People generally think that only adults have hemorrhoids, but this is not true. Almost every day in our surgical clinic, children are seen for anal lumps and the doctor examines them and diagnoses them as external hemorrhoids (a type of hemorrhoid that is common in children). We even encounter some newborns with external hemorrhoids, so what exactly causes these children to have hemorrhoids at such a young age? Generally speaking, external hemorrhoids are related to constipation. When we take a medical history, most children with hemorrhoids have varying degrees of constipation. Because of the dryness of the stool, the child struggles to defecate and each time takes a long time. Over time, this leads to dilatation of the perianal veins, which manifests as a paranal lump, purplish red and the size of a soybean, that increases in size during defecation. Sometimes it bleeds, or the lump is painful to touch. There is also a type of hemorrhoid called an anterior sentinel hemorrhoid, which is located at 12 o’clock in the truncus position and is mostly associated with anal fissures. There are also some children with hemorrhoids who have normal stools for unknown reasons, which may be related to genetic factors. Parents should see their child as soon as they notice the presence of an anal mass, or blood in the stool. Early detection and treatment are more effective. If constipation is present in the child, the problem of bowel movement should be addressed first. This can be done through diet (more fruits and vegetables, more water, etc.) and medication (open plug, Si Mo Tang oral solution, Dumic, etc.) to laxate and reduce the pressure on the perianal blood vessels. For external hemorrhoids, you can wash and dry them with water, apply local hemorrhoid ointment (such as Ma Yinglong hemorrhoid cream) and massage them gently for 5-10 minutes, 2-3 times a day. For older children, you can instruct them to do anal lifting exercises 50 times a day, several times a day, which is good for increasing perianal vein tension and shrinking external hemorrhoids. If the external hemorrhoid is large, bleeds frequently or is in more severe pain, surgery may be considered.