First, the basics: Everyone has hemorrhoids — they are a normal part of human anatomy. Hemorrhoids are bundles of blood vessels in the anus that probably help us to regulate stool and gas.

There are two sets of hemorrhoids:

• External hemorrhoids are on the outside of the anus. When they become inflamed, they can be painful and bleed. Sometimes a blood clot can form in an external hemorrhoid causing a lot of pain.
• Internal hemorrhoids are on the inside of the anus. Usually, when they cause problems, it is in the form of painless bright-red bleeding. Sometimes they can become enlarged and protrude to the outside of the anus.

Hemorrhoids may be caused by:

• Aging
• Chronic constipation or diarrhea
• Pregnancy
• Straining during bowel movements

In many cases, problematic hemorrhoids can be treated without surgery. If surgery is necessary, the type of procedure that you need will be based on the type of problem that you have. Often this can be a simple and relatively painless office procedure, though sometimes surgery in the operating room is required.