Internal hemorrhoids are a common condition. They develop inside the rectum and are usually not visible. In this article, we will look at the main symptoms of internal hemorrhoids.


1. Bleeding


Bleeding is one of the most common symptoms of internal hemorrhoids. Normally, the blood is bright red because it comes from the arteries and veins located near the surface of the rectal mucosa. Blood can appear on the toilet paper, in the toilet bowl, or in the stool.

Bleeding in internal hemorrhoids is painless, which distinguishes it from other anal diseases such as anal fissures, where the bleeding is accompanied by pain. Although bleeding is usually not profuse, it can be enough to cause concern in the patient. In rare cases, bleeding can be more intense and lead to anemia, especially if no treatment measures are taken.

When bleeding from internal hemorrhoids, it is important to rule out other serious conditions such as colorectal cancer, polyps, or inflammatory bowel disease. For this purpose, it is recommended to consult a doctor and carry out appropriate diagnostic tests such as colonoscopy or sigmoidoscopy.


Causes of bleeding


One of the main causes of bleeding is straining during bowel movements, which causes the delicate blood vessels in the hemorrhoids to rupture. To reduce the risk of bleeding, it is important to go to the toilet regularly and avoid constipation. This can be achieved by eating foods rich in fiber, drinking enough water and avoiding sitting on the toilet for a long time.


2. Pain and discomfort


Pain and discomfort with internal hemorrhoids are less common symptoms, but can occur in certain cases. Usually, internal hemorrhoids do not cause pain because they are located in the rectum, where there are no pain receptors. However, when internal hemorrhoids become significantly enlarged or fall out (prolapse) through the anus, they can become painful.


Causes of pain



Prolapse occurs when internal hemorrhoids are displaced outside the anus, which can lead to irritation and inflammation. In severe cases, prolapsed hemorrhoids can be compressed by the anal sphincter, which leads to suffocation of blood circulation in them and causes severe pain.



Thrombosis occurs when a blood clot forms in the hemorrhoid, causing sudden and intense pain. This type of pain is more common with external hemorrhoids, but it can also happen with internal hemorrhoids if they prolapse.


Discomfort and related symptoms


Discomfort with internal hemorrhoids can manifest as a feeling of fullness or pressure in the rectal area. This discomfort is often exacerbated by sitting, especially for long periods. Some people experience a sensation of a foreign body in the rectum, which can be very uncomfortable.

Inflammation of the hemorrhoids can also contribute to the feeling of discomfort. Inflamed hemorrhoids can cause itching and irritation, further complicating the condition.


Discomfort and related symptoms


How to deal with pain and discomfort


Hot sitz baths

Warm sitz baths can help relieve pain and reduce inflammation. Topical numbing creams and suppositories may also be helpful.


Medical intervention

In cases of severe pain and thrombosis, medical intervention may be required. Doctors may remove the clot or offer minimally invasive procedures such as rubber band ligation of hemorrhoids or sclerotherapy.


3. Itching and irritation


Itching and irritation are common symptoms of internal hemorrhoids. They can be particularly uncomfortable and often lead to significant discomfort. These symptoms are due to various factors that cause inflammation and irritation of the delicate mucous membrane of the rectum and anus.


Causes of itching and irritation



Inflamed hemorrhoids can secrete mucus that irritates the skin around the anus. This mucus can cause an itchy sensation, especially when left on the skin for a longer period of time.



Another factor that contributes to itching is the frequent passing of small amounts of stool. This can happen with internal hemorrhoids, which cause the anus to not close enough, allowing small amounts of fecal material to pass through and irritate the skin.




Itching and irritation can lead to frequent scratching of the affected area, which worsens the inflammation and can cause secondary infections. This further increases the discomfort and can complicate the treatment of hemorrhoids.


How to deal with itching and irritation


Proper hygiene

To relieve the itching and irritation of internal hemorrhoids, it is important to maintain good hygiene. Gentle cleaning of the anus with warm water and a soft cloth after bowel movements is recommended, avoiding the use of soap, which can dry and irritate the skin. Using alcohol-free wet wipes can also be helpful.


Ointments and creams

Topical creams and ointments containing hydrocortisone or other anti-inflammatory ingredients reduce inflammation and itching, providing temporary relief.


4. A feeling of incomplete emptying of the bowels


The feeling of incomplete bowel emptying is one of the more unpleasant symptoms of internal hemorrhoids.


Reasons for its appearance


Physical presence of hemorrhoids

Enlarged hemorrhoids can create the sensation of having something foreign in the rectum, which prevents complete emptying. This is due to the pressure that hemorrhoids put on the rectal wall.


Prolapse of hemorrhoids

In cases of prolapse (when the hemorrhoids protrude through the anus), the feeling of incomplete emptying can be even more pronounced. Prolapsed hemorrhoids can cause a feeling of blockage in the rectum, resulting in repeated attempts to have a bowel movement.


Inflammation and swelling

Inflammation and swelling of the hemorrhoids can also contribute to the feeling of incomplete emptying. The inflammatory process can create additional pressure on the rectal area and cause discomfort.




A feeling of incomplete emptying can lead to excessive straining and pressure during bowel movements. This can worsen the condition of the hemorrhoids and increase the risk of further complications such as anal fissures or secondary infections.


Methods of relief


To reduce the feeling of incomplete emptying, it is important to follow some basic recommendations:

  • Diet rich in fiber: Eating foods rich in fiber, such as fruits, vegetables, and whole grains, can help keep stools soft and easier to pass through the rectum;
  • Hydration: Drinking enough water is also important to prevent constipation and facilitate bowel movements;
  • Avoiding straining during bowel movements;
  • Physical activity: Regular physical activity can improve intestinal peristalsis and facilitate bowel movements;
  • Medical interventions: In some cases, medical intervention may be necessary, such as minimally invasive procedures to remove the hemorrhoids or other treatments recommended by a doctor.


5. Prolapse of hemorrhoids


Protrusion of internal hemorrhoids through the anus is a condition known as prolapse. This can be very unpleasant and lead to additional symptoms and complications. Prolapsed hemorrhoids can vary in severity and degree of displacement, which affects symptoms and treatment needed.


Degrees of prolapse


Prolapsed internal hemorrhoids are generally classified into four grades, depending on severity:

  1. First degree: Hemorrhoids remain inside the rectum and do not protrude through the anus;
  2. Second degree: Hemorrhoids protrude through the anus during defecation, but retract on their own afterwards;
  3. Third degree: Hemorrhoids protrude through the anus during defecation and require manual return;
  4. Fourth degree: Hemorrhoids are permanently bulging and cannot be reversed.


Prolapse symptoms



Prolapsed hemorrhoids can be painful, especially when pressed by the anal sphincter.



Bleeding can be more intense when the hemorrhoids have prolapsed.


Itching and irritation

Hemorrhoids that remain outside the anus can cause itching and irritation of the skin around the anus.


Sensation of a foreign body in the rectal area

Prolapsed hemorrhoids can cause a foreign body sensation in the rectal area.




Prolapsed hemorrhoids can lead to serious complications if left untreated. Compression of hemorrhoids by the anal sphincter can cause suffocation of blood circulation, leading to thrombosis or necrosis. This condition requires emergency medical attention.


Treatment of prolapsed hemorrhoids


Treatment for prolapsed hemorrhoids can vary depending on the extent of the prolapse and the severity of the symptoms. Some of the possibilities include:

  • Minimally invasive procedures: Procedures such as rubber ring ligation, sclerotherapy, or infrared coagulation can help reduce the size of hemorrhoids and prevent prolapse;
  • Surgery: In severe cases, especially with the fourth degree of prolapse, hemorrhoidectomy may be necessary - surgical removal of hemorrhoids.;
  • Self-help: Maintaining good hygiene, using warm baths and avoiding prolonged sitting can help relieve symptoms.


6. Leakage of mucous secretion


Mucous discharge is a symptom often associated with internal hemorrhoids. This symptom can be extremely uncomfortable and lead to additional irritation of the anus and the surrounding skin. Mucus discharge can also be a sign of inflammation or irritation in the rectal area.


Reasons for the presence of mucous discharge


The main cause of mucous discharge in internal hemorrhoids is inflammation of the hemorrhoidal tissues. When hemorrhoids become inflamed, they can produce and release mucus that drains from the rectum and out through the anus. This mucus can cause a feeling of wetness and contribute to the sensation of irritation and itching.




Mucous discharge can be accompanied by a variety of other symptoms, including:

  • Moisture: The constant feeling of moisture around the anus can be extremely unpleasant and lead to skin breakdown;
  • Itching and irritation: Mucus, when in contact with the skin, can cause itching and irritation, which can worsen the condition of hemorrhoids;
  • Feeling of incomplete emptying: Constant leakage of mucus can contribute to the feeling of incomplete emptying of the bowels.




If the mucous discharge is not treated, it can lead to serious complications such as infection of the anus or the surrounding skin. The constant presence of moisture creates favorable conditions for the growth of bacteria and fungi, which can cause additional problems.


How to cope


Maintaining good hygiene

Regular cleaning of the anus with warm water and a soft cloth can help remove excess mucus and prevent irritation. Using alcohol-free wet wipes can also be helpful.


Avoiding irritants and products

Using unscented and gentle hygiene products can help prevent further skin irritation.


Local treatments

Applying creams and ointments containing anti-inflammatory and soothing ingredients can help reduce inflammation and mucus discharge.


Medical consultation

In cases of prolonged or heavy mucus discharge, it is important to consult a doctor. They can recommend appropriate treatment, which may include medications or minimally invasive procedures to treat hemorrhoids.


7. Edema and swelling


Swelling and swelling are common symptoms of internal hemorrhoids. They are usually the result of inflammation and increased pressure on the venous system in the rectal area.


Causes of edema and swelling


The main causes of edema and swelling in internal hemorrhoids are:

  1. Inflammation: Inflammation of the hemorrhoids leads to fluid accumulation in the tissues, which causes swelling. Inflammation can be caused by chronic straining during bowel movements, constipation or diarrhea;
  2. Increased venous pressure: Prolonged sitting, excess weight and pregnancy can increase the pressure on the veins in the rectal area, causing the hemorrhoids to enlarge and swell;
  3. Constipation and diarrhea: Chronic constipation and diarrhea can increase the pressure on the rectal veins, leading to inflammation and swelling. Stools that are hard or too soft can also cause trauma to hemorrhoids.




Swelling and swelling in internal hemorrhoids can manifest with the following symptoms:

  • Feeling of pressure: A feeling of pressure in the rectal area is common and can cause discomfort when sitting or walking;
  • Pain: Swollen hemorrhoids can cause pain, especially if the hemorrhoids are thrombosed;
  • Enlarged hemorrhoids: When swollen, hemorrhoids can become visibly larger, which can cause a feeling of fullness or the presence of a foreign body in the anus.





When the swelling causes blood clots to form in the hemorrhoids, thrombosis can develop, which causes severe pain and requires emergency medical intervention.


Ulcerations (ulcers)

Constant swelling and inflammation can lead to ulceration (sores) of the hemorrhoids, which increases the risk of infection.




  • Cold compresses;
  • Anti-inflammatory drugs: Taking non-steroidal anti-inflammatory drugs can reduce inflammation and swelling.
  • Maintain good hygiene: Regular cleaning of the anus with warm water and a soft cloth can help reduce irritation and swelling;
  • Dietary changes: Eating foods rich in fiber and drinking enough water can prevent constipation and reduce pressure on hemorrhoids.


8. Discomfort when sitting


A common symptom that can significantly affect the daily life and work ability of affected people.


Discomfort when sitting


Causes of discomfort when sitting


Discomfort when sitting is mainly due to the pressure exerted on the hemorrhoids in the rectal area. Internal hemorrhoids can become painful and tender when they become inflamed or enlarged. The pressure of sitting on these inflamed tissues can cause pain and discomfort.

  • Inflammation and swelling: Inflammation of hemorrhoids causes swelling, which can make sitting uncomfortable and painful. The swelling increases the pressure on the nerve endings in the rectum, which leads to discomfort;
  • Prolapsed hemorrhoids: When internal hemorrhoids prolapse and fall out through the anus, they can become even more sensitive and susceptible to pressure when sitting;
  • Thrombosis: The formation of blood clots in the hemorrhoids (thrombosis) can cause intense pain and discomfort when sitting. Thrombosis leads to significant enlargement of the hemorrhoids and additional pressure on the rectal area.




Prolonged sitting discomfort can lead to secondary problems, such as:

  • Reduced work capacity: People who experience severe discomfort when sitting may have difficulty performing their daily duties, especially if their work requires long periods of sitting;
  • Psychological stress: Constant discomfort can lead to stress and anxiety, which further impairs quality of life.


Methods to relieve discomfort


Use of special pillows

Donut-shaped pillows or other special seats can reduce pressure on the hemorrhoids and relieve pain when sitting.


Frequent breaks

Taking frequent breaks and avoiding prolonged sitting can help reduce pressure on the rectal area.


Hot sitz baths

Warm sitz baths can reduce inflammation and ease the discomfort associated with hemorrhoids. These can be done several times a day for better results.


Medical treatment

In cases of severe discomfort, the doctor may prescribe medication or recommend minimally invasive procedures to treat hemorrhoids.


9. Bad smell


Foul odor is a less frequently discussed but no less important symptom of internal hemorrhoids. It can be a source of considerable discomfort and embarrassment. Bad breath is usually caused by a combination of factors, including mucus leakage, fecal contamination, and infections.


Reasons for the appearance of an unpleasant odor


Discharge of mucus

Internal hemorrhoids can secrete mucus that, when it accumulates around the anus, can cause an unpleasant odor. Mucus can trap bacteria and other microorganisms that contribute to odor.


Incomplete cleaning

Leakage of small amounts of fecal material due to incomplete closure of the anus can lead to contamination and foul odor. This is especially common with larger hemorrhoids or those that have prolapsed.



The inflammation and sores associated with hemorrhoids can become an entry point for bacteria, leading to infections. Infections can cause bad breath, especially if not treated promptly.


Symptoms and complications


The unpleasant smell can be accompanied by other symptoms such as itching, irritation and inflammation. If the odor is related to an infection, pain, redness, and swelling around the anus may also occur. In severe cases, the infection can spread and lead to more serious health problems.


How to cope


  • Maintain good hygiene: Regular and thorough cleaning of the anal area with warm water and mild soap can help remove mucus and debris. It is recommended to avoid aggressive or scented products;
  • Use of wet wipes: Alcohol-free wet wipes can be helpful for cleaning after a bowel movement and keeping the area dry and clean;
  • Topical antiseptics: Applying topical antiseptic creams or ointments can help prevent infections and reduce odor;
  • Medical consultation: If the unpleasant odor is associated with a persistent or severe infection, it is important to consult a doctor. The doctor may prescribe antibiotics or other appropriate treatments;
  • Avoiding prolonged sitting: Prolonged sitting can increase pressure on hemorrhoids and worsen the condition. Getting up and walking regularly can help reduce this pressure.


10. Feeling tense


A feeling of tension in the rectal area is a common symptom of internal hemorrhoids. This feeling can be very unpleasant and affect the daily life of those affected. Tension is often associated with the presence of enlarged hemorrhoids and inflammation in the rectum.


Causes of tension


Enlarged hemorrhoids

When internal hemorrhoids enlarge, they can create a feeling of pressure or tension in the rectum. This pressure is due to dilated blood vessels and surrounding tissue filling the space in the rectum.


Prolapse of hemorrhoids

In more severe cases, when hemorrhoids prolapse (bulge through the anus), they can cause a feeling of tension and pressure, which can be especially pronounced during bowel movements.



Inflammation of hemorrhoidal tissues can lead to swelling and increased tension in the rectal area. The inflammatory process increases the volume of hemorrhoids and causes discomfort.


Symptoms and sensations


Feeling tense can be accompanied by a variety of symptoms, including:

  • Constant feeling of fullness;
  • Sensation of pressure: This sensation may increase when sitting, walking or physical exertion;
  • The need to have frequent bowel movements: Feeling strained can lead to frequent attempts to have a bowel movement, but this does not completely relieve the discomfort.





Constant pressure can make it difficult to pass a bowel movement, leading to constipation and additional discomfort.



Prolonged strain can increase the risk of prolapsed hemorrhoids, which may require medical intervention.




To reduce the feeling of tension in internal hemorrhoids, the following methods can be applied:

  • Diet rich in fiber;
  • Hydration: Drinking enough water helps prevent constipation and ease the passage of stool;
  • Physical activity: Regular physical activity improves intestinal peristalsis and reduces the feeling of tension;
  • Warm baths: Warm baths can help relieve tension and inflammation;
  • Topical creams: Using topical anti-inflammatory and soothing creams can reduce inflammation and tension.




Internal hemorrhoids can cause various symptoms that can be very unpleasant. Recognizing these symptoms is important for prompt treatment and relief of the condition. If you experience any of the listed symptoms, consult a doctor for appropriate treatment and recommendations. Maintaining a healthy lifestyle and good hygiene can also help prevent and manage internal hemorrhoids.



1. Webmd: Hemorrhoids: Symptoms, Causes, and Treatment (25.05.2024)
2. Healthline: Causes of Hemorrhoids and Tips for Prevention (25.05.2024)
3. Mayo Clinic: Hemorrhoids: Symptoms (25.05.2024)