Hemorrhoids are swollen, inflamed veins in the rectum or around the anus, often called piles. They commonly develop due to increased pressure in the lower rectum, affecting about half of all adults by age 50. Recognizing their characteristics helps in identification.
Types of Hemorrhoids
Hemorrhoids are categorized as internal or external based on their location. Internal hemorrhoids form inside the rectum, above the dentate line, where pain-sensing nerves are scarce. They typically cause no discomfort unless they prolapse, pushing out through the anal opening, and are usually not visible externally.
External hemorrhoids develop under the skin around the anus, below the dentate line. This area has many pain-sensing nerves, making external hemorrhoids more prone to pain and discomfort. They are often visible and palpable as small lumps. Both types can swell and become irritated, causing noticeable symptoms.
Recognizing the Signs
Bright red blood during or after a bowel movement is a common sign. It may appear on toilet paper, in the toilet, or on stool. This bleeding is usually painless, especially with internal hemorrhoids, and occurs when fragile veins rupture.
Itching or irritation around the anal area is also common. This sensation, ranging from mild to intense, often results from skin inflammation around external hemorrhoids or moisture from prolapsed internal ones. It can be persistent and worsen after bowel movements.
Pain or discomfort frequently occurs, particularly with external hemorrhoids. This pain can worsen when sitting or during bowel movements. If a blood clot forms within an external hemorrhoid (thrombosed hemorrhoid), it causes sudden, severe pain and a firm, discolored lump.
A swelling or lump around the anus often indicates an external hemorrhoid. These lumps are typically soft, but a thrombosed one feels firmer and may appear blue or purple. Prolapsed internal hemorrhoids can also appear as protruding tissue that may be gently pushed back inside.
Mucus discharge from the anus may also be observed. This can cause irritation and make hygiene difficult. Mucus suggests a prolapsed internal hemorrhoid, which might also lead to a feeling of incomplete bowel evacuation.
When to Consult a Doctor
While many hemorrhoid symptoms respond to home care, consult a doctor if symptoms persist or worsen. Seek professional evaluation if home treatments don’t provide relief within a week, or if discomfort becomes severe. Persistent or increasing pain, especially if it interferes with daily activities like sitting, warrants medical attention.
Any rectal bleeding requires a doctor’s visit. While hemorrhoids commonly cause bright red blood, more serious conditions like inflammatory bowel disease, anal fissures, or colorectal cancer can also cause bleeding. A healthcare provider can accurately diagnose the source and rule out other issues.
If a new, painful lump develops around the anus, especially if severe or discolored, it may be a thrombosed external hemorrhoid. This condition often requires specific medical intervention for pain relief. Any new or changing symptoms, or uncertainty about the cause, should prompt a consultation.