Believe it or not, we all technically have hemorrhoids. They are normal structures within the anal canal. But, when we talk about hemorrhoids, we are typically talking about the problems and pain that one experiences when the hemorrhoids become inflamed and enlarged. Even if your internal hemorrhoids get swollen, you may not even be aware of it because there are few nerve endings within the anal canal that cause pain.
Hemorrhoids cause problems in people of all ages. They are more common in individuals ages 40-65, and affect both men and women of all nationalities. Men do seem to be at higher risk as they often have more vascular problems overall than women.
Once the internal hemorrhoids become so enlarged that they begin to protrude outside your anal canal, they are considered external hemorrhoids. This is when the pain really begins. There are several symptoms that are connected with external hemorrhoids.
Often times, rectal bleeding is the first sign that one may see to alert you to a problem. The bleeding is often bright red blood that is seen either on the toilet paper, inside the toilet bowl, or on the outer surface of the stool, often at the end of a bowel movement. The bleeding is from irritation of the swollen hemorrhoids, often due to hard stool.
You may notice that you are having anal discomfort, such as itching, pain, or even feeling a lump when you sit. All these symptoms often make it difficult to sit still and patients are often very uncomfortable. This could create problems for people with desk jobs as it is hard to work if you can’t sit still and concentrate.
The pain associated with external hemorrhoids can range from mild discomfort to severe rectal pain radiating to other areas, including your legs or back. The pain range is often in conjunction with the severity of your external hemorrhoids. Hemorrhoids are identified on a scale of Grade I to Grade IV.
- Grade I hemorrhoids are internal and not prolapsed, or external
- Grade II hemorrhoids will often prolapsed with bowel movements, but return to their internal state spontaneously
- Grade III hemorrhoids often prolapsed with bowel movements, but need to be reduced, or internalized, manually
- Grade IV hemorrhoids are prolapsed and cannot be reduced
If you are having severe pain that isn’t responding to over the counter treatments, and you can feel a hard lump outside your anus, this may be a thrombosed hemorrhoid. It is from a blood clot inside the external hemorrhoid that will need to either be dissolved with medications, or removed by your doctor. This pain is often the reason for a doctor’s visit as the pain tends to be unbearable.
You may be able to visually identify your external hemorrhoids, but it may be difficult as their location is not easy to see. If you have symptoms consistent with hemorrhoids, you may need to be evaluated by a doctor for appropriate treatment.
Fortunately, there are many hemorrhoid treatments available to those who are suffering. Many of them are over the counter and treat the symptoms. Some treatments are prescribed medications; and others are surgical options. Most importantly is to prevent the flare-ups of painful hemorrhoids.
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