Hello and welcome to Healthcaremagic.com. A precise definition of hemorrhoids does not exist, but they can be described as masses or clumps ( cushions ) of tissue within the anal canal that contain blood vessels and the surrounding, supporting tissue made up of muscle and elastic fibers. The anal canal is the last four centimeters through which stool passes as it goes from the rectum to the outside world. The anus is the opening of the anal canal to the outside world. Although most people think hemorrhoids are abnormal, they are present in everyone. It is only when the hemorrhoidal cushions enlarge that hemorrhoids can cause problems and be considered abnormal or a disease. It is not known why hemorrhoids enlarge. There are several theories about the cause, including inadequate intake of fiber, prolonged sitting on the toilet, and chronic straining to have a bowel movement (constipation). None of these theories has strong experimental support. Pregnancy is a clear cause of enlarged hemorrhoids though, again, the reason is not clear. Tumors in the pelvis also cause enlargement of hemorrhoids by pressing on veins draining upwards from the anal canal. It is recommended, therefore, that individuals with hemorrhoids soften their stools by increasing the fiber in their diets. Fiber is found in numerous foodstuffs including fresh and dried fruits, vegetables, grains, and cereals. Generally 20-30 grams per day of fiber are recommended whereas the average American diet contains less than 15 grams of fiber. Supplemental fiber (psyllium, methylcellulose, or calcium polycarbophil) also may be used to increase the intake of fiber. Stool softeners and increased drinking of liquids also may be recommended. Surgery is the only permanent solution to hemorrhoids. Even so, hemorrhoids may reappear several years later. Regarding the long term use of laxatives, this is not a wise solution. Your body will become dependent on laxatives. Increase fiber and water intake. Be well, Dr. Kimberly