Though it’s not your typical dinner party conversation topic, hemorrhoids are a lot more common than you might think. In fact, about 10 percent of adults in the U.S. will experience hemorrhoids at some point in their lives.

Obesity, pregnancy, chronic constipation, inactivity and a low-fiber diet can contribute to hemorrhoids. Straining with bowel movements and sitting on the toilet for long periods of time might also cause them to form.

Hemorrhoids are swollen veins – similar to varicose veins – in the lower part of the rectum. Symptoms can range from bleeding to anal itching to tissue actually protruding from the anus. It’s important to know what’s normal and when to see your doctor.

Bleeding from the anus is never normal and you should never blame it on hemorrhoids until you’ve been diagnosed by a doctor. To the untrained eye, a tumor can be mistaken for a bleeding hemorrhoid, sometimes for years.

External tags are often a normal part of the anus, particularly in women who have had children. It they don’t bleed, swell or grow, you usually will not need surgery to correct them.

External hemorrhoids are small, marble-like, purple painful bumps on the outside of the anus that last for about a month. They are caused by lifting, straining or diarrhea. If they are especially painful, your doctor can treat them with a small procedure in the office.

Internal hemorrhoids are often large and may protrude from the anus, either all the time or after a bowel movement. You might notice them if you have been constipated.

Treatment for hemorrhoids varies. It usually starts with a recommendation to increase the amount of fiber you eat. We suggest an over-the-counter fiber supplement. Even if your bowel movements are normal, they can be improved with fiber supplementation.

Bowel movements should be soft and fluffy like a banana, float in the toilet water and stay connected in the toilet bowl. They also should be low residue, so when you wipe, there are no streaks of stool.

Make sure you spend as little time on the toilet as possible – less than two minutes is the goal. The longer you spend on the toilet, the more time the hemorrhoids have to swell and fill with blood.

Never be embarrassed to talk to your doctor about your anal symptoms. It is much easier to treat problems as soon as they start. Fiber supplements and bowel habit changes are good first steps. But if they do not help, ask your doctor about surgical treatments for hemorrhoids that will provide the relief you need.

Dr. Elizabeth McKeown is the area’s only female colorectal surgeon. She sees patients at Memorial Health University Physicians | Surgical Care.