Hemorrhoids are a common condition that can cause significant discomfort. Hemorrhoid symptoms vary depending on the severity and type of hemorrhoids. In this article, we will look at the main symptoms of hemorrhoids and how they manifest.

 

1. Pain and discomfort

 

One of the main symptoms of hemorrhoids is pain. The pain can be sharp, burning, or dull and is felt worst when sitting or having a bowel movement.

 

It is often due to inflammation and irritation of the hemorrhoidal nodes. In some cases, the pain can be so severe that it makes normal movement difficult and causes a feeling of pressure in the rectal area. The pain may also spread to the lower back or thighs.

 

Hemorrhoids can cause different levels of pain, depending on their size and location:

  • External hemorrhoids located under the skin around the anus are especially painful to touch or pressure;
  • Internal hemorrhoids, which are located inside the rectum, usually do not cause pain unless they protrude outside the anus.

 

Causes of pain and discomfort

 

Prolonged sitting, especially on hard surfaces, can worsen the pain and cause more discomfort. This is especially true for people who work in a sitting position for most of the day. Hemorrhoid pain may also worsen with straining during bowel movements, which can lead to tears or small sores in the anus.

 

Various methods can be used to relieve the pain associated with hemorrhoids:

  • Warm sitz baths applied several times a day can help reduce inflammation and relieve pain;
  • Topical anesthetics and anti-inflammatory creams can also be effective in relieving symptoms;
  • In more severe cases, the doctor may recommend surgical methods to remove the hemorrhoids.

 

2. Bleeding

 

Bleeding is one of the most common symptoms of hemorrhoids and is often the first sign that attracts the attention of patients.

 

Bleeding from hemorrhoids is usually seen as bright red blood on the toilet paper or in the stool. This is due to the presence of dilated blood vessels in the hemorrhoidal tissue, which can easily rupture when straining or passing hard stools.

Bleeding from hemorrhoids is usually not profuse and does not result in serious blood loss, but it can be intermittent and repeat with each bowel movement. In some cases, bleeding may appear in the form of drops or streams of blood, which can be very worrying for the patient. Although hemorrhoid bleeding is rarely life-threatening, it is important to see a doctor to rule out other serious conditions, such as colorectal cancer or ulcers.

 

Causes of bleeding hemorrhoids include:

  • Constipation and hard stools: Constant straining and passing hard stools can tear the surface of the hemorrhoids, leading to bleeding;
  • Chronic diarrhea: Frequent bowel movements and irritation from diarrhea can cause inflammation and bleeding;
  • Excessive straining during bowel movements: Straining during bowel movements increases the pressure in the hemorrhoidal veins, which can lead to rupture and bleeding.

 

Treatment of bleeding hemorrhoids involves several approaches:

  • For light bleeding, dietary changes may be recommended, such as increasing fiber and fluid intake to facilitate stool passage;
  • Topical medications, such as creams and suppositories containing anti-inflammatory and hemostatic agents, can help reduce inflammation and stop bleeding;
  • In more severe cases, it may be necessary to use non-surgical procedures such as rubber band ligation or sclerotherapy to shrink the hemorrhoids and stop the bleeding.

 

3. Itching and irritation

 

Itching and irritation around the anus are common and extremely unpleasant symptoms of hemorrhoids. They can occur in varying degrees of intensity and often lead to significant discomfort, especially during prolonged sitting or after a bowel movement.

 

Causes of itching and irritation

 

  1. Inflammation: Inflammation of hemorrhoidal tissues can cause severe itching. This is the result of dilation of blood vessels and increased blood flow to the affected area;
  2. Mucous discharge: Hemorrhoids can produce a mucous discharge that irritates the skin around the anus. This secretion can cause a feeling of wetness and itching, which further complicates the condition;
  3. Skin trauma: Frequent rubbing and cleaning of the anus, especially when using coarse toilet paper, can injure and irritate the skin. This further worsens the itching and irritation.

 

How to relieve itching and irritation?

 

Maintaining hygiene

Regular and careful cleaning of the anus with a soft, damp cloth or special sanitary napkins can help reduce irritation. Avoid using rough toilet paper and aggressive soaps, which can dry and irritate the skin.

 

Avoiding irritating foods

 

Irritating foods

 

Spicy foods, caffeine, and alcohol can worsen hemorrhoid itching and irritation. Limiting these foods can help relieve symptoms.

 

Local treatments

Using creams and ointments containing hydrocortisone or other anti-inflammatory ingredients can help reduce inflammation and itching. Some products also contain anesthetics that temporarily relieve pain and itching.

 

Warm sitz baths

Soaking the anus in warm water for 10-15 minutes several times a day can help relieve itching and irritation. This helps reduce inflammation and improves blood circulation in the affected area.

 

Wearing loose clothing

Avoiding tight clothing and wearing cotton underwear can help reduce irritation and keep the area around the anus dry and clean.

 

4. Swelling

 

Swelling around the anus is another common symptom of hemorrhoids. This swelling is due to inflammation and dilation of the blood vessels in the hemorrhoidal tissue. The swelling can cause significant discomfort and pain, especially when sitting and defecating.

 

Reasons for the appearance of swelling

 

  • Dilated blood vessels: Hemorrhoids form when the veins in the rectal area become dilated and filled with blood. This leads to swelling and the formation of hemorrhoidal nodules, which can be painful and tender to the touch;
  • Inflammation: Inflammation of hemorrhoidal nodes also contributes to swelling. Inflamed hemorrhoids can swell and form painful lumps around the anus;
  • Excessive straining: Straining while having a bowel movement, lifting weights, or sitting for long periods of time can increase the pressure in the rectal veins, causing the hemorrhoids to swell.

 

Swelling in hemorrhoids can cause a feeling of pressure and heaviness in the rectal area. Patients often describe the sensation as the presence of a foreign body or lump in the anus. This can make it difficult to sit, walk, and carry out daily activities.

 

Treatment of swelling

 

  • Cold compresses: Applying cold compresses to the affected area can help reduce swelling and relieve pain. Cold constricts blood vessels and reduces inflammation;
  • Anti-inflammatory medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can help reduce inflammation and relieve swelling;
  • Phlebotonics: Medications that strengthen blood vessel walls and improve venous tone, known as phlebotonics, may also be helpful in treating swelling from hemorrhoids;
  • Warm sitz baths: Soaking the affected area in warm water several times a day can help reduce swelling and improve circulation;
  • Lifestyle changes: Increasing physical activity, avoiding prolonged sitting, and eating a healthy, high-fiber diet can help prevent swelling and relieve symptoms.

 

5. Prolapse of hemorrhoids

 

Prolapsed hemorrhoids, also known as prolapse, is a condition in which the internal hemorrhoids expand and protrude outside the anus. This can cause significant discomfort and pain and is one of the more serious symptoms of hemorrhoids.

 

Causes of hemorrhoids

 

  1. Straining during bowel movements: One of the main causes of prolapsed hemorrhoids is excessive straining during bowel movements. Constipation and hard stools increase the pressure in the rectal veins, which can cause the hemorrhoids to prolapse;
  2. Weakness of rectal tissues: With age or due to chronic stress, the tissues that hold hemorrhoids in place can weaken. This makes hemorrhoids more prone to falling out;
  3. Pregnancy and childbirth: Increased pressure in the pelvic area during pregnancy and the strain during childbirth can contribute to hemorrhoids falling out.

 

Symptoms of prolapsed hemorrhoids

 

Prolapsed hemorrhoids can cause the feeling of a lump or foreign body in the anus. This condition is often accompanied by pain, especially when sitting or having a bowel movement. Prolapsed hemorrhoids may be visible as soft, moist lumps around the anus that may be tender and painful to the touch.

In some cases, prolapsed hemorrhoids may return to the anus on their own after a bowel movement. In other cases, the patient may have to return them manually. If hemorrhoids remain prolapsed and cannot be returned, the condition can lead to complications such as thrombosis or infection.

 

Treatment of prolapsed hemorrhoids

 

  1. Manual Retraction: In the early stages of prolapse, hemorrhoids can be gently retracted back into the anus using lubricant and gentle pressure. This should be done with clean hands to avoid infection;
  2. Medications: Topical creams and suppositories containing hydrocortisone or other anti-inflammatory agents can help reduce inflammation and make it easier for hemorrhoids to return;
  3. Minimally invasive procedures: Procedures such as rubber band ligation, sclerotherapy, or infrared coagulation can be used to treat prolapsed hemorrhoids. These methods aim to shrink hemorrhoids and prevent them from falling out again;
  4. Surgical methods: In cases of severe prolapse or if minimally invasive procedures are not effective, surgical removal of hemorrhoids may be necessary. Hemorrhoidectomy is a procedure in which the hemorrhoids are excised and the surgeon restores the normal anatomy of the anus.

 

Prevention

 

To prevent hemorrhoids from falling out, it is important to maintain a healthy diet with high fiber content and sufficient fluid intake. Regular physical activity can also help prevent constipation and reduce straining during bowel movements.

 

6. Mucous secretion

 

Mucous discharge is another hemorrhoid symptom that can cause significant discomfort and irritation. This symptom is mainly related to internal hemorrhoids and can manifest itself in different ways.

 

Causes of the appearance of mucous discharge

 

  1. Mucosa irritation: Internal hemorrhoids, which are located inside the rectum, can irritate the rectal mucosa. This irritation leads to an increased production of mucus, which serves as the body's defense mechanism;
  2. Inflammation: Inflammation of hemorrhoids can stimulate the mucous glands to produce more secretions. Inflamed tissues secrete more fluid to protect themselves from further irritation and damage.

 

Symptoms and manifestations of mucous discharge

 

Mucous secretion can be noticed in different ways:

  • Wet sensation: Patients may feel a constant wetness around the anus, which is the result of mucus secretion;
  • Soiled underwear: Mucus can leave stains on underwear, which is not only unpleasant, but can also lead to further irritation and infections;
  • Itching and burning: Mucous discharge can cause itching and burning in the anal area. This is due to the chemical composition of the secretion and its interaction with the skin.

 

Treatment and relief of symptoms

 

Good hygiene

Maintaining good hygiene is essential to ease the discomfort caused by mucus discharge. Washing the anal area regularly with warm water and gentle hygiene products can help reduce irritation.

 

Cotton underwear

Wearing cotton underwear that allows the skin to breathe and absorb excess moisture can prevent further irritation and infections.

 

Topical medications

 

Topical medications

 

Creams and ointments containing anti-inflammatory and soothing ingredients can help reduce inflammation and discharge. Topical anesthetics can also relieve itching and burning.

 

Changes in diet

Maintaining a high-fiber diet can help reduce constipation and straining during bowel movements, which is a major factor in hemorrhoid irritation.

 

7. Difficulty in defecation

 

Difficulty with bowel movements is a common symptom in people with hemorrhoids and can significantly affect quality of life. This symptom manifests itself in different forms and can be caused by various factors related to the presence of hemorrhoids.

 

Causes of difficulty in defecation

 

  1. Pain and discomfort: Pain and discomfort caused by hemorrhoids can lead to stool retention. Patients often avoid going to the toilet because of the pain, resulting in constipation and hard stools;
  2. Inflammation and swelling: Inflamed and swollen hemorrhoids can block the normal path of stool, making it difficult for it to pass. This can lead to straining and straining during bowel movements, increasing the risk of further damage to the hemorrhoids;
  3. Psychological factors: Anxiety and stress related to the condition can contribute to bowel difficulties. Fear of pain during bowel movements can lead to conscious retention of stool.

 

Symptoms

 

  • Constipation: Constipation is common in people with hemorrhoids. It is characterized by infrequent bowel movements, hard and dry stools that are difficult to pass;
  • Straining: Patients with hemorrhoids often strain significantly when trying to have a bowel movement, which can worsen the condition and cause further inflammation and bleeding;
  • Feeling of incomplete emptying of the bowels: After a bowel movement, patients often feel that their bowels have not emptied completely, leading to frequent and unsuccessful attempts to have a bowel movement.

 

Treatment

 

Changes in diet

 

Changes in diet

 

Increasing fiber and fluid intake can help soften stools and make them easier to pass. Foods such as fruits, vegetables, whole grains, and legumes are excellent sources of fiber.

 

Regular physical activity

Moderate physical activity, such as walking or yoga, can stimulate bowel movement and reduce constipation.

 

Use of laxatives

In some cases, the attending physician may recommend the use of laxatives for a short period to relieve constipation and facilitate bowel movements.

 

Avoiding strain when walking as needed

Patients should avoid excessive straining when going to the toilet. Using a footstool can help achieve a more natural bowel position, reducing pressure on the hemorrhoids.

 

Treatment of hemorrhoids themselves

Treating the hemorrhoids themselves through minimally invasive procedures or surgery can reduce inflammation and swelling, making bowel movements easier.

 

8. Lumps around the anus

 

Observing lumps around the anus is one of the visible symptoms of external hemorrhoids. These lumps can be extremely unpleasant and often cause anxiety in patients. They are formed as a result of dilation and inflammation of the veins around the anus and can be felt to the touch.

 

Causes of the appearance of lumps around the anus

 

  • Dilated blood vessels: External hemorrhoids are the result of dilated veins under the skin around the anus. These varicose veins form hard lumps that can be seen and felt;
  • Thrombosis: In some cases, a blood clot (thrombus) can form in the hemorrhoidal veins, leading to the formation of painful and hard lumps. This condition is known as thrombosed hemorrhoids and requires immediate medical attention;
  • Inflammation: The inflammatory process associated with hemorrhoids can cause swelling and lump formation. Inflamed hemorrhoids are sensitive to touch and can cause significant discomfort.

 

Symptoms and manifestations

 

  • Palpable lumps: Lumps around the anus can be felt as hard or soft lumps under the skin. They can vary in size and are often painful to the touch;
  • Pain and discomfort: Patients often experience pain and discomfort when sitting or having a bowel movement due to the presence of the lumps;
  • Itching and irritation: Lumps can cause itching and irritation of the skin around the anus, further complicating the condition.

 

Treatment

 

Local treatments

Using creams and ointments containing hydrocortisone or other anti-inflammatory agents can help reduce inflammation and relieve pain.

 

Warm sitz baths

Soaking the affected area in warm water several times a day can help reduce swelling and ease discomfort.

 

Oral medications

In some cases, the doctor may recommend taking anti-inflammatory drugs or pain relievers to help reduce pain and inflammation.

 

Surgical methods

In the presence of thrombosed hemorrhoids or in cases of large and painful lumps, surgical intervention may be necessary. Hemorrhoidectomy is a procedure in which the hemorrhoids are excised and the surgeon restores the normal anatomy of the anus.

 

9. What to do when symptoms appear?

 

If you are experiencing any of the aforementioned hemorrhoid symptoms, it is important to seek medical attention. A doctor can diagnose the condition and suggest appropriate treatment. Early detection and treatment can prevent complications and improve quality of life.

Symptoms of hemorrhoids can vary, but recognizing them is the first step to successful treatment. If you experience pain, bleeding or other discomfort, do not delay the visit to a specialist.

 

SOURCES:

1. Mayo Clinic: Hemorrhoids symptoms and causes (27.05.2024)
2. Webmd: Hemorrhoid Symptoms and Getting a Diagnosis (27.05.2024)
3. Healthline: Causes of Hemorrhoids and Tips for Prevention (27.05.2024)