemorrhoids, also known as hemorrhoids, are conditions that generally do not cause symptoms and can improve in a matter of days. However, in severe conditions hemorrhoids can cause pain, itching, and bleeding after defecation.

Causes of hemorrhoids

The exact cause of hemorrhoids is not known, but this condition is thought to occur when pressure on the abdomen or legs increases. This increased pressure then causes the blood vessels around the anus to become swollen and inflamed.

Several factors can increase the risk of hemorrhoids, namely:

  • Prolonged constipation  or constipation due to lack of fiber intake from food
  • Often lift heavy weights
  • Habit of sitting for a long time
  • Prolonged diarrhea
  • The habit of straining when defecating
  • Cough  and vomiting that lasts a long time
  • Obesity or overweight
  • Pregnancy
  • Family history of hemorrhoids
  • anal sex

In addition, several medical conditions are also suspected to cause hemorrhoids, namely:

  • Inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis
  • Accumulation of fluid in the abdominal cavity (ascites)
  • Rectal prolapse
  • spinal injury
  • Colon cancer

Hemorrhoid Symptoms

Signs and symptoms that arise due to hemorrhoids depend on the type of hemorrhoid experienced. Here is the explanation:

External hemorrhoid

This type of hemorrhoid is characterized by swollen blood vessels outside the anus so that it can be seen from the outside. Symptoms that can appear on external hemorrhoids are:

  • Itching or irritation, pain , and swelling around the anus
  • Pain when touching the lump that hangs outside the anus
  • Bleeding during bowel movements

Internal hemorrhoid

Internal hemorrhoids occur when swollen blood vessels are inside the anus so that hemorrhoids are not visible or palpable from the outside. Symptoms that can be found in this type of hemorrhoid are:

  • Bleeding when defecating without pain
  • Pain when straining, if the hemorrhoid causes a lump that comes out of the anus (prolapse)
  • Itching of the anus

When to go to the doctor

Check with your doctor if you experience the symptoms of hemorrhoids as previously mentioned, or if your symptoms do not improve after you have been on self-care for 7 days. Also check with your doctor if the above complaints are accompanied by symptoms of a more serious illness or condition, such as:

  • Changes in stool color and consistency
  • Changes in bowel patterns that have been going on for a long time
  • Heavy bleeding
  • Dizzy
  • Faint

Hemorrhoid Diagnosis

In determining the diagnosis of hemorrhoids , the doctor will first ask about the symptoms and complaints felt, as well as the patient's medical history. After that, the doctor will perform a physical examination to see if there are lumps, swelling, or irritation in the area around the anus.

Next, the doctor will perform several other examinations, namely:

  • Digital rectal examination , to check for abnormalities in the blood vessels in the rectum and rectum
  • Anoscopy, to view the lining of the anus and rectum using a lighted tube equipped with a camera
  • Sigmoidoscopy, to see the inside of the large intestine and rectum using a long tube with a camera
  • Colonoscopy , to find out if the cause of hemorrhoids comes from disorders of the digestive system
  • Biopsy, to examine further samples of colon or rectal tissue in the laboratory

After the examination is complete, the doctor will classify hemorrhoids based on their size and severity, namely:

  • Grade I: small swelling appears inside the anal wall, but is not visible from outside the anus
  • Grade II: larger swelling that comes out of the anus during defecation (BAB), but goes back on its own after a bowel movement
  • Grade III: one or more small lumps hanging from the anus, but can be pushed back
  • Grade IV: there is a large lump that hangs from the anus and cannot be pushed back

Hemorrhoid Treatment

Although generally hemorrhoids can recover on their own within a few days, treatment must still be done to reduce the complaints felt. Some methods of hemorrhoid treatment that can be done are:


One method that can be used to treat hemorrhoids is with drugs. These drugs can be obtained at pharmacies or with a doctor's prescription. Some of these drugs include:

  • Topical
    medication Topical medication can be used to relieve swelling and itching due to hemorrhoids. Hemorrhoid ointments are available in the form of creams, ointments, and suppositories.
  • Corticosteroids
    To relieve inflammation that occurs inside or outside the anus, the doctor will prescribe a corticosteroid cream to the patient.
  • Pain relievers
    Patients can take pain relievers, such as paracetamol , to relieve pain and swelling caused by hemorrhoids. However, first consult with your doctor regarding the right type of pain reliever to avoid worsening symptoms.
  • Laxatives (laxatives)
    If hemorrhoids are caused by constipation, the doctor will prescribe laxatives that work to help smooth bowel movements.

Non-surgical medical procedures

Some non-surgical medical procedures that can be used to treat hemorrhoids are:

  • Hemorrhoid binding (ligation)
    In this procedure, the doctor will tie the hemorrhoid using an elastic cord so that the blood flow to the hemorrhoid can be cut off.
  • Sclerotherapy injections
    In sclerotherapy, the doctor will inject special drugs into the veins around the hemorrhoids. This injection serves to shrink the hemorrhoids without pain.
  • Coagulation
    Coagulation is a procedure of burning hemorrhoid tissue using infrared. This procedure also serves to cut off blood flow so that the hemorrhoid can shrink.


If hemorrhoids still do not heal with medication and simple procedures, the doctor will recommend surgery to treat hemorrhoids. Operational procedures that can be performed include:

1. Hemorrhoidectomy

Hemorrhoidectomy surgery procedure is done by cutting the hemorrhoid through open surgery. During the operation, the doctor will give a local anesthetic so that the patient does not feel pain.

2. Stapled hemorrhoidopexy

Stapled hemorrhoidopexy is a surgical procedure that uses a special stapler to the rectum, to stop blood flow to the hemorrhoid and shrink the hemorrhoid.

Hemorrhoid Complications

Hemorrhoids can last a long time and cause chronic pain. In addition, in rare cases, hemorrhoids can cause complications such as:

  • Anemia due to bleeding
  • Twisted hemorrhoids
  • Blood clots in swollen veins
  • Infection of external hemorrhoids
  • Skin damage

Hemorrhoid Prevention

Some ways that can be done to prevent hemorrhoids are:

  • Eat foods rich in fiber.
  • Increase the intake of body fluids.
  • Do not delay defecation.
  • Avoid straining too much .
  • Avoid sitting too long.
  • Do exercise regularly.
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