Hemorrhoids: Symptoms, Causes and Treatment

Hemorrhoids are quite common, affecting at least half of all people over the age of fifty. These conditions stem from increased blood pressure in the venous networks surrounding the anal canal, leading to swollen blood vessels either inside the rectum or under the skin around the anus. This issue is not restricted to older adults; younger individuals, including pregnant women and occasionally children with constipation, also frequently experience hemorrhoids.

Understanding Hemorrhoids

Hemorrhoids are a normal part of our anatomy and are a common cause of symptoms. The most common symptoms of hemorrhoids are painless bright red bleeding and prolapse with bowel movements.

This issue is not restricted to older adults; younger individuals, including pregnant women and occasionally children with constipation, also frequently experience hemorrhoids.

Internal Hemorrhoids

Internal hemorrhoids are found within the anal canal. These are a complex of veins. When they engorge, these can lead to bright red bleeding with bowel movements. The bleeding is often seen when wiping or squirting/dripping into the toilet bowl. They can also lose their normal attachment and prolapse with bowel movements. The symptoms often develop due to our bowel habits including hard stools, straining and prolonged sitting on the toilet.

External Hemorrhoids

External hemorrhoids, also called skin tags, are excess skin seen around the anus. They are often associated with internal hemorrhoids. External hemorrhoids can be asymptomatic or can cause issues with itching and discomfort. On occasion, a blood clot can form in an external hemorrhoid, called a thrombosed external hemorrhoid, and this can be quite a painful condition.


The symptoms of hemorrhoids vary widely, from mild to severe symptoms. While bleeding with bowel movements is most often hemorrhoid in nature, sometimes it can be a sign of something more sinister like colorectal cancer. Being a sensitive topic, it’s important to openly discuss these symptoms with your doctor to see if further investigations should be done.

Contrary to common belief, hemorrhoids can affect people of any age and gender, not just the elderly. Factors like low physical activity and prolonged sitting can exacerbate the condition by diminishing blood flow. Increased pressure during pregnancy or as a result of obesity, along with diets low in fiber, are also significant contributors to hemorrhoid development.

Causes of Hemorrhoids

Hemorrhoids develop mainly due to increased pressure in the rectal and anal areas, with several contributing factors:

Dietary Habits

Poor dietary choices are a leading cause of hemorrhoids. Foods high in spices, fats, and processed ingredients contribute to low fiber intake, dehydration, and consequently, harder stools that strain veins in the anal region, leading to hemorrhoids. Learn more about how diet affects hemorrhoids.

Obesity and Chronic Constipation

Obesity and chronic constipation can also increase the likelihood of developing hemorrhoids by putting additional pressure on the pelvic veins. Find out more about these risk factors.

Lack of Physical Activity

Inactivity, especially sitting for prolonged periods, significantly contributes to the risk of hemorrhoids. While excessive physical exertion can also be harmful, moderate exercise is beneficial for preventing and managing hemorrhoids.

Hereditary Factors

Genetic predispositions, such as venous weakness, can also play a role in the development of hemorrhoids, highlighting the importance of understanding family health history. Explore the impact of genetics on hemorrhoids.

Treating Hemorrhoids

For the vast majority of people, the mainstay of treatment is improvement of bowel habits, as that is most often the underlying cause of the hemorrhoids. Aiming for 1-2 bowel movements per day, avoidance of hard stools and straining and not sitting on the toilet for prolonged periods of time can improve symptoms. In addition, a colonoscopy might be needed to ensure that the symptoms are from hemorrhoids and not for something more sinister.


If improving bowel habits does not improve the symptoms, there are multiple treatment options. These range from office based procedures like hemorrhoidal banding and sclerotherapy to hemorrhoidectomy, surgical removal of the hemorrhoids.

Hemorrhoid Surgery

Office based procedures are low risk, usually with fast recovery, but only to treat symptoms of internal hemorrhoids. Hemorrhoidectomy has a longer recovery, but removes both the internal and external hemorrhoids.

Referral For Hemorrhoid Treatments

If you’re experiencing symptoms of hemorrhoids, we encourage you to speak with your doctor about a referral to our clinic. As a dedicated department within North York General Hospital, we specialize in effective hemorrhoid treatments.