Hemorrhoids are swollen veins located in the rectum or anus. They often develop due to increased pressure in the lower rectum, commonly from straining during bowel movements, chronic constipation or diarrhea, or pregnancy. This article focuses on the sensations associated with internal hemorrhoids, which originate inside the rectum.
Understanding Internal Hemorrhoids
Internal hemorrhoids form above the dentate line, a demarcation point within the anal canal. This area has very few pain-sensing nerve endings. Consequently, internal hemorrhoids often do not cause direct pain. Their presence is usually noticed through other distinct sensations and symptoms.
Despite the lack of pain nerves, internal hemorrhoids can still create unique feelings. These sensations typically arise from their size, location, and how they interact with the surrounding tissues during daily activities. The absence of pain often leads individuals to be unaware of internal hemorrhoids until other symptoms become noticeable.
Common Sensations and Symptoms
When internal hemorrhoids become enlarged, they can create a feeling of pressure or constant awareness of something present within the rectum. Individuals might also experience a feeling of fullness, as if the rectum is not completely empty after passing stool. This sensation, known as tenesmus, can lead to repeated, ineffective attempts to evacuate.
During a bowel movement, internal hemorrhoids can cause a distinct sensation of a “bulge” or protrusion. This occurs as the swollen tissue descends with the passage of stool, sometimes momentarily exiting the anal opening.
One of the most common symptoms of internal hemorrhoids is painless bleeding. This bleeding is usually bright red and can be observed on toilet paper, in the toilet bowl, or on the surface of the stool. The bright red color indicates fresh blood from delicate vessels on the hemorrhoid’s surface, which can be easily damaged by hard stool. If an internal hemorrhoid prolapses and remains outside the anal canal, it can become irritated, leading to itching or discomfort around the anal opening.
Distinguishing Internal from External Hemorrhoids
Understanding the difference between internal and external hemorrhoids is key to interpreting the sensations experienced. External hemorrhoids develop below the dentate line, in the anal skin rich in pain-sensing nerves. This anatomical distinction means external hemorrhoids are often associated with sharp pain, tenderness, and a noticeable lump around the anal opening. The discomfort is typically immediate and can be intense, especially if a blood clot forms within them (thrombosed external hemorrhoid).
In contrast, internal hemorrhoids rarely cause pain unless they prolapse significantly or become thrombosed. Their sensations are generally more subtle, such as pressure, fullness, or the feeling of incomplete evacuation, rather than acute pain. While external hemorrhoids present as palpable, tender lumps on the outside, internal hemorrhoids are usually not felt externally unless they have prolapsed and are visible or palpable outside the anus.
When to Seek Medical Advice
It is advisable to consult a healthcare professional if you experience persistent bleeding during bowel movements. While often associated with hemorrhoids, rectal bleeding can also indicate other, more serious conditions.
Seeking medical advice is also important if you experience significant pain, which might suggest a thrombosed hemorrhoid, a severely prolapsed internal hemorrhoid, or another underlying issue. Any noticeable changes in bowel habits, such as unexplained constipation or diarrhea, or any other concerning symptoms, warrant a medical evaluation. A healthcare provider can provide an accurate diagnosis and recommend appropriate treatment options.