Hemorrhoids are a common condition involving swollen veins in the lower rectum and anus, similar to varicose veins found elsewhere in the body. They develop when the walls of these blood vessels stretch and become irritated, particularly during bowel movements. Many individuals will experience hemorrhoids at some point in their lives.
Understanding Internal Hemorrhoids
Internal hemorrhoids are located inside the rectum, above the dentate line. This location means they are typically not visible or felt directly, as this part of the anal canal has few pain-sensing nerves. They usually do not cause discomfort unless they significantly enlarge or protrude.
These vascular cushions are a natural part of human anatomy, aiding in stool continence by adding bulk to the anal canal. When these veins swell due to increased pressure, they can become problematic. This swelling can occur from factors like straining during bowel movements, chronic constipation or diarrhea, or prolonged sitting.
Recognizing the Signs
Internal hemorrhoids are not usually visible from the outside, but their presence is indicated by specific signs. The most common is painless, bright red bleeding during or after a bowel movement. This blood may be noticed on toilet paper, in the toilet bowl, or mixed with stool. The bright red color indicates that the blood is fresh, often from arterial sources within the hemorrhoidal tissue.
If an internal hemorrhoid becomes enlarged, it can push outside the anal opening, known as a prolapsed hemorrhoid. A prolapsed internal hemorrhoid appears as a soft, reddish lump protruding from the anus. It might be visible upon inspection, sometimes requiring manual reduction back inside.
Other non-visual indicators include a feeling of fullness in the rectum or a sensation of sitting on something. Some individuals may experience itching or irritation around the anal area.
Distinguishing From External Hemorrhoids
Internal hemorrhoids differ from external hemorrhoids in location and typical symptoms. External hemorrhoids develop under the skin around the anus, an area rich in pain-sensing nerves. This makes external hemorrhoids more painful and noticeable.
External hemorrhoids can be felt or seen as lumps around the anal opening, which may appear bluish if a blood clot forms within them (thrombosed hemorrhoid). Unlike internal hemorrhoids, external ones cannot be pushed back inside. While both types can bleed, external hemorrhoids are more prone to significant pain and discomfort, especially when sitting or during physical activities.
When to Consult a Doctor
Consult a doctor if hemorrhoid symptoms persist or worsen. If you experience persistent bleeding during bowel movements, seek medical advice. Rectal bleeding can indicate various conditions, some more serious than hemorrhoids, such as inflammatory bowel disease or colorectal cancer.
A doctor’s evaluation is recommended if you notice severe pain, a change in bowel habits, or if home treatments do not provide relief after about a week. Any new or unusual changes around the anal area should be checked by a professional. A medical professional can accurately diagnose the condition and rule out other potential causes for your symptoms.