Hemorrhoids are swollen veins that develop in the anus and lower rectum. This swelling leads to various uncomfortable sensations and visible signs. Since many people experience these symptoms without knowing the underlying cause, understanding what hemorrhoids feel like can provide clarity and guide decisions about care. This article details the common sensations and physical manifestations associated with this condition.
Distinguishing Internal and External Hemorrhoids
The type of sensation experienced is determined by the location of the swollen veins relative to the dentate line, a dividing line inside the anal canal. Internal hemorrhoids form above this line, deep within the rectum, where there are very few pain-sensitive nerve endings. Consequently, these internal swellings often do not cause discomfort unless they progress to a significant degree, such as when they prolapse or swell drastically.
In contrast, external hemorrhoids are situated beneath the highly sensitive skin surrounding the anal opening. This area is richly supplied with somatic nerves that detect pain, pressure, and temperature. External hemorrhoids are far more likely to cause immediate, noticeable pain and a constant sense of irritation due to this difference in nerve supply.
Core Sensations Itching Burning and Irritation
The persistent sensations of itching and burning are common complaints. Anal itching, medically termed pruritus ani, is a frequent complaint that arises from the inflammation of the swollen tissue. The body’s immune response to this inflammation can trigger the release of chemicals like histamine, which mediates itching sensations.
A feeling of burning or generalized irritation often accompanies the itching, sometimes caused by friction against clothing or during wiping. This irritation can be exacerbated by difficulty keeping the area clean, as residual fecal matter can further inflame the delicate skin. The continuous nagging presence of these sensations can significantly affect a person’s quality of life.
Physical Signs and Acute Pain
Beyond the chronic irritation, hemorrhoids often present with tangible physical signs that can be felt, along with episodes of acute pain. A primary physical sign is the sensation of a lump or swelling around the anus, which is typically an external hemorrhoid or an internal one that has bulged outward, known as a prolapse. Prolapsed internal hemorrhoids can also create a feeling of pressure or incomplete evacuation after a bowel movement.
A distinct and severe form of pain occurs when a blood clot forms inside an external hemorrhoid, creating a condition called a thrombosed hemorrhoid. This event causes a sudden onset of intense, throbbing pain due to the rapid pressure increase from the clot within the vein. Thrombosed hemorrhoids are often visible as a hard, tender lump that may appear dark blue or purple under the skin.
Identifying Bleeding and Mucus Discharge
One of the most common signs of hemorrhoids is the presence of blood, often detected on toilet paper or in the toilet bowl. This bleeding is usually bright red, indicating fresh blood originating from the lower gastrointestinal tract. Hemorrhoidal bleeding is typically painless because it most often comes from internal hemorrhoids located above the pain-sensitive dentate line.
The blood may appear as streaks on the surface of the stool, on the wiping tissue, or sometimes drip into the toilet bowl after a bowel movement. The presence of mucus or a sticky discharge is another sign, particularly with prolapsed internal hemorrhoids. This is because the lining of the rectum, which produces mucus, is pushed outside the anal canal, leading to increased moisture and subsequent skin irritation.
When Symptoms Warrant Medical Attention
While many hemorrhoidal symptoms are mild and can resolve with simple home care measures, certain signs indicate the need for professional medical evaluation. If symptoms such as pain, itching, or swelling persist for more than a week despite using over-the-counter treatments, consult a healthcare provider. Persistent symptoms may suggest a more advanced or complicated condition.
Any occurrence of severe, sudden pain should prompt immediate medical attention, as this could signal a thrombosed hemorrhoid requiring intervention. It is also important to seek professional guidance for heavy or continuous rectal bleeding. A change in the color of the blood to dark red or maroon, or any associated change in bowel habits or unexplained weight loss, requires prompt evaluation to rule out other, potentially more serious conditions.