Hemorrhoids are swollen, enlarged veins found either inside the rectum or beneath the skin around the anus. The sensory experience of having hemorrhoids is highly variable and depends on their location and extent of inflammation. Symptoms can range from mild, intermittent annoyance to sudden, severe, and debilitating pain.
Persistent Irritation and Discomfort
The most common complaints are an insistent itching and a low-grade burning sensation. This persistent irritation results from inflammation of the delicate perianal skin. The swelling of external hemorrhoids irritates the surrounding nerve endings.
The sensation can also be exacerbated by moisture and discharge. Prolapsed internal hemorrhoids sometimes drag mucus onto the external skin, which mixes with trace amounts of stool. This combination is highly irritating, leading to a relentless urge to scratch that further damages the sensitive tissue. Constant friction from clothing or sitting maintains this cycle of discomfort, making the area feel chronically inflamed and tender.
Sensations During and After Bowel Movements
Passing stool frequently triggers the most acute sensory experiences associated with hemorrhoids. When a firm or large stool passes, it scrapes against the swollen tissue, causing sharp, tearing pain during defecation. This is especially true for external hemorrhoids, which are covered by highly sensitive skin.
Straining to pass a bowel movement significantly increases pressure on the already engorged veins, heightening the pain. Immediately following the bowel movement, the sharp pain often subsides, leaving behind a sensation of residual throbbing or soreness. This lingering ache is due to the trauma and continued swelling from the passage of stool.
The Feeling of Physical Presence
Some individuals experience a constant sensation of fullness or pressure in the rectal area. This feeling is a direct result of the physical presence of the enlarged hemorrhoidal tissue within the anal canal or protruding outside of it. Swollen internal hemorrhoids can create a constant pressure on the rectum, mimicking the sensation of needing to pass stool.
For external or prolapsed hemorrhoids, the sensation is one of a soft, sensitive lump or bulge at the anal opening. This mass can be felt when wiping or sitting, and it creates a dull, constant awareness of “something being there.” The feeling of incomplete evacuation is also common because the swollen tissue partially obstructs the passage or gives a false signal of fullness.
When the Pain Becomes Severe
More intense pain occurs with complications, such as a thrombosed external hemorrhoid. This happens when a blood clot forms inside the swollen vein, causing rapid enlargement and substantial pressure. The resulting sensation is one of sudden, severe, and unrelenting pain, sharply contrasted with the intermittent discomfort of typical hemorrhoids.
The pain is often described as an intense, localized throbbing that makes sitting, walking, or even light movement extremely difficult. Because the clot causes a hard, tender lump under the sensitive perianal skin, the feeling is often likened to sitting on a stone. This severe pain typically peaks within the first 48 to 72 hours of the clot forming and indicates the condition has escalated beyond mild irritation.