GI Health | Hemorrhoids
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Symptoms, Causes and Treatment

What Are Hemorrhoids?

Hemorrhoids are engorged veins in the lower rectum or anus. Hemorrhoids are extremely common and will affect more than half the population at some point in their lives.

There are two types of hemorrhoids – internal and external, without an examination it is very difficult to know the difference between the two. An internal hemorrhoid can look and feel like an external hemorrhoid, so it is important to have a physical examination that determines if internal hemorrhoids have prolapsed, or if you have external hemorrhoids.

Internal Hemorrhoids

Don’t let the name mislead you – internal hemorrhoids can be on the outside when they become large and prolapse. The symptoms of internal hemorrhoids include:

  • A bulge or bump
  • Itching
  • Bleeding
  • Dull pressure sensation
  • Pain after bowel movement

Hemorrhoids are graded on a scale from 1-4 to measure severity.

Grade 1: Small and on the inside
Grade 2: Medium size on the inside
Grade 3: Prolapsing out but can be easily pushed back in
Grade 4: Prolapsing out and cannot be pushed back in

*Most patients have hemorrhoids from grade 1-3

External Hemorrhoids

External hemorrhoids often occur after straining during a bowel movement and appear as painful bumps that have a purple discoloration. External hemorrhoids can be especially painful because they are surrounded by nerve endings near a nerve line known as the dentate line.
Symptoms of external hemorrhoids include:

  • Pain during bowel movement
  • Sensation of pressure near the anus
  • Bump or bulge around the anus
  • Anal bleeding
  • Anal itching

Many people believe they have external hemorrhoids when they really have anal fissures, which are cracks in the rectal skin. Symptoms include:

  • Pain
  • Sensation of razor blades passing when having a bowel movement
  • Blood in stool
  • Itching
  • Other hemorrhoid-like symptoms

Over-the-counter treatment for hemorrhoids will not treat anal fissures. If you believe you have hemorrhoids, but are not feeling any relief, contact a GI doctor.

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