Hemorrhoids are swollen veins located around the anus or in the lower rectum. According to the American Society of Colon and Rectal Surgeons, millions of Americans suffer with hemorrhoids (ASCRS).

There are two types of hemorrhoids, internal and external. Internal hemorrhoids develop within the anus; external hemorrhoids develop outside of the anus. Hemorrhoids are also called piles.

Of the two forms of hemorrhoids, external hemorrhoids are the most common and the most troublesome. Hemorrhoids cause pain, severe itching, and difficulty sitting. The good news is that they are treatable.

How Do Hemorrhoids Develop?

Experts are not sure what causes hemorrhoids to develop. Several factors could be to blame, including:

  • Straining during a bowel movement
  • Complications from chronic constipation
  • Sitting on the toilet for a long time
  • Pregnancy (when the uterus enlarges it presses on the vein in the colon causing it to bulge)

If someone in your family had hemorrhoids, you are also more likely to develop them.

Sometimes, hemorrhoids can lead to other complications. External hemorrhoids may develop painful blood clots. Internal hemorrhoids may prolapse (drop through the rectum and bulge from the anus). External or prolapsed hemorrhoids can become irritated or infected and may require surgery.


A hemorrhoidectomy is used for large external hemorrhoids and internal hemorrhoids that have prolapsed. This procedure usually takes place in a hospital. You and the surgeon will decide on the best anesthesia to use during the surgery.