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Last Medical Review: March 26, 2020
Medically Reviewed by Dr. David Costa Navarro
Hemorrhoids (March 26, 2020)

What are Hemorrhoids are pads of richly vascularized tissue, which cover the lower part of the rectum and which have the function of completely closing the anal canal, contributing to faecal continence. When these tissues undergo modifications, they produce the characteristic symptoms of hemorrhoidal disease, commonly called “hemorrhoids”. Hemorrhoids represent one of the most common problems of the intestine, although it is difficult to establish its real incidence (only a minority of patients consult the doctor). However, it is estimated that at least 50% of the adult population suffers from industrialized countries. Hemorrhoids most often occur between the ages of 45 and 65 and, as regards their appearance, there seems to be no difference between the sexes. Relapses are frequent. The symptoms of the disease vary depending on whether it is internal or external hemorrhoids. Internal hemorrhoids, located inside the anus, cause pain, bleeding and itching only in relation to the passage of stool and can be considered the initial stage of the disease. Over time, the disease progresses and the hemorrhoidal cushions first come out during defecation but return spontaneously, then return only by pushing them manually inside the anus; finally they remain permanently external (prolapsed). At this stage they are extremely painful and can frequently be complicated by the formation of clots inside them (hemorrhoidal thrombosis).

The causes

Hereditary predisposition, certain individual behaviors and socio-environmental factors play an important role in provoking the appearance of hemorrhoids. Constipation, a diet low in fiber, jobs that involve lifting heavy weights, the habit of sitting on the toilet for a long time, causing prolonged pressure on the hemorrhoidal veins, are all aggravating factors. Pregnancy can both induce and aggravate hemorrhoids, especially in the delivery phase.


Signs indicating the likely presence of hemorrhoids are painless, bright red blood loss at the time of defecation. Symptoms like discomfort, itching, prolapse, edema, pain and mucus discharge are also often present. Discomfort and pain are generally due to the external part of the hemorrhoid; particularly acute pain can however be a sign of hemorrhoidal thrombosis. The itching can be caused by an inaccurate cleaning of the anal orifice after defecation (prevented by edema around the anus) and by the annoying losses that are often the consequence of an increased production of mucus from the prolapsed tissues.

What are the risks

The presence of blood in the stool could also be the consequence of serious pathologies; in particular when bleeding occurs for the first time it is good to consult your doctor, while you can contact the pharmacist when the symptoms are recurrent and known. In the presence of nausea, vomiting, abdominal pain, diarrhea, loss of appetite or intense pain, symptoms that could be indicative of important pathologies, it is advisable to contact your doctor.  

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