Most people who get hemorrhoids are shocked to have them. Since they’re a rather sensitive subject, people don’t usually share with their friends and family when they have them, so you typically only hear about them in medical articles or from your doctor, making them almost feel like myths. But hemorrhoids are, indeed, quite common, and can occur at any age. They can be quite painful, tedious to treat, and downright embarrassing. Because of the nature of hemorrhoids, they can make daily activities like sitting or going to the bathroom uncomfortable. If we’re being completely open and honest, depending on what you and your partner like to do in the bedroom, they can make that quite unpleasant, too. So let’s talk about what nobody wants to discuss: here are facts about hemorrhoids you should know, no matter your age, gender or lifestyle.

There are three kinds, let’s start with external

There are internal, external and thrombosed hemorrhoids. External ones exist beneath the skin, around the anus (this is where the digestive tract empties your bowels out of your body). Depending on how closely you look, these can be visible, so some people elect to have them removed.

Internal ones

Internal hemorrhoids exist in the lower rectum (what connects the large intestine to the anus). These mostly go away on their own, but if an internal one prolapses, it can be quite painful and must be treated.

Thrombosed ones

Thrombosed hemorrhoids will feel like a hard lump around your anus. These occur when blood clots in an external hemorrhoid, causing it to swell up.

How do you know if you have them?

If you see blood in the toilet, or on your toilet paper, after having a bowel movement, there is a chance you have hemorrhoids. If this only happens once or twice then you may have just passed hard stool, but if it’s consistent, and there is a lot of blood, you should check with your doctor to see if you have hemorrhoids.

Who gets them

Seventy-five percent of individuals over the age of 45 get hemorrhoids. Pregnant women, however, are quite susceptible to them because the pressure of the expanding uterus can cause veins around the rectum to swell.

What causes them

Constipation is a common cause of hemorrhoids. When people are constipated, they tend to sit on the toilet for longer periods of time, as well as push harder to have a bowel movement, both of which can lead to hemorrhoids.

But they also come with age

As you get older, the connective tissues in your rectum and anus are not as strong as they once were, which can interfere with your motility (your bowels’ ability to move properly).

When should you see a doctor

While hemorrhoids are not life-threatening, any time you see excessive blood in your stool you should see a doctor, as this could be a symptom of more serious conditions like colorectal cancer.

How your doctor will diagnose you

Your doctor will use gloves, lubricant, and a light to manually examine your rectum. Doctors can typically identify hemorrhoids quickly so the exam shouldn’t take more than a few minutes.

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