First Degree Hemorrhoids Treatment Guide - What Are 1st Degree Hemorrhoids?

Suffering from First Degree Hemorrhoids? We'll cover exactly how to deal with 1st-degree hemorrhoids so you can get back to living the life you deserve.

Hemorrhoids, although an uncomfortable subject for adults and younger people alike are a common enough problem to send 10 million Americans to their doctors each year.  

Even though this is a widely occurring problem, especially for older adults and pregnant women, many people are unaware that there are two different types of hemorrhoids. 

Internal hemorrhoids are bulges inside of the anal canal.  Internal hemorrhoids are graded in four degrees, the most critical form being a prolapsed hemorrhoid that has fallen through the rectum.  Grade IV hemorrhoids will typically require intervention from your hemorrhoid doctor and most likely a surgical procedure to follow. 

People who have internal hemorrhoids won't be aware of their existence unless they spot bright red blood covering their stools or when they go to wipe after a bowel movement. 

If you find yourself straining while on the toilet or have chronic constipation, you may already have seen blood in the toilet afterward.

External hemorrhoids are bumps of inflamed blood vessels that take formation around the anus or directly on the anal opening.  External hemorrhoids are not graded in severity, unlike internal hemorrhoids.  

However, this doesn’t mean that they cannot worsen.  External hemorrhoids can become thrombosed, in which a blood clot has formed inside the veins, turning the bump into a purple or bluish hue. 

Many doctors recommend having the blood clot lanced and then drained during an in-office procedure to prevent it from rupturing on its own and causing an infection. 

When left untreated, both types of hemorrhoids can become unmanageable and can hinder daily life. 

Yes, hemorrhoids are an uncomfortable topic to address with your doctor, but by catching them early on, you can mitigate symptoms and avoid having to proceed with aggressive treatment, like hemorrhoid surgery. 

Youtube Video on 1st Degree Hemorrhoid Issues

What are First-Degree Hemorrhoids?

Despite there being two different types of hemorrhoids, only internal hemorrhoids are rated by the degree system. These inflamed bumps inside the rectal cavity are graded in four degrees, and each degree increases in severity.

The categorization, also known as Goligher’s classification, of internal hemorrhoids was first implemented in 1985. 

By separating internal hemorrhoids into four categories, doctors can better prepare treatment methods for optimal results.  For practicality, hemorrhoid grades are based on the appearance of the hemorrhoids and degree of prolapse. 

First-degree hemorrhoids are ranked as the mildest form of internal hemorrhoids.  This degree of hemorrhoid involves the swelling and inflammation of a cushion of veins and blood vessels.  This cluster protrudes into the anal canal due to its irritation. 

First-degree hemorrhoids may bleed, but they are not prolapsed. 

The inflammation occurs when the veins and blood vessels inside the anal canal are disrupted.  This could be from many different factors.  The most common reason for swelling is the passing of a hardened stool that abrasively makes contact with the anal passage’s walls. 

Constipation plays a prominent role behind the hardening of stools, but what makes it difficult with this symptom is that it is typically being caused by another problem, like lack of fiber in the diet.

Why Do First-Degree Hemorrhoids Occur?

• Aging
• A family history of hemorrhoids
• Constipation and straining on the toilet
• Other gastrointestinal disorders
• Chronic diarrhea
• Not getting enough fiber, water, or exercise
• Pregnancy and childbirth
• Lifting heavy objects often
• Sitting and standing for extended amounts of time
• Abnormal pressure on the lower rectal muscles

Remember that it could be a culmination of multiple factors above.

Many of these circumstances cannot be helped, like aging or genetics.  For Grade I hemorrhoids, the factors behind their cause are not as dramatic and could merely be concluded as the patient not getting enough fiber.

When internal hemorrhoids become worse, so do the symptoms and their grades, and especially if they are reoccurring and left untreated.  From second-degree hemorrhoids and on, the internal hemorrhoid will prolapse outside of the anal canal. 

How to Treat First Degree Hemorrhoids 

As millions of Americans make their way to their doctor's office to seek advice on how to treat their first-degree hemorrhoids, the first thing doctors will often suggest to do is try non-operative methods first. 

These methods will strive to bulk stools and prevent straining, two key factors that will prevent first-degree hemorrhoids.

Methods of treatment for first-degree hemorrhoids include:

• Using the best hemorrhoid pills like HemRid Max.
• Soaking in sitz baths or baths with warm water
• Adding dietary fiber supplements or seeking fiber from whole foods
• Increasing fluid intake to promote moisture in stools
• Adding a stool softener
• Ligation treatment
• Topical therapy with astringents, hydrocortisone, and emollients
• Sclerotherapy
• Infrared photocoagulation (IRC) treatment 

Rubber band ligation is a non-operative treatment method for hemorrhoids that has proven its effectiveness in relieving symptoms for months to years.  The rate of success in patients ranges from about 70% to 97%. 

Rubber band ligation is one of the safest methods of treatment for first to third-degree hemorrhoids and has the highest rate of success. 

Ligation treatment works without anesthesia because bands are placed in an area that lacks the ability to sense pain, specifically above the dentate line. 

About one to three bands can be applied per office visit, and the entirety of the hemorrhoid treatment will usually take a maximum of about three appointments for first-degree hemorrhoids on average.

Your doctor will place a band around the internal hemorrhoid’s base, causing the strangulation of the hemorrhoid due to blood supply loss. 

The hemorrhoid will fall off in five days to a week on its own accord.  Only about 2% of patients experience complications following a rubber band ligation.

For first-degree hemorrhoids, rubber band ligation is the primary choice of treatment by gastroenterologists. 

Other non-operative procedures include cryotherapy, sclerotherapy, and anal dilatation, but doctors do not as widely use these methods in comparison to band ligation, which is a more streamlined procedure.

First Degree Hemorrhoid Symptoms 

The trickiest part about identifying Grade I internal hemorrhoids is that there may not be too many symptoms present to inform you of them. 

While having first-degree hemorrhoids is relatively mild and not a danger to your overall health, it is still crucial that you can recognize signs to begin treating them immediately.

Untreated first-degree hemorrhoids can worsen and result in different stages of prolapse.  The longer internal hemorrhoids go untreated, and the more progressive the prolapse can become. 

Grade IV hemorrhoids usually require hemorrhoid surgical intervention, and that’s the last thing you will want to have to go through.  It’s much better to spot the signs of internal hemorrhoids while they are nominal. 

The only sign of first-degree hemorrhoids that some people may experience in what is normally considered an asymptomatic stage of internal hemorrhoids is rectal bleeding. 

Bleeding from the rectum can be jolting and even frightening for most of us who do not expect it.

Rectal bleeding during first-degree hemorrhoids occurs after a bowel movement and is painless. 

The lack of nerves in the lower rectum and inside of the anal canal does not signal our brains of any pain, which is why we never feel these first-degree hemorrhoids forming, swelling, or when they become irritated from a passing stool.

Sometimes the blood is discovered in the toilet after elimination, covering the stools in a bright red coat.  Other times, people notice rectal bleeding when going to wipe and finding bright red blood on the toilet paper. 

This can be alarming, but the chances of rectal bleeding after a bowel movement indicating anything other than first-degree hemorrhoids is relatively low.

A hardened stool in union with straining and frequent constipation is all apart of the recipe for the sensitive walls of the anal canal to become inflamed. 

Abrasion, scraping, and friction come into play and irritate delicate cushions of blood vessels and veins, forming bulging bumps that protrude into the anal passageway known as first-degree internal hemorrhoids. 



This is how the typical symptom of rectal bleeding can occur.  If you notice bright red blood after elimination, you don't need to panic just yet. 

It is a good idea, however, to talk to your doctor just in case, but otherwise, this is your body indicating that it likely lacks the proper fiber intake for softening stools. 

Your doctor may want you to begin taking a stool softener or a fiber supplement to prevent your first-degree hemorrhoids from becoming irritated any further.