Hemorrhoids can be very painful and are located in the anus. They occur when the veins around your anus or in your lower rectum become swollen and inflamed. While you do not know exactly what causes hemorrhoids, there are some factors that lead to their development.

Things like pregnancy, chronic constipation or diarrhea, and sitting on the toilet for long periods of time can all put you at risk for hemorrhoids. As you age, the tone of the muscles in the anal area can decrease, weakening the tissue and causing hemorrhoids to bulge.

Obesity and pregnancy can also increase the risk for hemorrhoids because there is more pressure on tissue in that area. Hemorrhoids are fairly common and usually not dangerous or life-threatening, but they can be painful. They're caused by repeated straining to have a bowel movement, as well as constipation.

Internal Hemorrhoids

Internal hemorrhoids develop inside the lower rectum. You might not even know you have them because they do not usually hurt. But sometimes when you go to the bathroom and wipe, you might notice that there is bright red blood. That's because internal hemorrhoids often bleed painlessly.

Internal hemorrhoids are usually not visible to the naked eye. But in some cases, they may protrude through the anus, which is known as becoming prolapsed. When this happens, they will usually shrink back inside the rectum on their own.

However, protruding hemorrhoids can become irritating and itchy. This may make it difficult for patients to clean themselves after a bowel movement. Internal hemorrhoids are classified by how severe they are, which helps doctors determine the best treatment plan.

There are four grades of hemorrhoids. Grade 1 means there is no prolapse, or protrusion, of tissue through the anal opening. A prolapse that goes back in by itself is categorized as grade 2.  A prolapse that needs to be pushed back in by the patient is considered grade 3. Grade 4 is when the prolapse can’t be pushed back in.

External Hemorrhoids

This type of hemorrhoids can develop either under the skin around the outside of the anus. They can be itchy or painful, and may feel lumpy. External hemorrhoids are called thrombosed hemorrhoids when a blood clot develops within the hemorrhoid. The increased pressure can be very painful, especially within the first 48 hours after it develops.

If you have a thrombosed hemorrhoid, you may notice that the affected area is bluish in color. This is due to the blood clot. In some cases, the blood clot will go away on its own.

However, because the clot has stretched the skin, it may result in an anal skin tag. This is a piece of excess skin that is left when the blood clot in a thrombosed hemorrhoid is absorbed by the body. Skin tags do not require removal, but if they are bothersome to a patient, excision may be an option.

The pain from a thrombosed hemorrhoid usually peaks within two days and then starts to go away on its own. If you can get to your doctor during this time, they may be able to remove the clot with a minor in-office procedure that involves numbing the area and cutting out the hemorrhoid. If you have to wait for the clot to clear up on its own, there are some things you can do at home to help with the pain and swelling.

Doctor’s Diagnosis

If you think you might have hemorrhoids, it's always a good idea to check in with your doctor, especially if you are noticing any bleeding from your anus or rectum, or if you have blood in your stools. If you are experiencing any of these symptoms, please do not hesitate to book an appointment with your doctor.

Hemorrhoids may cause symptoms that are similar to other anal and rectal problems. Your doctor will ask you questions about your medical history and describe your symptoms. They may ask about your eating habits, toilet habits, and use of enemas and laxatives.

Your doctor will also examine you for any lumps, swelling, prolapsed hemorrhoids, external hemorrhoids, skin irritation, skin tags, and anal fissures. These fissures are small tears in the anus that can cause itching and bleeding. 

Some doctors will probably want to take a look up your anus to check for any internal hemorrhoids. This is called a digital rectal examination, and it is done with a gloved, lubricated finger or also called digital rectal examination and a tool called an anoscope.

The anoscope is a type of endoscope, which is a hollow and lighted tube inserted a few inches into the anus. This helps the doctor see any problems inside your rectum. The procedure is done in the doctor’s office and does not require anesthesia.

Key Takeaway

Hemorrhoids are a non-life threatening medical situation but can be extremely painful and itchy. Knowing the early signs of hemorrhoids will help you take the necessary actions as early as possible before it will distract you from your daily activities.