Digestive · Symptom
Hemorrhoids
Also called: piles, anal bleeding, rectal pain
Hemorrhoids are swollen veins in the anal canal. Internal hemorrhoids cause painless bleeding with bowel movements; external hemorrhoids cause pain, itching, or a tender lump. Treatment starts with stool softeners, fiber, hydration, sitz baths, topical hydrocortisone, and witch hazel pads. Clindle evaluates symptoms, prescribes topical nifedipine-lidocaine compounds when indicated, and refers to GI for banding or surgery for refractory cases. Any rectal bleeding in someone over 45, with weight loss, or with a family history of colon cancer needs a colonoscopy.