Hemorrhoids: Signs Symptoms And Complications
Andy Miller, MD, is board-certified in internal medicine and infectious disease. He is an associate professor at Weill Cornell Medicine in New York City.
For most people, the signs and symptoms of hemorrhoidsitchiness, swelling, discomfortwill be mild and respond to home remedies. In a minority of cases, however, hemorrhoid signs and symptoms will be severe enough that they require treatment from a physician. Rarely, hemorrhoids that cause significant blood loss or a blood clot can be life-threatening. Itâs important to note that one of the chief calling cards of hemorrhoids, blood in or on the stool or on toilet paper, should never be considered normal. While the cause could indeed be hemorrhoids, a more serious condition could be afoot.
Hemorrhoids can come with external and/or internal symptoms, depending on how they form.
Hemorrhoids on the outside of the anus are known as external hemorrhoids. A hard lump might be felt in that area and can often be uncomfortable because it is irritated by bowel movements and by wiping with toilet paper. External hemorrhoids are painful because of the many nerve endings located on the skin around the anus.
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Dealing With External Hemorrhoids
Pressure on the rectum can lead to an external hemorrhoid. If you develop this problem, it’s time to treat your rear with extra care for the next few days. If the issue doesn’t clear up soon, see a doctor for assistance. To locate an experienced colorectal physician with expertise in treating hemorrhoids, use our online Find a Doctor feature.
As with all medical issues, your physician is the ultimate source as to what procedure best fits your needs. Discuss all options and get a second opinion if you have any doubts. These articles are intended to be a source of general information only.
Hemorrhoids : : Yellow Color Mucus
Recently 3 internal piles were removed through surgery some white n yellow coloured mucus like substance is coming out of anus and itâs stenching a lot even if there is nothing around anus also the smell was there. And i have recently observed small lumps nearer to anus towards my penis.but no pain because of them.I was embarrassed a lot and afraid to move with the people.
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Will Preparation H Get Rid Of External Hemorrhoids
Preparation H is not a product that will get rid of hemorrhoids, but it will reduce the occurrence of symptoms and provide relief while hemorrhoids resolve.
The benefits of preparation H on external hemorrhoids can include:
- Numbing pain, itch, and discomfort
- Create a protective barrier to prevent irritation
- Promote the healing of skin around the anus
- Provide temporary relief from the symptoms of external hemorrhoids
There are several types of Preparation H products:
- Avoiding sitting for long periods of time
- Eating a healthy, balanced diet
How Are External Hemorrhoids Diagnosed
Because many of the symptoms of external hemorrhoids can also be caused by other conditions, it is necessary to have an in-depth exam. Your doctor may use a series of tests to confirm the presence of external hemorrhoids near the anus. These tests may include:
Your doctor may begin with a physical exam. In cases of external hemorrhoids, they may be able to see the hemorrhoids.
If your doctor suspects that you have internal hemorrhoids instead of external hemorrhoids, they may use an anoscopy to examine the inside of the anus. Internal hemorrhoids can also be seen with colonoscopy, sigmoidoscopy, or proctoscopy.
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Worsening Of Your Itching And Irritation
External hemorrhoids develop under the highly sensitive skin near your anus. With this type of hemorrhoid, you may experience itching, burning, and general irritation. By comparison, internal hemorrhoids, which develop inside your rectum underneath the sensitive tissue, dont cause physical discomfort but may cause you to have blood in your stool.
If your external hemorrhoid develops a blood clot and becomes thrombosed, you may notice a worsening of your symptoms. On a scale of 1-10, your discomfort level may jump from a 3 to a 10.
Thrombosed hemorrhoids develop quickly, and discomfort tends to worsen during the first 48 hours and then improve slightly.
Classification Of Internal Hemorrhoids:
- Grade 1 – A hemorrhoid is present but only visualized by a doctor with ansocopy or colonoscopy. The hemorrhoid does not extend out the anus.
- Grade 2 – The hemorrhoid extends out of the anus with a bowel movement or with straining. After your BM, the hemorrhoid goes back inside on its own.
- Grade 3 – The hemorrhoid extends out of the anus with a bowel movement or with straining. You have to manually push the hemorrhoid back inside the anus. If you have this, you should seek medical attention, but it is not urgent.
- Grade 4 – A hemorrhoid extends outside the anus and are not able to be manually pushed back inside. If you have this seek medical attention immediately. There are significant potential complications.
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Enhancing Healthcare Team Outcomes
External hemorrhoids affect millions of people and even though not life-threatening can seriously affect the quality of life. Over the years, many treatments have been developed to manage hemorrhoids but none is perfect. Today, the aim of treatment is to prevent hemorrhoids in the first place. Hemorrhoids are best managed by an interprofessional team that includes an emergency department physician, general surgeon, gastroenterologist, and an internist. The primary care provider, pharmacist, and nurse practitioner play a vital role in educating the patient on preventing these lesions.
Conservative therapy is considered first-line treatment for symptomatic hemorrhoids. This includes increased dietary fiber, stool softeners, and increased water intake. Rubber band ligation is a minimally invasive treatment option for first, second, and some third-degree internal hemorrhoids that do not respond to conservative therapy. Other minimally invasive options include sclerotherapy and infrared photocoagulation. While surgery is effective, the results are not optimal and recurrences are common. Many patients do have residual anorectal pain after surgery.
The outcomes for most people who do not change lifestyle are not satisfactory. Even those who undergo surgery cannot be guaranteed of a good result. Pain, urinary retention and recurrence are common postoperatively. 12.
Do Hemorrhoids Cause Back Pain
From a scientific perspective, the link between hemorrhoids and back pain is dubious. Some have speculated that hemorrhoids require so much blood that they drain blood from other sources. Such instances they claim may cause back pain in muscular regions of the back due to a lack of blood flow.
The other possible connection between hemorrhoids and back pain is the location. People often complain of hemorrhoid pain near the tailbone because hemorrhoids grow near their tailbone. Such growths can cause sufferers to equate hemorrhoids pain with tailbone pain, thus establishing a back pain connection. Again, both connections are dubious and not scientifically founded.
Hemorrhoids, under normal circumstances, should be seen by a doctor. When hemorrhoids begin bleeding and occur outside the body, a physician should be consulted. Anal bleeding can be a symptom of more serious issues such as colon or rectal cancers.
Over-the-counter medications can be helpful in treating most hemorrhoids. The over-the-counter creams relieve pain and reduce swelling. Other treatments help external hemorrhoids without the aid of a doctor. Treatments include adding more fiber to meals, drinking more water and the hemorrhoid creams to reduce itch-inducing inflammation. These treatments have also been shown effective in treating internal hemorrhoids.
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Blood Clots In The Hemorrhoid
External hemorrhoids can be very painful if they become thrombosed. Thrombosed hemorrhoids are usually purple-blue.
A thrombosed hemorrhoid occurs when the veins that cause the bulge in the hemorrhoid develop a blood clot. As a result, blood is unable to flow to the hemorrhoid, and the effect can be extremely painful.
The body will often absorb the blood clot, therefore reducing the symptoms and easing the pain.
When the blood clot passes or the body reabsorbs it, an external hemorrhoid may sometimes leave behind a perianal skin tag. A doctor may recommend surgical removal if this skin tag regularly catches stool and is difficult to keep clean.
Treatments include home remedies and surgery.
Examples of home remedies people can use to treat hemorrhoids include:
- taking warm baths
- gently cleaning the anus after a bowel movement, often by using moistened wipes or cotton pads
- applying cloth-covered ice packs to reduce swelling
- taking over-the-counter pain relievers, such as ibuprofen or acetaminophen, to relieve pain and discomfort
- applying ointments, such as creams with witch hazel or hydrocortisone- that relieve itching
Home Treatment For Hemorrhoids
If youre experiencing a lot of pain from hemorrhoids, you might want to try some home remedies. These are just some DIY and over-the-counter treatments that can help manage and reduce symptoms of hemorrhoids:
- Use soothing wipes. They can provide immediate relief when you feel swelling after using the bathroom. Look for alcohol-free options with natural botanical ingredients like witch hazel or aloe vera.
- Soak in a warm sitz bath. A sitz bath can help to cleanse the area and soothe inflammation.
- Try an over-the-counter pain reliever. Some examples of these medications include acetaminophen or ibuprofen.
- Use a hemorrhoid cream or suppository.This option is for short-term relief, and shouldnt be used as a long-term solution.
- Take a stool softener.This can decrease pain during bowel movements and reduce the amount you have to strain to use the bathroom.
After youve had a hemorrhoid flare-up, you may want to take steps to prevent more from developing. Hemorrhoids can be activated by:
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What Are The Symptoms Of Hemorrhoids
The symptoms of hemorrhoids depend on the type you have.
If you have external hemorrhoids, you may have
- anal itching
- one or more hard, tender lumps near your anus
- anal ache or pain, especially when sitting
Too much straining, rubbing, or cleaning around your anus may make your symptoms worse. For many people, the symptoms of external hemorrhoids go away within a few days.
If you have internal hemorrhoids, you may have
- bleeding from your rectumbright red blood on stool, on toilet paper, or in the toilet bowl after a bowel movement
- a hemorrhoid that has fallen through your anal opening, called prolapse
Internal hemorrhoids that are not prolapsed most often are not painful. Prolapsed internal hemorrhoids may cause pain and discomfort.
Although hemorrhoids are the most common cause of anal symptoms, not every anal symptom is caused by a hemorrhoid. Some hemorrhoid symptoms are similar to those of other digestive tract problems. For example, bleeding from your rectum may be a sign of bowel diseases such as Crohns disease, ulcerative colitis, or cancer of the colon or rectum.
Internal Rectal Prolapse Or Hemorrhoids Incomplete Evacuation
Iâve been having problems recently that iâm pretty sure is either internal rectal prolapse or pretty bad haemorrhoids. This has made wiping after a bowel movement very difficult. I have also been suffering from incomplete evacuation, presumably as a result of the blockage.I tend to use wet wipes but i still find that i am on the toilet wiping for a very long time. Its an extremely frustrating and demoralising experience. I wonder if anyone else has a similar issue? if so, does anyone have any tips so that I can ensure that i get the whole area clean? As i often worry that i havenât been able to clean everywhere properly and that its making me smell bad.I have tried wetting the wet wipes with warm water, but i find this makes the area more sensitive which causes pain when wiping further down the line.
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Why Do External Hemorrhoids Itch
External hemorrhoids often cause moderate to severe itching around the anus. The itching comes from the inflammation of your anal area.
As inflammation increases due to external hemorrhoids, the intensity of your itching will increase as well.
For a list of products that can help, take a look at our guides below.
Can Hemorrhoids Be Prevented Or Avoided
Just about everyone has hemorrhoids at some time. But some things may make you more likely to get them. People whose parents had hemorrhoids may be more likely to get them. Pregnant women often get hemorrhoids because of the strain from carrying the baby and from giving birth. Being very overweight or standing or lifting too much can make hemorrhoids worse.
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Severe Hemorrhoids Vs Mild Hemorrhoids: Stages
Many physicians use a grading system to categorize hemorrhoids along four stages:
- First-degree hemorrhoids: Hemorrhoids that bleed, but do not prolapse. These are slightly enlarged hemorrhoids, but they do not protrude outside the anus.
- Second-degree hemorrhoids: Hemorrhoids that prolapse and retract on their own . These may come out of the anus during certain activities like passing stool, and then return back inside the body.
- Third-degree hemorrhoids: Hemorrhoids that prolapse and must be pushed back in by a finger.
- Fourth-degree hemorrhoids: Hemorrhoids that prolapse and cannot be pushed back in the anal canal. Fourth-degree hemorrhoids also include hemorrhoids that are thrombosed or that pull much of the lining of the rectum through the anus.
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Risk Factors For Hemorrhoids
There are certain factors that can increase your risk of experiencing hemorrhoids. This condition, though more common in younger adults, can also happen in older adults between 45 and 65 years of age since they are also at a greater risk of having hemorrhoids due to the age factor. Risk factors include:
Hemorrhoids are sometimes likely to occur in people with weakened supporting tissues or a family history of hemorrhoids
The older you get, the higher the chances of your body weakening at a faster rate, weakened or poor pelvic floor muscles can also contribute to causes of hemorrhoids.
Lifestyle risk factors
Unhealthy habits like a poor fibre diet, tight clothing, dehydration can lead to constipation or diarrhea that trigger hemorrhoids.
Not taking enough water can dehydrate your skin and your body and cause constipation.
This may arise from anal intercourse and increase your risk of developing hemorrhoids
Tendency to be constipated
There are some individuals who experience constipation frequently than others, these people are more likely to have a higher chance of developing hemorrhoids than others.
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How Big Can External Hemorrhoids Become
External hemorrhoids can become quite large and inhibit daily life and activities. The size of external hemorrhoids varies, ranging anywhere from grape-sized to the size of a golf ball.
Typically, the more enlarged the hemorrhoid becomes, the more challenging and severe the symptoms are.
Symptoms of enlarged hemorrhoids consist of itching, burning, severe pain, and the discharge of stool or mucus. If you notice that your hemorrhoids do not go away by themselves after a few days or so, you will want to talk to your doctor.
Getting on track for the right treatment for your external hemorrhoids can help curb the risk of the hemorrhoids becoming enlarged.
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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What Are The Causes Of External Hemorrhoids
The most common cause of hemorrhoids is repeated straining while having a bowel movement. This is often caused by severe cases of constipation or diarrhea. Straining gets in the way of blood flow into and out of the area. This results in the pooling of blood and enlargement of the vessels in that area.
Pregnant women may also be at an increased risk of hemorrhoids because of the pressure that the uterus places on these veins.
How To Get Rid Of External Hemorrhoids Permanently
There are a few different ways to get rid of external hemorrhoids permanently. For some patients, hemorrhoids only occur during pregnancy.
Once you give birth, your hemorrhoids may resolve permanently.
For other patients, lifestyle changes may be the resolution needed to say goodbye to hemorrhoids forever.
Lifestyle changes can include eating healthier foods, avoiding straining during bowel movements, exercising, and avoiding prolonged sitting.
For those with more severe external hemorrhoids, a surgery called a hemorrhoidectomy may be necessary to permanently resolve the symptoms of hemorrhoids.
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Symptoms Of Prolapsed Internal Hemorrhoids
Hemorrhoids prolapse when their blood vessels swell and extend from their location in the rectum through the anus. In the anal canal, the hemorrhoid is exposed to the trauma of passing stool, particularly hard stools associated with constipation. The trauma can cause bleeding and sometimes pain when stool passes.
The presence of
- inflammation, and
- constant moisture
can lead to anal itchiness , and occasionally the constant feeling of needing to have a bowel movement. The prolapsing hemorrhoid usually returns into the anal canal or rectum on its own or can be pushed back inside with a finger, but falls out again with the next bowel movement.
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