Can internal hemorrhoids hurt? This question is asked by those who are suffering rectal pain but are showing no external hemorrhoid symptoms. When swollen tissue in the form of a lump is present around the opening of the anal canal a diagnosis of external hemorrhoid can be simple to make. However when pain is present with no tangible sign of an external hemorrhoid often times the assumption is made the pain is generating from an internal hemorrhoid.

Because internal hemorrhoids tend to develop on the upper two thirds of the rectum wall these hemorrhoids do not usually produce pain. However, a hemorrhoid can develop in the lower regions of the rectum closer to the dentate line. This line is the dividing line between the upper and lower anal canal. If they internal hemorrhoid developed close enough to this line the resulting swollen tissue can cause rectal pain due to its proximity to tissue with more nerve endings.

You want to monitor your condition if the pain persists for an extended period of time this could be the indication of a more severe type of hemorrhoid. These types of hemorrhoids include either a prolapsed internal hemorrhoid or a thrombosed internal hemorrhoid. Hemorrhoids are graded on a scale ranging from Grade I threw Grade IV. Hemorrhoids which are Grade I and II usually rectify themselves within a short amount of time if the proper steps are taken to rectify the underlying cause of the problem. Hemorrhoids, which are Grade III to Grade IV, are more severe and may require more pervasive intervention by you and/or a medical professional.

No matter the type of hemorrhoid you had either internal or external all hemorrhoid treatments can benefit from the following:

• Diets High in Fiber
• Staying Adequately Hydrated by Drinking Water
• Using Sitz Bath to Help Reduce Pain, Swelling and Irritation

If you find yourself asking the question “Can internal hemorrhoids hurt?” You should discover the treatment methods I found to stop my hemorrhoids cold!

Thrombosed hemorrhoids are hemorrhoids that develop a clot inside the swollen vein. They are often internal hemorrhoids that have prolapsed out of the rectum and are quite painful. The only way to stop the pain is to remove the clot. Although there are some medical treatments for them, it is often necessary to have them surgically removed. Surgery ranges from a quick office procedure to a trip to the operating room.

If the clot is small and removable in the doctor’s office, you will receive local numbing medicine and within a few minutes the doctor can remove the clot. You will likely have instant relief from the terrible pain you have been experiencing. You may feel numb for a few hours in the rectal area. The recovery is simple and consists of keeping the area clean. A few doses of acetaminophen may be necessary if there is any residual discomfort, a sitz bath may give local relief as well as help keep the area clean.

Some surgical procedures are more complex and involved. These procedures require you to be in the hospital and go into the operating room. Typically, it is considered a day procedure and you will return home a few hours after the procedure to recover. Although you may not spend much time in the hospital, the recovery may take some time.

Recovery from thrombosed hemorrhoid surgery will depend on the extent of the hemorrhoids. If severe, you may need to be on prescribed pain medication. Although you don’t want to be in pain, don’t overdo it on the pain medications. It is important to understand that narcotic pain medication, such as Percocet or Vicodin, may lead to constipation. Acetaminophen and ibuprofen should be used if the pain is not severe as there is no risk of constipation with these medications. It is extremely important to take stool softeners, drink lots of fluids, and eat fruits and vegetables to counteract constipation.

If you do get constipated, keep in mind it may cause some pain to have a bowel movement, and you may see some bleeding. This is normal. After a bowel movement, you may also use a sitz bath. This will provide local warm water to your surgical site, assist with pain management and cleanse the area. Don’t use the sitz bath until the surgeon has cleared you to do so.

In addition to avoiding constipation and keeping the area clean and dry, it is also important to get some rest and not put too much pressure on the rectal area. Sitting or standing will put added pressure on the area, causing increased discomfort. Do not strain either.

Surgery for thrombosed hemorrhoids, although uncomfortable, may be the only option if you have exhausted other less invasive types of thrombosed hemorrhoid treatment. Plan on being out of work for some time; possibly 4-6 weeks. Eat well, drink lots of fluids and rest. This will help you heal and recover from your thrombosed hemorrhoid surgery.

Unfortunately many people suffer from hemorrhoids. There is a broad range of severity of hemorrhoids, from internal hemorrhoids that are minimally uncomfortable, to large, prolapsed, and thrombosed clustered hemorrhoids. Hemorrhoids are veins that become engorged with blood and are located in the anorectal canal. They often cause rectal itching, bleeding or pain.

People often don’t know they have hemorrhoids until they see bright red blood after a bowel movement. The blood may be visible on the toilet paper, on the outer surface of a constipated stool, or even in the toilet bowl. This often is alarming to individuals as when the blood mixes with the water in the toilet, it looks like a very large amount of blood, when in actuality it may not be.

Hemorrhoids are often benign and uncomplicated, not causing discomfort. On the other hand, if you suffer from a thrombosed hemorrhoid, you are likely to encounter great pain in the rectal area. A thrombosed hemorrhoid is an external hemorrhoid that develops a clot inside the sensitive enlarged vein. This clot will feel like a hard, painful lump in the rectal area. It may be difficult to sit or stand, let alone walk, as the nerves in the rectal area get very irritated by the thrombosed hemorrhoid.

Thrombosed Hemorrhoid Treatment Options

There are a few treatments for these painful hemorrhoids, and all of them require a doctor’s evaluation. Conservative treatment may include medication to break up the clot systemically and should be prescribed by your doctor. Another, slightly more invasive treatment, involves numbing the hemorrhoid with a local anesthetic, and making a small incision in it to remove the clot itself. This sounds quite uncomfortable, but there is immediate relief once the clot is gone.

Sometimes it may occur that conservative treatments are not appropriate is there are large amount of hemorrhoids that have prolapsed and thrombosed external to the anal canal. In these instances, surgical removal is often indicated. Surgery ranges from applying a band to the base of each hemorrhoid and cutting off the blood circulation to the area; this is called band ligation. This will allow the tissue to die and the hemorrhoid will fall off. If the hemorrhoids are so severe that banding isn’t enough, a hemorrhoidectomy may be necessary. This is the most involved treatment and recovery is timely.

Preventing Future Hemorrhoidal Outbreaks

Once your thrombosed hemorrhoid is treated and gone, it is important to take measures to decrease the risk of developing them again and going through the pain. There are several dietary and lifestyle modifications that will help diminish the chances of ongoing hemorrhoids. These modifications include:

Dietary changes: adding fiber by eating fresh fruits and vegetables, drinking 8-10 glasses of water every day, lowering fat and salt intake;

Lifestyle changes: avoid constipation and straining; use a stool softener if necessary; don’t sit or stand for long periods of time without changing positions frequently; exercise regularly

Although not everyone who suffer from hemorrhoids will develop a thrombosed hemorrhoid, if you do you should have it taken care of quickly to alleviate your pain.

Many wonder why do people get hemorrhoids, what is the cause of hemorrhoids? Well, here is the answer. We all have veins in our body, and we all have hemorrhoidal veins in our anal area. Sometimes, these veins get swollen and inflamed. This is what most people consider hemorrhoids. Often times, these hemorrhoids get irritated, painful and even bleed. But the question is why does this happen? Hemorrhoids are often caused by an increase of pressure within the veins of the anus. There are several things that could increase the pressure down below.

In women, a leading cause of hemorrhoids is pregnancy. As a woman’s pregnancy continues, it is normal for her to gain weight. This weight can be over the whole body but is often centralized and within the abdomen. The pressure of the baby on the blood vessels within the stomach can also put pressure on the rectum; this causes an inflammation and swelling of the hemorrhoidal veins. Leading to large, often prolapsed, hemorrhoids. Unfortunately, it doesn’t end there, if she is having a natural birth (not cesarean section), the pressure of labor and delivery of the baby can cause even more pressure on the veins, worsening them and causing pain and bleeding.

Obesity is also a leading cause of hemorrhoids, both internal and external. Similarly to pregnancy, the added weight on the body often puts pressure on the veins within the anus, leading to irritation, pain and bleeding. Often times, obesity and poor diets go hand in hand. If you are eating a high fat, low fiber diet, this could lead to obesity. In addition, it could lead to constipation. Constipation adds a mechanical reason for irritation of hemorrhoids as hard stool is often difficult to pass. In addition to mechanical irritation, straining with passing a constipated stool also adds increased pressure. This could lead to increased pain and sometimes bleeding of already swollen and irritated hemorrhoids.

In contrast to constipation, chronic or profuse diarrhea may also lead to problems with hemorrhoidal flares. Although one may not be straining to have a bowel movement, the constant irritation to hemorrhoidal veins from diarrhea is often just what it takes to flare the irritated veins, often causing protrusion of the hemorrhoids. Added fiber to the diet is sometimes necessary to add bulk to stools of those individuals with chronic diarrhea.

Your career choice may also increase the risk of developing hemorrhoids. If you have a desk job where you have limited ability to stand, walk around and change position, you may be at risk for developing hemorrhoids. Also, standing for long periods of time can also increase your risk. Factory line workers, who stand in the same place with minimal movement for long periods of time, are also at risk. It is important if you do have a career with similar environments, it is important to try to change positions, sit or stand for a break on your hemorrhoidal veins.

Although many of the causes of hemorrhoids are temporary, there are also people who have hemorrhoids for reasons that are beyond their control. Age, sex, family history and personal history of varicose veins may also put individuals at risk.
Internal Hemorrhoids and external hemorrhoids can be very uncomfortable and bothersome to many people every day. If you can watch your diet, manage your weight, and keep your bowel habits regular, you may be a happier, healthier and have a less irritated bottom.

Additional Resources:

Webmd.com

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.

Additional Resources:

Medicinenet.com

People may not even know that they have a problem with internal hemorrhoids or external hemorrhoids until the day they look in the toilet and they see bright red blood inside the bowl after a bowel movement.  This is often alarming and very concerning as it appears to be more blood than it often is. The combination of blood in water makes the bleeding look severe.     In addition, hemorrhoidal bleeding is most often painless.

It is important to be evaluated by a medical professional if you are experiencing rectal bleeding. Bright red blood per rectum is most often due to hemorrhoids, something more serious could be overlooked if not properly diagnosed. Other things that could possibly cause rectal bleeding include colorectal cancer, colitis, polyps, or vascular malformations. Anorectal fissures may also cause bleeding and are often painful.

Hemorrhoids are the most common cause for lower GI bleeding in patients. They do not typically cause massive blood losses that require emergent blood transfusions. That being said, patients may experience chronic blood loss, from inadequately treated hemorrhoids, that could potentially be substantial enough to cause iron deficiency anemia. In this situation, iron supplements may be required to assist in the regeneration of blood cells.

Once a diagnosis of hemorrhoids is made, and more serious diagnoses are ruled out, it is important to get appropriate treatment, depending on the severity of the hemorrhoids. Relieving the pressure on the hemorrhoidal veins will help to stop the bleeding.

Ways to decrease the pressure include, but are not limited to weight loss, relief of constipation, frequent position changes, and exercise. Adding fiber to your diet and decreasing fat content will help to develop more regularity with bowel movements. Drinking 8-10 glasses of water daily will also combat constipation. If dietary changes alone are not helpful, you may consider over the counter stool softeners such as colace or senekot, or fiber supplements such as Metamucil or Benefiber.

Rectal bleeding from hemorrhoids may create rectal irritation that becomes bothersome to many people. While you are having a hemorrhoidal flare, you may consider sitting in a sitz bath 3 times daily with warm water for approximately 10 minutes. If a sitz bath is unavailable, sitting in a shallow bath tub of warm water may also help. The warm water will increase blood flow to the area as well as relax the anal sphincter. This will give you symptomatic relief, as well as assist in the healing process.

Additional Resources:

Google Health

Hemorrhoid

Hemorrhoids are veins within the rectum that become irritated and swollen for a number of reasons. Internal hemorrhoids will sometimes get so large that they protrude from the anus, they are now considered external. They are similar to varicose veins of the legs, or anywhere else in the body, for that matter. They are often worsened by increased pressure within the rectum, such as from pregnancy or straining. Many people do not even know they have hemorrhoids, until they are so large that they have changed from internal hemorrhoids, to external.  In general, although you may experience discomfort, most hemorrhoids will not harm you. It is important to talk to your doctor about your symptoms to be sure that you do not have something more serious, like colorectal cancer.

Signs and Symptoms of Internal Hemorrhoids

Bright red blood after a bowel movement, especially if constipated; the blood may be on the toilet paper, on the surface of the stool, or inside the toilet bowl.  This is often the only symptom of internal hemorrhoids as there are few nerve endings within the rectum that will sense the discomfort of the hemorrhoid.

Some people experience anal itching and irritation, this is often due to leaking mucous from the hemorrhoid within the anal canal. It often leaks out and irritates the external skin of the anus. Another source of itching and irritation is leaking stool and the inability to clean the area well, or over-cleaning the area causing local skin irritation.

If the hemorrhoid gets large and becomes external, symptoms often worsen and pain develops. If the hemorrhoid thromboses, or clots, the pain may become severe. This is often when a person will seek medical attention.

Who is At Risk for Internal Hemorrhoids:

Internal hemorrhoids are created when there is an increase of pressure within the veins of the rectum or anus. The veins become engorged with blood. This may happen for a number of reasons, including: pregnancy, obesity, sitting or standing for long periods of time, straining with bowel movements or heavy lifting.

Poor dietary habits may also put you at risk for internal hemorrhoids. These habits include low fiber, high fat diet, and decreased fluid intake. This may lead to constipation and therefore straining to have a bowel movement.

There are also some risk factors that are unable to be modified to decrease your risk; these include age, sex, family history and cirrhosis of the liver.

How are Internal Hemorrhoids Diagnosed:

It is extremely important to be evaluated by a medical professional if you are having rectal bleeding of any sort, even if you are not experiencing any pain. A doctor will perform a history and physical exam. He will discuss your symptoms, dietary habits, behavioral habits, as well as your family history. In addition, a physical examination of your anus and internal examination of your rectal vault will be done to check for the presence of hemorrhoids, as well as something more concerning, such as a mass or tumor.

Possible Treatment Options for Internal Hemorrhoids:

Because many people don’t have the same symptoms with internal hemorrhoids as they do with external hemorrhoids, many of the topical creams and ointments are not necessary. Treatment often includes decreasing risk factors and diet modification. The goal for patients with internal hemorrhoids is to reduce their size, stop the bleeding, and prevent them from becoming large and prolapsed, or external hemorrhoids.

The itching caused by seeping mucous may be resolved with topical treatments such as Preparation H. There are patients that may need hydrocortisone in suppository form, that will treat the internal symptoms, including pain, itching and inflammation.

If they do become large and painful, there are several surgical treatments that you can discuss with your doctor if other topical or oral medications haven’t been helpful. These surgical procedures can be as simple as removing a clot from within the hemorrhoid at the doctor’s office with local anesthesia, to having large hemorrhoids banded or removed in the operating room.

It is important to try to control your hemorrhoid situation with less invasive ways. It is not always necessary to have surgery if you can modify your behaviors. Unfortunately, some patients simply have bad luck and need more aggressive treatment than others.

Hemorrhoids is a condition cause by swollen and inflamed veins in the lower portion of the anal canal (rectum), inside the anus (internal hemorrhoids) and/or just beneath the skin around the anus (external hemorrhoids). This condition is painful. However if properly treated and cared for not serious.

Symptoms of Internal Hemorrhoids:

Bleeding during your bowel movements, this may result in bright red blood on toilet paper, covering stool, or in the toilet bowl.  Irritation and pain may occur if an internal hemorrhoid begins to protrude from the anus to the exterior of the body. An internal hemorrhoid that does this is often called a protruding hemorrhoid.

Pain from a protruding hemorrhoid may intensify during bowel movements because of the excess pressure applied to the swollen vein by the anal muscles. You may also notice the draining of mucus from both internal and treating hemorrhoids. Draining mucus can intensify itching. Also, you may find it difficult to clean the anal area due to pain.

Symptoms External Hemorrhoids:

Pain, swelling, or a firm lump in the anus region caused by the formation of a blood clot, referred to as a thrombosed or clotted hemorrhoid. Draining mucus may also intensify itching. It may be difficult to clean the anal area due to pain.

Excessive straining when having a bowel movement, excessive rubbing or cleaning around the anus can cause additional irritation with increased bleeding and itching. This can lengthen the recovery time, making your situation that much more intense.

Methods of Treatment

The treatment of hemorrhoids will vary depending on the severity and type of hemorrhoid in question.

Many cases of internal and external hemorrhoids can be treated in the home. Corticosteriod creams, some of which can be purchased over-the-counter at your local drugstore can help to alleviate pain and reduce swelling. You may also consider purchasing a cream or ointment that contains lidocaine, which has properties that can help to relieve pain.

Witch hazel an extract from the witch hazel plant can be purchased from your local drugstore or supermarket can help to alleviate itching. Cotton undergarments allow for good air flow and have absorbent properties that can also help reduce itching caused by hemorrhoids. You will want to avoid toilet tissue that contains any dyes or perfumes. The dyes and perfumes used in the production of toilet paper can irritate and external hemorrhoid in the area surrounding anus.

Another home technique for relieving some of the symptoms of the hemorrhoid include sitting in a tub of plain warm water for approximately 10 minutes several times a day. You may also consider using a sitz bath to soothe the area, reduce itching, and help with pain.

The use of stool softeners or adding fibber the diet can also help reduce the symptoms of a problematic hemorrhoid. With the stool softened bowel movement will be less a irritating to the hemorrhoids both internal and external, which can lessen the symptoms.
If the hemorrhoids do not respond well to the steps being taken at home for the action may need to be taken by a surgeon or a gastroenterologist. The following are some of the procedures that a healthcare provider may choose to rectify your hemorrhoidal problem:

• Infrared Coagulation: a method of applying heat to shrink internal hemorrhoids, this procedure can help avoid the need for surgery.
• Rubber Band Ligation: A procedure in which bands are placed around the hemorrhoid at the base or around scar tissue to cut off blood circulation. The blood no longer flowing anymore either shrinks or goes away.
• Sclerotherapy: Is a method that requires an injection of a special chemical solution around the affected blood vessel, which will aid in the shrinking of the hemorrhoid.
• Hemorrhoidectomy: Is usually an outpatient surgical procedure reserved for the spheres of cases or those that do not respond to other types of treatment.

Preventive Measures for Hemorrhoids

To help reduce recurring bouts with hemorrhoids, one needs to reduce the amount of pressure and straining associated with constipation. Increasing your daily intake of fiber and water can help to reduce constipation, thereby helping to reduce the chances of a recurring hemorrhoid. The goal is to have softer bulkier stool. This can be achieved by drinking 6 to 8 glasses of water daily, while also ingesting the proper amount of fiber.

To increase your to increase your fiber, you will want to incorporate the following food types into your daily diet:

• Fruits High in Fiber
• Vegetable High in Fiber
• Whole Grains

Your doctor may suggest or you yourself can consider some dietary supplements for additional fiber. Psyllium found in Metamucil or methylcellulose found in Citrucel are two popular forms of fiber supplements.

It may be also suggested to increase physical exercise. Exercising can increase blood circulation overall health. (Always check with your doctor before starting a new exercise regimen.)

What is a hemorrhoid?

A hemorrhoid is a term to refer to the veins inside or outside the rectum/anus that become swollen, inflamed or irritated. Another term for it is a varicose vein of the rectum/anus.  They are often exacerbated by increased pressure within the rectal vault, leading to increased pressure of the rectal/anal  veins. Although many people with these have no symptoms at all, many others suffer from severe symptoms, including rectal pain and bleeding. In general, aside from the discomfort one may encounter from hemorrhoids, they are benign and not going to harm you. That being said, it is very important to discuss your symptoms with a healthcare provider to be sure that you do not have something more serious, like colorectal cancer.

Who is at risk?

Anything that puts added pressure on your rectum could put you at risk:

• Pregnancy
• Obesity
• Chronic constipation or diarrhea
• Straining to move bowels
• Sitting or standing for long periods of time
• Anal intercourse
• Other factors include:
• Poor dietary habits: low fiber, high fat intake
• Cirrhosis of the liver
• Age
• Family history of hemorrhoids
• Other varicose veins in the body

What are the symptoms of external hemorrhoids?

• Bright red blood with bowel movements, either on the toilet paper, on the surface of the stool, or in the toilet
• Anal itching
• A lump outside the anus that may become larger with increased pressure
• A hard lump outside the anus that causes a lot of pain in the rectal area, or even in your legs, is often a clot that has developed within the hemorrhoid. It is called a thrombosed hemorrhoid.

How are external hemorrhoids diagnosed?

A visit to your healthcare provider is very important if you are suffering from the above symptoms. The provider will perform a targeted history and physical. During the history, be prepared to discuss what your symptoms are, when they began, what have you done to make them better (or worse), how long do the symptoms last. In addition, you may be asked to describe your eating and exercising habits, as this may greatly effect the development and treatment of hemorrhoids.  Your sexual habits may also be discussed. For the physical exam, be prepared for the provider to examine your anal area, by first doing a visual exam of the external area, and then an internal exam to be sure there is nothing more serious going on.

What is the treatment for external hemorrhoids?

The treatment for external hemorrhoids depends on the severity of the symptoms and the size of the hemorrhoids:

• Local over the counter creams and lotions to sooth itching and irritation
• Sitting in a warm bathtub or sitz bath several times a day to sooth the area
• Ice packs
• Dietary changes such as increased fiber, decreased fat, increased fluid intake such as water
• Stool softeners
• Surgical procedures may be a last resort for some patients. The surgery may be as minor as an office visit to lance and remove the clot (thrombosed hemorrhoid) or more involved such as banding or even surgically removing the hemorrhoid if very severe.

How do you prevent external hemorrhoids?

Eat a well balanced diet with high fiber and low fat intake
Drink 8-10 glasses of water daily
Exercise
Avoid sitting or standing for long periods of time
Avoid straining with bowel movements
Use stool softeners for chronic constipation

What else should I know?

It is always important to be evaluated by a healthcare provider with rectal pain, bleeding and irritation. Although external hemorrhoids can be quite bothersome and problematic for many patients, there are also many who are able to control the symptoms and live a happy and fulfilling life. A few lifestyle changes may make the world of difference for hemorrhoid sufferers.
If you are suffering with pain and are embarrassed to see your healthcare provider, just remember, this is what they do for a living. They understand that it may be embarrassing for you, the patient, but as trained professionals, they can help you relieve the suffering.