Hemorrhoids are swollen veins that can form inside or outside the anus and rectum. While external hemorrhoids are known for discomfort, internal hemorrhoids are often thought to be painless due to their location in an area with fewer pain-sensing nerves. However, internal hemorrhoids can lead to bothersome symptoms, including itching.
What Are Internal Hemorrhoids?
Internal hemorrhoids are swollen veins located inside the rectum. This region has fewer nerve endings, which explains why they typically do not cause pain. Their most common symptom is painless bleeding, often appearing as bright red blood on toilet paper or in the toilet bowl after a bowel movement.
These vascular cushions help with stool continence. While internal hemorrhoids usually remain unseen and unfelt, they can protrude or become irritated, potentially leading to other noticeable symptoms.
The Link Between Internal Hemorrhoids and Itching
Internal hemorrhoids can cause itching, especially when the tissue moves or prolapses. When an internal hemorrhoid prolapses, it protrudes outside the anal opening, bringing mucus-producing tissue into contact with the sensitive skin around the anus.
The mucus discharged from these prolapsed hemorrhoids is a significant factor in causing itching. This fluid can irritate the perianal skin. If the prolapsed tissue remains outside for an extended period, continuous mucus discharge can lead to persistent moisture and irritation of the surrounding skin.
Prolapsed tissue can also complicate anal hygiene. It becomes more challenging to clean the area, potentially trapping fecal matter and moisture against the irritated skin. This combination of mucus, moisture, and residual stool can intensify irritation and inflammation, leading to itching.
Managing the Itch and When to See a Doctor
Managing itching from internal hemorrhoids involves home care strategies. Gentle hygiene practices include cleaning the anal area with soft, unscented wipes or water after bowel movements, then gently patting dry. Soaking the anal area in a warm bath (sitz bath) for 10 to 20 minutes several times a day can soothe irritation and aid healing.
Dietary adjustments also play an important part in managing hemorrhoid symptoms. Increase fiber intake through fruits, vegetables, and whole grains, and drink plenty of fluids. This can soften stools and reduce straining during bowel movements. Over-the-counter topical treatments like witch hazel or hydrocortisone can provide temporary relief from itching and inflammation. Hydrocortisone creams should not be used for more than a week without medical guidance.
Consult a doctor if itching or other hemorrhoid symptoms persist for more than a week despite home treatment. Any rectal bleeding should be evaluated, especially if accompanied by changes in bowel habits or stool color, to rule out other conditions. Severe pain, worsening symptoms, or a hard, painful lump around the anus require prompt medical attention.