Hemorrhoids Guide: Treatment, Symptoms and Relief For Internal and External Hemeroids

Although not a polite dinner conversation, hemeroids are one of the most common ailments experienced by adults, so much so that about half of all Americans over the age of 50 have them. 

Hemorrhoids tend to favor women during pregnancy and childbirth, but are equally common in both men and women.  Surprisingly, 75% of people will experience hemeroids at one point in their lives. 

This explains why the term “hemeroids” rapidly peaked at 80,000 searches on Google in 2008, further increasing to an astounding 120,000 searches in 2013.

What Is a Hemeroid?

What exactly are hemeroids? This cushion of clustered veins is located beneath a mucous membranes lining on the lowest part of the rectum.  Hemorrhoids can become swollen from strained bowel movements. 

Hemorrhoids typically result in bleeding from the rectum and general discomfort during bowel movements. 

There are two different types of hemorrhoids—internal and external.  They can be diagnosed by either noticing painless bleeding after a stressful bowel movement, feeling a lump outside the anus or noticing a protrusion emerging from the anus. 

Physicians can also diagnose hemorrhoids if you have not done so already on your own by a simple gloved examination and a description of your symptoms.

 What are Internal Hemorrhoids? 

Internal hemorrhoids occur inside the anus.  Internal hemorrhoids are receded far into the rectal cavity usually cannot be seen or felt.  Because of this, this type of hemorrhoid generally does not cause much discomfort, only during bowel movements.

Internal hemorrhoids can become painful if straining pushes them outside of the anal opening.  This exposure of internal hemorrhoids is called prolapsed or protruding hemorrhoids.  These prolapsed hemorrhoids can be gently pushed back inside the rectum if they do not retract on their own.

What are External Hemorrhoids? 

As the name of this type of hemorrhoid suggests, external hemorrhoids occur outside the anal opening under the skin.  External hemorrhoids are the more painful of the two kinds due to the skin becoming irritated more often. 

There is a tendency for a blood clot to form inside an external hemeroid, which can be extremely painful.  Clots may need to be lanced and drained if they do not dissolve on their own.  Once clots are gone, excess skin might remain and cause further irritation and itch.

Are Bleeding Hemorrhoids Dangerous? 

Both external and internal hemorrhoids will likely produce bleeding, as the veins and skin swell and become irritated during and after a strained bowel movement. 

For internal hemorrhoids, bleeding is almost always painless, and is sometimes only noticed after applying toilet tissue or examining the toilet bowl after a bowel movement.

It is important to note that if you notice bleeding on toilet paper or in the bowl after a bowel movement, to notify your doctor.  Hemorrhoids that bleed are not life threatening, but rather a common symptom. 

However, you should tell your doctor in case this is a sign of a different condition. 

What are My Options for Hemorrhoid Treatment? 

Treatment for hemorrhoids, both external and internal, is relatively straightforward.  It is suggested to take warm baths in order to help relax muscles, use an ice pack to reduce swelling (which is recommended for external hemorrhoids), and cleaning the anus after each bowel movement with moistened toilet paper or baby wipes.

Alternatively, local drug stores carry topical creams that can be applied to relieve the symptoms of hemorrhoids.  This is especially beneficial for those suffering from external hemeroids.

Creams that contain a numbing agent or witch hazel can be effective in stopping the itchiness and irritation. A hemorrhoid cream can help reduce hemorrhoid pain as well as itching, burning, and bleeding.

Acetaminophen and ibuprofen are helpful treatment options as well.  Both pain relievers can assist with the pain of either type of hemorrhoids. 

Hemorrhoids symptoms usually disappear after a few days, even if untreated, and the unusually painful ones will cease hurting in about 1 to 2 weeks.   

How Do I Get Rid of Hemorrhoids? 

Hemorrhoids are extremely common and anyone can get them, however, there are lifestyle changes that can be taken to prevent the occurrence of hemorrhoids. 

Exercising regularly to maintain a healthy weight will help prevent hemorrhoids, as studies have shown that those who overweight are more likely to suffer from them.  

Drinking plenty of water throughout the day and making sure you have the appropriate amount of fiber in your diet will also ease the stress of bowel movements, in turn preventing the cause of hemorrhoids.

For persisting and excruciating hemorrhoids, surgery is another alternative.  The American Society of Colon and Rectal Surgeons indicates that less than 10% of hemeroids cases require surgery. 

Surgeries performed without anesthetic include banding, which is the application of a tight band around the hemorrhoids' base, cutting off its blood supply and eventually ridding it, or sclerotherapy, which is injecting the hemorrhoid with a chemical compound, forcing it to shrink and stop the bleeding. 

There is also coagulation treatment, where much like a treatment for warts, applies extreme temperatures to the hemorrhoid to force it to shrink.

Invasive surgeries include hemorroidsectomy, the removal of an abnormally large hemeroid, and hemeroidsopexy—the stapling of a protruding hemorrhoid, where like a banding procedure, is designed to cut off the blood supply and placing it back inside the rectum.  

See your doctor if you are bleeding from the anus and do not assume that the bleeding is a result of hemorrhoids, especially if you are over the age of 40. 

A rectal examination may be needed to detect diseases such as colon cancer, polyps, and colitis. 

Depending on the decision of your doctor, they may want to proceed with a bowel endoscopy examination, or for enlarged hemorrhoids, a proctoscopy might be required.