Chronic Hemorrhoids

What is a Hemorrhoid?

Half of all Americans will experience hemorrhoids in their lifetimes. For most, hemorrhoids will go away on their own or with diet changes, topical treatments, medications or supplements. For some, they can also persist and cause bleeding, itching and painful bowel movements. These are commonly known as “chronic hemorrhoids.”
Man sitting on a stool with his hands clasped between his knees
01

The potential complications of hemorrhoids

Skin tags
Pain
Infection
Bleeding (due to a burst hemorrhoid)
Anemia
Blood clots or Perianal thrombosi
Prolapsing hemorrhoids, which can become trapped (incarcerated)

What causes hemorrhoids?

Most people have the wrong idea about hemorrhoids. Hemorrhoids are actually swollen veins inside the lower rectum or under the skin around the anus, similar in nature to varicose veins. They most commonly occur in those between 45 and 65, but can occur at any age. They may be caused by an increase in pressure in the lower rectum through one or more of the following factors:
  • Sitting for long periods
  • Straining or excessive exercise
  • Spinal cord injury
  • Chronic constipation or diarrhea
  • Being overweight
  • Pregnancy or childbirth
  • Family history

A diet high in fiber, as well as drinking plenty of fluids and getting regular exercise can help decrease the risk of hemorrhoids.

Doctor pointing to an anatomical model of the rectum showing hemorrhoids

What are my chronic hemorrhoid treatment options?

Conservative treatment for chronic hemorrhoids may include diet changes, topical treatments (such as an over-the-counter hemorrhoid cream), sitz baths and oral pain relievers (such as Tylenol). If the symptoms do not disappear, and if you are experiencing severe pain, bleeding, changes in bowel habits or changes to the color or consistency of your stools, you should talk with your doctor about other treatment options.
If conservative treatments fail, some patients opt for a hemorrhoidectomy, an invasive surgical procedure to remove hemorrhoids. However, surgery comes with risks and complications that can include infection, bleeding, difficulty emptying the bladder, rectal prolapse and more.1,2 Recovery takes at least 2 weeks, and it can be as long as 3-6 weeks before you feel normal again.
Another procedure, called rubber band ligation, is a less invasive technique that has been used more commonly in the last few years. However, this approach is also associated with pain and complications, especially for those taking anti-platelet or anti-coagulation medication and who have a higher risk of hemorrhage and infectious complications.3
A new and minimally invasive option to treat hemorrhoids is called hemorrhoidal artery embolization (HAE). This is typically recommended for patients with grade 1 to 3 internal hemorrhoids who have not responded to conservative treatment. Click here if you’d like to take our quiz to see if you are a candidate for HAE.
View Treatment

Do I have chronic hemorrhoids?

Answer a few quick questions to find out if you may be a candidate for hemorrhoid artery embolization (HAE).

Have you been diagnosed with chronic hemorrhoids/piles?

Do you have any of the following symptoms?

How would you describe your symptoms?

Have you tried any of the following?

How long have you been experiencing chronic hemorrhoids?

Are you looking for an alternative to surgery to treat chronic hemorrhoids?

Please answer the questions above to see your result.

You may be a candidate for hemorrhoid artery embolization.

Based on your responses, HAE could be an option for you. Please fill out the form on this page so we can schedule your consultation with one of our providers.

Schedule my consultation

You may not have chronic hemorrhoids.

Based on your responses, we recommend consulting with your primary care provider for more information. If you would still like to speak with one of our providers, please fill out the form on this page.

Contact our team

Let's find the right next step together.

Your answers don't point clearly one way or the other. The best way to know whether HAE is right for you is a conversation with our team — please fill out the form on this page.

Contact our team
← Retake the quiz

International Prostate Symptom Score (I-PSS)

Answer each question about your urinary symptoms over the past month. Your total score is calculated instantly.

0 of 7 answered

1. Incomplete Emptying: How often have you had the sensation of not emptying your bladder?

…

2. Frequency: How often have you had to urinate less than every two hours?

…

3. Intermittency: How often have you found you stopped and started again several times when you urinated?

…

4. Urgency: How often have you found it difficult to postpone urination?

…

5. Weak Stream: How often have you had a weak urinary stream?

…

6. Straining: How often have you had to strain to start urination?

…

7. Nocturia: How many times did you typically get up at night to urinate?

…

Please answer all questions to see your score.

Your I-PSS score

—

—

This score is for informational purposes and is not a diagnosis. Share it with your provider to discuss what it means for you — or fill out the form on this page to talk with our team.

Talk to our team

WOMAC Osteoarthritis Index

Rate each activity by the degree of difficulty you have experienced in the last 48 hours due to your knee.

0 of 24 answered

Pain

1. Walking

…

2. Stair climbing

…

3. Nocturnal

…

4. Rest

…

5. Weight bearing

…

Stiffness

1. Morning stiffness

…

2. Stiffness occurring later in the day

…

Physical Function

1. Descending stairs

…

2. Ascending stairs

…

3. Rise from sitting

…

4. Standing

…

5. Bending to floor

…

6. Walking on flat surface

…

7. Getting in/out of car

…

8. Going shopping

…

9. Putting on socks

…

10. Lying in bed

…

11. Taking off socks

…

12. Rising from bed

…

13. Getting in/out of bath

…

14. Sitting

…

15. Getting on/off toilet

…

16. Heavy domestic duties

…

17. Light domestic duties

…

Please answer all questions to see your score.

Your WOMAC score

—

—

—

—

—

This score is for informational purposes and is not a diagnosis. Share it with your provider to discuss what it means for you — or fill out the form on this page to talk with our team.

Talk to our team

Foot & Ankle Disability Index (FADI)

Rate each item by your current level of difficulty. Higher scores indicate better foot and ankle function.

0 of 26 answered

Activity

1. Standing

…

2. Walking on even ground

…

3. Walking on even ground without shoes

…

4. Walking up hills

…

5. Walking down hills

…

6. Going up stairs

…

7. Going down stairs

…

8. Walking on uneven ground

…

9. Stepping up and down curbs

…

10. Squatting

…

11. Sleeping

…

12. Coming up to your toes

…

13. Walking initially

…

14. Walking 5 minutes or less

…

15. Walking approximately 10 minutes

…

16. Walking 15 minutes or greater

…

17. Home responsibilities

…

18. Activities of daily living

…

19. Personal care

…

20. Light to moderate work (standing, walking)

…

21. Heavy work (push/pulling, climbing, carrying)

…

22. Recreational activities

…

Pain

23. General level of pain

…

24. Pain at rest

…

25. Pain during your normal activity

…

26. Pain first thing in the morning

…

Please answer all questions to see your score.

Your FADI score

—

—

This score is for informational purposes and is not a diagnosis. Share it with your provider to discuss what it means for you — or fill out the form on this page to talk with our team.

Talk to our team

Book a Consultation

Submit
Submit
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.