Hemorrhoids may be prolapse and protrude externally. They may protrude when straining to eliminate, coughing, sneezing, laughing, sitting for a long time, or standing. Hemorrhoids may also be invisible, occurring higher up in the rectum.

Hemorrhoids may be caused during childbirth, due to constipation & straining to eliminate, excessive downward flow of blood, or inflammation of the rectum. The rectum becomes inflamed due to various causes but most commonly when fecal matter putrefies in the colon or if there is an infection.

Hemorrhoids may clot or burst. They may be painful, itchy or asymptomatic. Mucus leakage may create a feeling of incomplete elimination. If you have hemorrhoids you may notice streaks of blood on the toilet paper when wiping. If hemorrhoids are irritated, cleanse the colon after evacuation with your hand instead of toilet paper, which irritates the sensitive tissues. Hemorrhoids may obstruct bowel movements. Call the doctor if hemorrhoids bleed more than once, bleeding occurs between bowel movements or lasts more than a week, or if stool becomes narrow or has a groove in them, if a lump grows in the area, or if you have a fever.

If you have hemorrhoids, avoid straining to eliminate, straining to lift heavy objects, and foods that cause gas, constipation, or irritation of the digestive lining. Avoid hard seats, eliminate any infection of the colon including parasites, and snacking between meals. Salty, sour and sweet foods tend to soften stools. Slimy foods including cooking oils, okra, oatmeal, flax and chia seeds can help. Use stool softening herbs like vidanga and haritaki. The hemorrhoid CD below contains a more comprehensive list of treatments.