Common myths and facts about internal and external hemorrhoids

Many people experience hemorrhoids but few openly discuss them. Below, we help you to sort facts from fiction to be able to prevent or treat the condition accordingly. 

Myth n°1: there are no differences between internal and external hemorrhoids.^1,2 

Hemorrhoids, also called piles, are swollen veins located in the anus and lower rectum. When they develop inside the rectum – the part of your digestive system that connects your colon to your anus – they are called internal hemorrhoids. You usually cannot see or feel them. When they develop under the skin around the anus – the canal where your poop comes out – they are called external hemorrhoids. 

Myth n°2: hemorrhoid signs and symptoms are the same for internal and external hemorrhoids.^1,2 

Symptoms of hemorrhoids actually depend on the type of hemorrhoid: 

• Internal hemorrhoids: signs and symptoms
  

  Internal hemorrhoids rarely cause discomfort. But straining or irritation when passing stools can cause: 
  • Painless bleeding during bowel movements. You might notice small amounts of bright red blood on your toilet tissue or in the toilet. 
  • A hemorrhoid to push through the anal opening, called a prolapsed or protruding hemorrhoid. This may result in pain and irritation. You may be able to feel them bulging outside of your anus and gently push them back inside. 

• External hemorrhoids: signs and symptoms 

  Symptoms might include: 

  • Itching or irritation in the anal region 
  • Hard lumps near your anus that feel sore or tender 
  • Pain or discomfort, in your anus, especially when you sit 
  • Swelling around the anus 
  • Rectal bleeding 

Myth n°3: internal and external hemorrhoids are permanent, and you cannot cure them.³ 

As with most other health issues, internal and external hemorrhoids are not permanent because of their very nature. They are swollen veins that can change as time goes by. As such, there are plenty of ways in which you can cure and solve your hemorrhoid problem over time.   

Myth n°4: I am the only one with hemorrhoid signs and symptoms.⁴ 

Piles are quite common. Many people will develop internal and external hemorrhoids before the age of 50. Indeed, more than 75% of people will experience hemorrhoids at least once in their lifetime. 

Myth n°5: spicy foods cause internal and external hemorrhoids.^3,4 

Spicy foods can cause problems with your digestive system because they tend to upset the balance of your stomach. However, they cannot cause internal and external hemorrhoids because spicy foods do not affect the veins in the rectal area. Hemorrhoids are caused by strain on the veins near the anus. This results from pressure on the blood vessel, not by anything happening in the body’s metabolism. It is worth noting that hemorrhoid signs and symptoms do not get worse in people who eat hot chili peppers. 

Myth n°6: only older people get internal and external hemorrhoids^.3,4 

Any person of any age can get internal and external hemorrhoids, as a common cause of hemorrhoids is pressure on the anus from straining associated with constipation or diarrhea. Pressure on the abdomen during pregnancy, which causes veins to swell, can also lead to hemorrhoids. 

So, while piles are most common between the ages of 45 and 65, it is not unusual to see them in younger adults. But older people are more likely to suffer with them because of the aging of the body and weakening of the connective tissue between the anus and rectum. However, you should not dismiss the possibility based on age.  

Myth n°7: internal and external hemorrhoids can lead to cancer.^3,4 

There is no evidence that internal and external hemorrhoids increase the risk of cancer. The only concern is that people with a history of hemorrhoids can sometimes be dismissive of having bleeding with bowel movements and miss warning signs. If you are older than the age of 50 or have someone in your immediate family with a history of colorectal cancer, you should be mindful of any changes in symptoms or any new digestive symptoms that accompany common hemorrhoid signs and symptoms. Make sure you share this information with your doctor. 

Myth n°8: exercise should be avoided if you have internal and external hemorrhoids.^1,4 

Exercise is actually an important part of hemorrhoid prevention, with one small exception: lifting heavy weights with poor technique, such as holding your breath while you lift, can increase the risk of internal and external hemorrhoids or make existing hemorrhoids worse. Other than that, regular exercise can help prevent constipation and weight gain and, in turn, reduce the risk of hemorrhoids. 

It is also recommended to avoid extended periods of sitting. Indeed, sitting too long, especially on the toilet, can increase the pressure on the veins in the anus. 

Myth n°9: what you eat does not affect internal and external hemorrhoids.^1,4 

Constipation is one of the biggest risk factors for developing internal and external hemorrhoids. Eating a high-fiber diet and staying well hydrated – 6 to 8 glasses of water and other liquids each day – can help keep bowel movements soft and prevent constipation and straining. It is recommended, for hemorrhoid prevention, to consume 20 to 35 grams of fiber daily by eating more fruits, vegetables, and whole grains, and to avoid alcohol. 

Myth n°10: cold surfaces cause internal and external hemorrhoids.^3,4 

There is no evidence that cold surfaces, such as a cold sidewalk or seat, can cause internal and external hemorrhoids. On the contrary, cold seats will cause the veins to move further into the body to retain heat. That is why a cold compress may be helpful to relieve some of the signs and symptoms of hemorrhoids. You can use cold packs to reduce swelling and relieve discomfort by placing them on the anus for short periods of time.