Types Of Hemorrhoids: Internal And External
Hemorrhoids are either internal or external.
Internal Hemorrhoids These hemorrhoids develop inside the rectum and are not usually visible to the naked eye. Internal hemorrhoids generally don’t hurt, but they often bleed painlessly.
In some cases, internal hemorrhoids may protrude through the anus and can be seen, which is known as becoming prolapsed. When this happens, they will usually shrink back inside the rectum on their own or can be pushed back in.
External Hemorrhoids These hemorrhoids develop under the skin around the outside of the anus. These are the most uncomfortable hemorrhoids and can be itchy or painful, and may feel lumpy. When a blood clot forms within an external hemorrhoid, this is known as a thrombosed hemorrhoid, which can result in severe, ongoing pain. Sometimes clots dissolve on their own, but if they dont, your doctor can remove the clot, a procedure thats most effective if done within 72 hours of the clot forming.
Causes And Risk Factors
The underlying cause of hemorrhoids that form in the anus or rectum is still a matter of debate. One theory is that it is due to the breakdown of the supporting tissues in the anal canal.
When hemorrhoids are untreated, last for a long time, or are under more physical pressure, they can become prolapsed and protrude out of the anus or rectum.
There are several risk factors for prolapsed hemorrhoids, including:
- Advanced age
- Overuse of anti-diarrhea medications
Sometimes, placing something in the anus, such as during sexual activity, or for medical treatment, can also cause pressure, resulting in a prolapsed hemorrhoid.
Home Remedies To Prevent Constipation
The healthy bacteria needed for your digestive tract, known as probiotics, may significantly reduce constipation and accompanying symptoms. The role of these microorganisms is to balance the micro flora in the digestive system and allow your body to form healthy stool to more easily pass through the colon. You can purchase probiotics at a health food store with a dosage of approximately 7-12 billion with multiple strains .
2. Fiber from foods
There are two types of fiber: soluble and insoluble. Generally, insoluble fiber is the most helpful for constipation as it passes virtually undigested through the digestive tract, adding bulk to stool and moving waste out of the body. Food sources are less harsh than herbal laxatives, such as cascara or psyllium husks, so you may want to try eating more nuts and seeds, brown rice, flax seedsand sweet potatoes first. Both types of fiber are beneficial as soluble fiber helps lower cholesterol and keep your blood sugar balanced.
3. Eat smaller meals
4. Stress reduction
Try something like yoga for constipation. There are specific poses to help move things along. Deep breathing and going for walks can also help relax and balance you, including your digestion.
5. Food intolerance
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Relieve Pain And Itching
- Take nonprescription pain relievers. Acetaminophen can help with pain. Aspirin and other nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen can help with pain and swelling. Be safe with medicines. Read and follow all instructions on the label.
- Apply ice several times a day for 10 minutes at a time. Follow this by placing a warm compress on the anal area for another 10 to 20 minutes.
- Take a sitz bath. Fill your bathtub with just enough warm water to cover the anal area. Do this several times a day, especially after you have had a bowel movement. Soak for about 15 minutes at a time. Be careful! If the water is too warm, it can burn you.
Use nonprescription medicines as recommended by your doctor or pharmacist. See Medications for information on nonprescription ointments, creams, and suppositories.
What Do External And Internal Hemorrhoids Look Like
Normal hemorrhoidal tissue cannot be seen since they must first swell and become inflamed or develop a clot to cause symptoms. One can see swollen external hemorrhoids or internal prolapsed hemorrhoids exposed outside the anus but internal hemorrhoids cannot be seen because they remain inside the anus. A thrombosed hemorrhoid will appear as a lump at the anal verge, protruding from the anus, and will be dark bluish in color because of the blood clot contained inside the swollen blood vessel. Non-thrombosed hemorrhoids will appear as a rubbery lump. Often more than one swollen hemorrhoid appears at the same time.
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How Do You Stop Internal Hemorrhoids From Bleeding
Bleeding from internal hemorrhoids can cause pain, distress and embarrassment, but the condition is surprisingly common. Occasionally, hemorrhoids are serious and require medical procedures, but often, the patient is able to stop internal hemorrhoids from bleeding with simple measures, such a change of diet. Over-the-counter medication might also provide relief and help to stop the bleeding.
Internal hemorrhoids form as bulbous cushions on the upper wall of the rectal canal. The cause of hemorrhoids is not fully understood, but constipation, sitting for prolonged periods and pregnancy are generally recognized as contributory factors. Symptoms include itching, pain and bleeding.
Constipation and the straining associated with passing hard stools is widely believed to cause hemorrhoids to swell and to aggravate existing hemorrhoids. As the stool passes, pressure and friction can rupture the hemorrhoid and cause pain and bleeding. By treating constipation, the patient can keep the internal hemorrhoids from bleeding.
Increasing dietary fiber can reduce constipation. Many people, especially in the developed world, do not eat enough fiber-rich foods, and including more fiber in the diet can have dramatic results. Dietary fiber supplements and stool softeners might also help to manage constipation.
What To Think About
Sometimes, increased pressure on external hemorrhoids causes them to get irritated and to clot. This causes a lump to form. You may suffer from severe pain at the site of a clotted hemorrhoid.
A procedure to relieve the pain can be done in a doctor’s office or outpatient clinic. The doctor applies local anesthesia and then makes a small incision where the lump has occurred to remove the clot and reduce pressure and pain. The procedure works best if it is done soon after the clot has formed.
If the pain is tolerable, you may choose to wait to see a doctor. The pain usually goes away in a few days. After 4 or 5 days, the pain from cutting and draining the hemorrhoid is usually worse than the pain from the clot.
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What Does Severe Fibroids And Constipation Pain Feel Like
Fibroid pain is often debilitating, affecting all areas of a womans life. Cramps are often so severe, NSAIDs dont manage the pain as well as they do for regular menstrual discomfort. Depending on the size and number of fibroids within the uterus, the pelvic area might feel full, enlarged, or heavy. Additionally, fibroids can cause back and leg pain if they press on sensitive nerves.
In comparison, hemorrhoid pain can range anywhere from little to no pain, to itching or burning. Wiping or going to the restroom might be uncomfortable and feel hot. Experiencing sharp abdominal pain is also associated with constipation and hemorrhoids. Both fibroids and rectal pain is uncomfortable and can be treated easily with the right measures.
Muscle Tone And Nerve Supply Can Contribute To Constipation
Your bowel moves whatever is inside it through its length by a muscular action called peristalsis. Its quite a vigorous action, and its the same one thats used when you swallow.
Your intestines can be considered in five major parts your mouth is the first, then the throat or oesophagus, then the stomach, then the small bowel and then the large bowel.
The throat and stomach have very vigorous peristaltic action, kneading the bowel contents around, back and forth, allowing them to mix with secretions that cause digestion.
Muscles dont fire without getting nerve impulses, and the body controls all this muscular action without conscious effort, using the autonomic nervous system .
Equally, if theres anything affecting the muscles, then it doesnt matter how many nerve impulses arrive, not much will happen.
Diet and drugs can affect muscles and nerves, and hence can cause constipation and diarrhea
Although many diseases can affect either of these systems, the most common way you will affect muscles and nerves in your gut is with drugs, either deliberately when you are taking prescribed ones or without realizing it when you eat or drink certain foods.
Chillies contain a chemical that can irritate the lining of the bowel, for example, and the body responds by flushing the bowel contents through Im sure thats not news to anyone who likes strong curry diarrhea.
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Can Hemorrhoids Block Bowel Movements
Although hemorrhoids are common, they arent easy to deal with for most patients. When it comes to having a bowel movement, hemorrhoids can make it difficult.
Whether hemorrhoids occur internally or exist around the opening of the anus, they can make it hard to pass your stool.
The swelling that occurs from hemorrhoids can keep you from being able to pass a bowel movement. If you have constipation and hemorrhoids simultaneously, it only worsens your condition.
When Do I Need To See A Doctor About Rectal Bleeding
Its usually a good idea to reach out to your healthcare provider whenever you have rectal bleeding. It can be a sign of another health condition that might need treatment. If you have heavy bleeding or are seeing blood in multiple bowel movements, its urgent that you see your provider. Rectal bleeding can have serious causes that need to be treated.
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Modify Your Daily Activities
- Avoid prolonged sitting or standing. Take frequent short walks.
- If possible, avoid lifting heavy objects frequently. If you must lift heavy objects, always exhale as you lift the object. Don’t hold your breath when you lift.
- If you are pregnant, sleeping on your side will lower pressure on the blood vessels in your pelvis. This can help keep hemorrhoids from becoming bigger.
What Makes Constipation Happen
The first thing that can cause constipation is the medicine that is too high in calcium or aluminum. The next thing that can make constipation is colon cancer when suffering hemorrhoids.
The next thing that can cause constipation is eating too many dairy products. The next thing that can make constipation is because of a lack of water consumed.
Then, the thing that can make constipation is problems in your digestive process. Lastly, similarly bearing the need for having a bowel movement which is because of hemorrhoids can also be a reason.
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What Questions Should I Ask My Doctor
You may want to ask your healthcare provider:
- Why did I get hemorrhoids?
- What is the best treatment for me?
- What lifestyle changes can I make to keep from getting hemorrhoids again?
- When will symptoms improve?
- Should I look out for signs of complications?
A note from Cleveland Clinic
An estimated 15 million Americans have sought treatments for hemorrhoids at some point in their lives. But many more suffer needlessly. Dont be too embarrassed to talk to your healthcare provider about your symptoms. If hemorrhoids cause pain or discomfort, your provider has treatments that can help. You can also take steps to keep hemorrhoids from coming back.
Last reviewed by a Cleveland Clinic medical professional on 01/18/2021.
What Are Hemorrhoids Symptoms Causes Diagnosis Treatment And Prevention
Hemorrhoids are enlarged and swollen veins around the outside of the anus or in the lower rectum. The rectum is the last part of the bowel and leads to the anus, the opening at the end of the bowel where fecal matter leaves the body.
Everyone has hemorrhoidal tissue in this area thats made up of blood vessels, connective tissue, and some muscle. These cushions dont always become enlarged or distended, but as we age, this phenomenon becomes more common causing what we call hemorrhoids, also known as piles.
Hemorrhoids can be caused in a number of ways, most commonly by straining to make a bowel movement. Lifting heavy objects, along with other activities that may cause straining, can also lead to hemorrhoids. Experiencing increased pressure during pregnancy and being overweight are other contributing factors.
Hemorrhoids may be painful and particularly bothersome if they are recurrent, but they’re not dangerous or life-threatening, and symptoms usually go away within a few days. There are plenty of effective ways to treat them, as well as options for the less common types of hemorrhoids that may be more problematic.
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What To Do When Your Hemorrhoid Comes Out During A Bowel Movement
If your hemorrhoid protrudes out of the anal opening during a bowel movement, there are a few things you can do.
- Internal hemorrhoids that are prolapsed sometimes spontaneously retract on their own.
- In some cases, when prolapsed internal hemorrhoids dont retract on their own, they can be pushed back into place manually.
- Creams, ointments, and suppositories are available to treat hemorrhoids and reduce swelling.
- If you have a prolapsed internal hemorrhoid that does not spontaneously retract or cant be pushed back inside manually, you may need to have hemorrhoid surgery. A hemorrhoid doctor can assess your situation and determine whether you need a surgical procedure called stapling.
What Causes Colon Cancer And Hemorrhoids Do Hemorroids Lead To Colon Cancer
Colon Cancer Causes
Most colorectal cancers arise from adenomatous polyps. Such polyps are comprised of excess numbers of both normal and abnormal appearing cells in the glands covering the inner wall of the colon. Over time, these abnormal growths enlarge and ultimately degenerate to become adenocarcinomas.
People with certain genetic abnormalities develop what are known as familial adenomatous polyposis syndromes. Such people have a greater-than-normal risk of colorectal cancer. In these conditions, numerous adenomatous polyps develop in the colon, ultimately leading to colon cancer.
- There are specific genetic abnormalities found in the two main forms of familial adenomatous polyposis.
- The cancer usually occurs before age 40 years.
- Adenomatous polyposis syndromes tend to run in families. Such cases are referred to as familial adenomatous polyposis . Celecoxib has been FDA approved for FAP. After six months, celecoxib reduced the mean number of rectal and colon polyps by 28% compared to placebo 5%.
Another group of colon cancer syndromes, termed hereditary nonpolyposis colorectal cancer syndromes, also runs in families. In these syndromes, colon cancer develops without the precursor polyps.
HNPCC syndromes are sometimes linked to tumors in other parts of the body.
Other high risk factors for developing colon cancers include any one of the following:
- Ulcerative colitis or Crohn’s colitis
- Breast, uterine, or ovarian cancer now or in the past
- A family history of colon cancer
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Do Hemorrhoids Cause Constipation
Sometimes, patients notice that their hemorrhoids flare up right around the same time a bout of constipation hits. This leads some patients to wonder Do hemorrhoids cause constipation? The answer is no. In fact, its actually the other way around. If your hemorrhoids are causing more discomfort, pain, or bleeding, constipation is a likely cause. As stated above, constipation leads to straining, causing veins to swell and become permanent hemorrhoids.
Hemorrhoids Constipation Treatment: Diet And Lifestyle
Prolonged or frequent constipation often causes hemorrhoids by increasing the pressure in the anal region. To treat hemorrhoids effectively, the constipation must be treated simultaneously. Here are some measures to cure constipation and hemorrhoids:
Your diet must contain fiber in each meal, since fiber stimulate the bowel to work better and empty itself in due time. Food sources containing fiber are full corn cereals, full corn bread, vegetables and fruit.
Your diet must contain the right amount of fat. Too little fat makes the stool hard, too much can irritate the digestion. Vary between these natural fat sources: Fat fish, almonds, olive oil, rape oil, canola oil and flax oil. The fat type in these oils alleviates inflammations in the digestive system. In addition you should consume some, but not too much of these fat sources: Nuts, sunflower seeds, avocados, eggs, spawn, sunflower oil, corn oil and soy oil.
Drink enough water, since water makes the stool softer.
Eat regular meals each day. Do not overfill your stomach at each meal. It can be better to eat four or five smaller meals that three larger.
Go to the toilet every time you feel the urge to pass stool. Relax at the toilet and let it all get the time to pass out. Try to avoid straining to pass the stool out. To ease the passing of stool you can smear the anal opening with vaseline or with special ointments made for this purpose.
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Are There Any Tests For Rectal Bleeding
There are several ways your healthcare provider can evaluate rectal bleeding to help figure out the cause. Your provider might start by asking you about the situation around your rectal bleeding. Some questions may include:
- When did the rectal bleeding start?
- What did you eat the day before seeing the rectal bleeding?
- How frequently do you have a bowel movement?
- Have you been constipated?
- Were you straining during your bowel movement?
- Do you have pain when you have the rectal bleeding?
- Is there blood on your stool , in the toilet bowel or when you wipe?
- Do you have hemorrhoids?
- Do you have any inflammatory bowel conditions?
- Do you have a family history of colorectal cancer?
These questions can help your healthcare provider narrow down a possible cause of your bleeding. There are also tests that your provider can do to help determine the cause.
Tests to help diagnose the cause of rectal bleeding can include:
- A physical exam of the rectum and anus.
- A sigmoidoscopy.
- A fecal occult blood test .
Your healthcare provider may suggest only one of these tests, or do several of them together to try and discover the cause of your rectal bleeding.