Hemorrhoid Symptoms and Diagnosis: Internal and External Hemorrhoids

Hemorrhoids are enlarged veins seen in the lower rectum or around the anus. They affect nearly three out of every four individuals at some point and are caused by a variety of factors, the majority of which are unknown.

Internal or external hemorrhoids can occur

  • Internal hemorrhoids develop in the scrotum or anus.

  • Hemorrhoids that are external to the antrum develop. The term "piles" can be used to describe hemorrhoids.

The most common and uncomfortable hemorrhoids are those on the outside. Extreme itching, pain, and problems sitting can all be symptoms of hemorrhoids. Fortunately, there are effective treatments for hemorrhoids. Many people find healing through homemade cures and lifestyle adjustments.

What are the signs and symptoms of hemorrhoids?

Internal hemorrhoids can result in the following −

  • Blood on tissue after a bowel movement 

  • Skin that protrudes from the anus during bowel movements

External hemorrhoids cause the following symptoms −

  • Intense itching around the anus

  • Painful lump(s) or swelling around your anus

  • Aches or soreness around the anus, particularly while sitting

Thrombosed hemorrhoids

If blood pools and forms a clot (thrombus) in external hemorrhoid, it can cause −

  • Extreme discomfort

  • Swelling 

  • Inflammation

  • A hard lump next to your anus

Although hemorrhoids are unpleasant, they are not life-threatening and generally resolve independently without treatment.

Consult your doctor if you have any bleeding or dark bowel motions. Bleeding can be caused by factors other than hemorrhoids and should be investigated. Consult your doctor if your hemorrhoids do not improve after one week of home therapy.

Who is prone to hemorrhoids?

Even teens can get symptomatic hemorrhoids. (However, because hemorrhoids grow slowly, they are uncommon in children.) You may be more vulnerable if you −

  • Have excess weight/obesity.

  • pregnancy

  • Consumption of a low-fiber diet.

  • Have frequent constipation or diarrhea.

  • Lift large items regularly.

  • Spending a lot of time on the toilet seat.

  • While having bowel motions, strain.

What are the causes of hemorrhoids?

Staining produces hemorrhoids by exerting pressure on the veins in your rectum or anus. They may be compared to the spider veins on the legs.

Anal and rectal veins may enlarge and aggravate with any strain that stresses your stomach or lower body. These factors may contribute to hemorrhoids −

  • Weight increase causes pelvic strain, especially during pregnancy.

  • Constipation has made it challenging to have a bowel movement.

  • Lifting oversized items with effort or weightlifting.

How are hemorrhoids identified?

Hemorrhoids are diagnosed by a healthcare expert based on symptoms and a physical exam. You might also have −

  • Digital rectal examination − Your rectum is probed by the doctor's gloves and lubricated finger to look for swollen veins.

  • Anoscopy − Your doctor uses an anoscope, a lit tube, to look at the lining of your rectum and anus. 

  • Sigmoidoscopy − A sigmoidoscope (lighted tube with a camera) is used by your provider to see inside your colon and rectum's lower (sigmoid) section. Flexible sigmoidoscopy and rigid sigmoidoscopy are two procedures (proctoscopy).

    These exams are unpleasant but not painful. They are often performed without anesthesia at a doctor's office or outpatient clinic. You return home the same day.

What are the hemorrhoid treatment options?

Hemorrhoids can be treated at home or at a local clinic.

  • Pain reduction − To alleviate pain, soak in a lukewarm tub of water for at least 10 to 15 minutes per day. You also can sit on a lukewarm water bottle to help relieve the discomfort of external hemorrhoids.

  • To ease the burning and itching − Apply an over-the-counter (OTC) medicinal suppository, ointment, or cream. Hemorrhoid suppositories are available both online and in shops.

  • Supplemental fiber − If you're constipated, an OTC fiber supplement might help soften your stool. Psyllium and methylcellulose are two examples of this sort of supplement.

  • Homemade cures − Hemorrhoids can be relieved with over-the-counter topical medications such as hydrocortisone or hemorrhoid cream. Witch hazel pads can also help with hemorrhoids.

    Both hydrocortisone and hemorrhoid cream is available online.

    Soaking your anus for 10 to 15 minutes daily in a sitz bath can assist.

  • Maintain proper hygiene by cleansing your anus with warm water daily during a shower or bath. However, do not use soap since it might worsen hemorrhoids. Avoid using dry or scratchy toilet paper when wiping after a bowel movement.

  • A cold compress applied to your anus will help minimize hemorrhoid swelling. Pain medicines such as acetaminophen, ibuprofen, or aspirin might also help.

  • Medical treatments − If home remedies aren't working for your hemorrhoid, your doctor may offer a rubber band ligation. The doctor performs this operation by wrapping a rubber band around the hemorrhoid and cutting off circulation.

  • This reduces circulation to the hemorrhoid, causing it to shrink. Only a medical expert should do this surgery. Do not attempt this on your own.

  • If rubber band ligation is impossible for you, your doctor may recommend injectable treatment, also known as sclerotherapy. In this operation, your doctor immediately injects a drug into a blood artery. This causes the hemorrhoids to shrink.

Complications regarding Hemorrhoids

Hemorrhoid complications are uncommon; however, they can include −

  • Anemia, or a shortage of vital red blood cells, which carry oxygen to your cells, can occur in rare cases due to persistent blood loss from hemorrhoids.

  • A strangulated hemorrhage − Internal hemorrhoids may become "strangulated," producing intense agony if the blood supply to the hemorrhoid is harmed.

  • A clump of blood − In rare situations, a hemorrhoid may generate a clot (thrombosed hemorrhoid). While it isn't harmful, it may still be quite painful and has to be lanced and drained sometimes.


The most straightforward strategy to avoid hemorrhoids is to make your stools quite soft, making them pass easily. Follow these guidelines to prevent hemorrhoids and alleviate their symptoms −

  • Consume high-fiber meals − Increase your consumption of whole grains, fruits, and vegetables. By softening and expanding the feces, you can avoid straining, which could result in hemorrhoids. To prevent gas issues, gradually increase your fiber intake.

  • Drink lots of water − Drinking a lot of water (about eight glasses per day) helps to soften the stool, which prevents constipation and maintains proper metabolism.

  • Consider taking fiber supplements − Most individuals do not consume enough fiber, which should be 20 to 30 grams daily.

  • Over-the-counter(OTC) fiber supplements − Studies have shown that some medications, like "psyllium" (Metamucil) or methylcellulose (Citrucel), can reduce hemorrhoid bleeding and general discomfort.

  • If you use fiber supplements − drink at least two-three liters of water each day. Otherwise, the supplements have the potential to induce or aggravate constipation.

  • Don't strain yourself − Straining and holding your breath when pushing the stool increases internal pressure in the veins of the lower rectum.

  • It would be best if you went as soon as you sensed the desire. If you neglect the urgency of having a bowel movement, your feces may become dry and difficult to pass.

  • Exercise − Exercises keep your blood flow active, so your metabolism rates will be standard. Exercise can also help you decrease extra weight, which may be causing your hemorrhoids.

  • Avoid sitting for extended periods − Sitting for too long, especially on the toilet seat, can put more pressure on the veins in the anus.


Hemorrhoids are enlargements and bulging veins in the anus and rectum. They are pretty prevalent and are caused by rectal vein strain. Risk factors include chronic constipation, pushing during bowel movements, a family history of hemorrhoids, and pregnancy.

The majority of hemorrhoids resolve on their own. Treatments frequently focus on symptom treatment and may include warm baths and a hydrocortisone cream or suppository. Exercise, drinking plenty of water, and eating extra fiber can help relieve constipation and prevent future hemorrhoids.

Updated on: 06-Feb-2023


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