With a prevalence of 4.4% in the US, hemorrhoids fall under the category of frequently occurring disorders. The symptoms of this issue can range from mild to severe, but it’d require professional assessment regardless of the severity.
But how does one know if one has hemorrhoids? Since the symptoms resemble those of other gastrointestinal disorders, making the distinction between them is very important.
Internal vs. External Hemorrhoids
In a sense, every person has hemorrhoids. These normal structures are present in the lowest segment of the rectum and anus. These clusters of veins lie beneath the mucous membranes and are not considered an issue until they become enlarged. This is why the more appropriate way to describe this issue is swollen hemorrhoids, or piles.
Hemorrhoids can be internal or external. These types present themselves in different ways, so it might not always be possible to notice them. Let’s take a look at the differences between them.
What Do Internal Hemorrhoids Look Like?
Internal hemorrhoids can be found on the inside of the rectum, close enough to the anus to be visible from the outside. Structurally, they resemble varicose veins and are almost completely painless. The reason for this is that there are very few pain receptors in this area.
The only symptom a person may notice is bleeding. The blood should be bright red in most cases, but sometimes regular-colored. Dark blood coming from the anus is a sign that something might be wrong with the upper part of the gastrointestinal system.
Another thing that can happen is prolapsing of the internal hemorrhoids. In this case, hemorrhoids protrude outside the anal sphincter and can be felt by hand. Pain is often the accompanying symptom, which reaches its peak during and after bowel movements. Prolapsed hemorrhoids can either go back inside on their own or be pushed inside.
What Do External Hemorrhoids Look Like?
External hemorrhoids appear under the skin surrounding the anus. This area has quite a lot of pain-sensing nerves, so pain is more frequent and usually more severe. In addition, straining during bowel movements can cause serious bleeding.
Sometimes, blood clots can form inside both internal and external hemorrhoids. This is referred to as a thrombosed hemorrhoid, and in this situation, external hemorrhoids can have a blueish or purple color. Thrombosed hemorrhoids can cause quite a number of issues, as they can hurt and itch badly, even after bowel movements. The blood clot can also dissolve, in which case the leftover skin stays in the hemorrhoid’s place and can become easily irritated and cause further issues.
External hemorrhoids are much easier to diagnose than internal since they’re often clearly visible. The symptoms of external hemorrhoids often resolve within a couple of days, but they can persist for longer. This is when medical attention would be needed.
Now that we’ve established a difference in the way internal and external hemorrhoids look and feel, we should do the same for different stages of this disorder.
Hemorrhoids by Stages
There are four stages of hemorrhoids. Each stage presents different symptoms, during which the hemorrhoids have a different look and feel to them. Determining the exact stage of the hemorrhoids helps the doctor find the most appropriate remedy. Even though it should be done by a professional, everyone can estimate the state of their hemorrhoids by following the classification below:
- Stage I – Stage I hemorrhoids are minor inflammations that can only be found inside the anal canal. They can’t be seen or felt by hand. Common symptoms include bleeding and mild discomfort during bowel movements.
- Stage II – The hemorrhoids grow larger and can cause more discomfort, but they are often painless. They can protrude during bowel movements but should get back inside the anal canal on their own immediately after.
- Stage III – Referred to as prolapsed hemorrhoids, they stay outside the anus. They can be felt by hand and can sometimes cause pain during and after bowel movements. They don’t go back inside on their own and need to be pushed back.
- Stage IV – Hemorrhoids stay outside the anus indefinitely. Can’t be pushed back manually and often require surgery, as other treatments are ineffective.
The stages don’t just define the look and feel of the hemorrhoids. Their identification assists in finding the fitting treatment.
For example, stage I hemorrhoids can often be cured by simple lifestyle changes, including a fiber-rich diet and exercise. Symptoms of stage II and III hemorrhoids can be managed by OTC (Over-The-Counter) medications in the form of creams, pads, or painkillers. Around 10 % of sufferers will end up having Stage IV hemorrhoids, for which surgical treatment is necessary.
When to Visit a Doctor
Even though hemorrhoids are fairly harmless in most cases, they might result in some severe complications. This is why it’s important to identify them as soon as possible since there’s a much higher chance curing them without the need for surgical procedures or long-term lifestyle changes.
One should visit a doctor if one notices anal bleeding, as this is the most common symptom of all hemorrhoids. Blood spots or traces can be noticed on toilet paper after bowel movements. Sometimes, however, the bleeding can be more profuse, and if it keeps happening, it’s necessary to seek help, as this can lead to anemia.
Other signs that point out to a need for medical attention are constant pain of varying intensity, feeling the need for bowel movements even when there’s nothing there, and itchiness that doesn’t go away with OTC solutions. If there are external hemorrhoids present, or if the internal ones have protruded, a rubbery lump can be felt around and on the anus.
The Final Word
Hemorrhoids can appear in various forms. The effect that they can have on a person’s health can range from discomfort to serious, even life-threatening complications.
For this reason, seeking medical advice from a professional is recommended even if the symptoms don’t appear to be serious. The sooner hemorrhoids are discovered, the easier it will be to get rid of them. On the other hand, those that have had them for a while and those suffering from late-stage hemorrhoids should seek medical help as soon as possible.