Hemorrhoids are varicose veins (swollen or dilated) located inside the anus (internal hemorrhoids) or outside the anus (external hemorrhoids). Nobody knows exactly what causes these veins to dilate and inflame, but few connections were established. Hemorrhoids usually are not very painful, but can be upsetting.

Internal hemorrhoids
A classic symptom is the blood in stool. Blood is seen both in the stool, on toilet paper and in the toilet. Internal hemorrhoids occasionally extend outside the anus. Various conditions can cause internal hemorrhoids to swell or to be irritated and bleed, including the following:

- Trauma during labor
- Excess weight during pregnancy
- Obesity
- Chronic constipation
- Diarrhea
- Anal sex.
Sometimes, an inflamed internal hemorrhoid can cause the appearance of a blood clot.

External hemorrhoids
External hemorrhoids are veins located outside the anus and are frequently associated with a painful irritation, especially when a blood clot is formed between the dilated veins. Hemorrhoids caused by a blood clot (thrombosed piles) need to be treated immediately by your doctor. There are many non surgical hemorrhoid treatments so you don't have to think about surgery.

Symptoms:
- Itching and pain around the anus
- Blood on underwear, toilet paper, seat surface or in the toilet.

Causes:
Hemorrhoids may be caused by the following:
- Defecation during bowel movements
- Constipation
- Diarrhea (frequently and in large quantity)
- Pregnancy (especially third trimester)
- Liver cirrhosis (may cause blood accumulation in the vessels around the rectum)

Treatment
- avoid dehydration
- use cream for hemorrhoids
- eat more fibre
- for temporary relaxation try cold showers

There are many ways to treat hemorrhoids, and you can see some of this here.