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Side Effect: Hemorrhoids

What are hemorrhoids?

A hemorrhoid is a swollen or inflamed vein in the anal or rectal area. Hemorrhoids can be internal (inside the rectum) or external (outside the anus). They can cause pain, itching, and bleeding. When a hemorrhoid collects blood and forms a clot, it is called a thrombosed hemorrhoid.

What do hemorrhoids look like?

Hemorrhoids can vary in size and appearance. Internal hemorrhoids are usually painless and may not be visible, but they can cause bleeding during bowel movements. External hemorrhoids can be seen and felt as a lump or swelling around the anus and can cause discomfort, itching, and pain.
If you have rectal bleeding problems due to hemorrhoids and your immune system has been weakened by cancer treatment, you may be at risk for infection. Signs and symptoms of infection include fever, chills, tiredness and pain.


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Who gets Hemorrhoids?

Up to 75% of adults will have hemorrhoids in their lifetime. Hemorrhoids can be caused by many factors, including straining during bowel movements, chronic constipation, obesity, and aging. Cancer patients are at a higher risk of developing hemorrhoids due to the effects of chemotherapy and radiation therapy on the digestive system. Additionally, opioids are commonly prescribed for pain in patients with cancer. These medications can cause constipation and increase the risk of developing hemorrhoids.

How to prevent Hemorrhoids

To prevent hemorrhoids, it is important to have healthy bowel movements and avoid constipation. This can be achieved through increasing fiber intake, staying hydrated, and staying physically active. Patients should also avoid straining during bowel movements and should use a laxative if necessary.

How to treat Hemorrhoids

Treatment of hemorrhoids depends on the severity of the symptoms and the type of hemorrhoid. Most treatments can be done at home. If constipation is the cause of the hemorrhoids, increasing water and fiber intake can help stool move easier. Topical creams, witch-hazel pads, or sitz baths may help with itching and discomfort. It is recommended to limit the use of topical steroids as they can thin the skin around the anus making it easier for future hemorrhoids to form. In some cases, prescription medications may be necessary.
Another treatment is to remove the hemorrhoid. This requires a medical procedure such as rubber band ligation, laser, infrared light, or hemorrhoidectomy (surgical removal of the hemorrhoids).


1) Davies A, Leach C, Caponero R, et al. MASCC recommendations on the management of constipation in patients with advanced cancer. Support Care Cancer 2020;28(1):23-33

2) Sandler RS and Peery AF. Rethinking What We Know About Hemorrhoids. Clin Gastroenterol Hepatol 2019;17(1):8-15

3) Wald A, Bharucha AE, Cosman BC, and Whitehead WE. ACG clinical guideline: management of benign anorectal disorders. Am J Gastroenterol 2014;109(8):1141-57

Created: January 20, 2024 Updated: January 25, 2024