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Hemorrhoid Symptoms Guide - Internal and External Hemorrhoid Symptoms Debunked

Posted on 03 March 2018 by

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What hemorrhoid symptoms are you suffering with? Symptoms of hemorrhoids can range from discomfort to severe hemorrhoid pain.

For some patients, symptoms may be concerning. Many patients become concerned when they notice blood during bowel movements.

When it comes to hemorrhoids, this is a common symptom and is not generally dangerous.

Let’s take a closer look at the symptoms of hemorrhoids.

What Are the First Symptoms of Hemorrhoids?

The first symptoms of hemorrhoids vary based on what type of hemorrhoid you are battling.

The first symptom of internal hemorrhoids is often bleeding.

Because internal hemorrhoids are in an area of the rectum that lacks pain-sensing nerves, internal hemorrhoids often go undetected.

During bowel movements, internal hemorrhoids may become irritated and bleed.

Blood in the stool, in the toilet bowl, or on your tissue paper after wiping is often the first symptom of internal hemorrhoids.

External hemorrhoids can display many different symptoms first. For some patients, the presence of swollen lumps at the opening of the anus is the first symptom.

For others, hemorrhoid itching or burning (pain) is the first symptom.

And, for many patients, bleeding or sharp pain during bowel movements is the first symptom.


Internal Hemorrhoids Symptoms

The most common symptom of internal hemorrhoids is painless bleeding. Outside of bleeding, internal hemorrhoids are only symptomatic when they prolapse.

Grade 2-4 internal hemorrhoids prolapse to different extremes.

While grade 1 internal hemorrhoids remain inside the rectum and are unseen and unable to be felt, grade 2 internal hemorrhoids protrude out of the rectum.

They return inside the rectum spontaneously, while grade 3 need to be manually pushed back into place.

Grade 4 prolapsed hemorrhoids do not return on their own and often need surgery.

The symptoms of prolapsed hemorrhoids are:

  • Hemorrhoid bleeding during bowel movements
  • Itching around the opening of the anus
  • Feeling of incomplete evacuation during a bowel movement
  • Pain in the case of thrombosis
  • Difficulty passing stool

Thrombosed Hemorrhoid Symptoms

A thrombosed hemorrhoid occurs when a blood clot forms inside of a hemorrhoid. This condition is much more painful than any other hemorrhoid symptoms.

Thrombosed hemorrhoids are an external hemorrhoid that turns purple or blue because of a blood clot and display symptoms of:

  • Itching around the anus
  • Difficulty sitting due to pain
  • Difficulty walking due to pain
  • Difficulty passing stool
  • Bleeding during bowel movements
  • Large lump or significant swelling around the anus

In some cases, patients may have a fever in addition to pain and swelling.

It is important to contact a hemorrhoid doctor or general physician if this occurs because it may be sign of an infection.

External Hemorrhoid Symptoms

External hemorrhoids are generally the most symptomatic of the various types of hemorrhoids.

They are a source of discomfort and pain.

Besides discomfort and pain, symptoms of external hemorrhoids include:

  • Painless bleeding during bowel movements, especially noticeable on the toilet tissue or in the toilet bowl
  • Itching or irritation in the anal region
  • Swelling around the anus
  • A lump near your anus which may be sensitive or painful

Are There Any Specific Female Hemorrhoid Symptoms?

Research has not shown a connection between gender and the severity, or presence, of hemorrhoid symptoms.

The only known link that differentiates males and females when it comes to hemorrhoids is common causes. 

The causes of hemorrhoids are very different for men and women.

Since many women develop hemorrhoids during pregnancy and childbirth, the only female specific aspect of hemorrhoids is known causes.

Most Common Hemorrhoids Pregnancy Symptom

The development of hemorrhoids is common among pregnant women. That’s because of the increase in pressure on the pelvic veins from the growing uterus.

Since constipation is often common during pregnancy as well, this can lead to the development of the condition.

Because of the extreme increase in pressure during pregnancy, pain and itching are the most common symptoms.

These may be exaggerated during or after bowel movements.

You may also be able to see hemorrhoids during pregnancy or feel a lump or mass.

Pregnancy hemorrhoids tend to bleed, so bleeding during bowel movements is a common symptom.

Are There Any Common Hemorrhoid Symptoms in Males?

The symptoms of hemorrhoids are the same between males and females. The causes, however, may be different.

While women are more likely to develop hemorrhoids during pregnancy, men are more likely to develop them because of an increase in strain to the lower region.

For men who work or lift out with heavy weights, painful and symptomatic hemorrhoids may develop.

It is also important to note that there are symptoms of hemorrhoids that mimic symptoms of more serious conditions in men.

Although it is rare, bleeding during bowel movements is a sign of colon cancer in younger males.

Therefore, regardless of what symptoms you may attribute to hemorrhoids, you should always consult with your doctor to be sure your self-diagnosis is correct.

What are Typical Infected Hemorrhoids Symptoms?

Internal and external hemorrhoids can become infected.

Whether you have internal or external hemorrhoid infection, you may experience:

  • Bleeding during bowel movements
  • Itching around the anal area. This is very common in the first stages of infection because the disease spreads around the anal area.
  • Rectal pain that becomes more intense with touch
  • Difficulty passing stool
  • Leakage of stool due to failure in normal function of muscles because of the infection

Internal hemorrhoids may display the following symptoms when they become infected:

  • Streaks of blood that appear on your toilet paper or in the toilet after a bowel movement, especially with the absence of pain
  • The emergence of large, sagging veins that protrude out of the anus and are marked by pain and discomfort
  • Feeling the urge to have a bowel movement, even though you may have already had one
  • Pain, specific to a strangulated hemorrhoid
  • Mucus on the tissue paper when you pass stool

External hemorrhoids may display the following symptoms when they become infected:

  • Irritation of the skin, particularly severe itching around the anal opening
  • Clotting under the skin that causes pain
  • Difficulty sitting due to pain in the anal area
  • Behavioral changes, including how you walk and how you socialize with others, due to the infection

Common Symptoms of Bad Hemorrhoids

Hemorrhoids are a common condition that can often be treated by at-home remedies and with over-the-counter medications.

In the case of bad hemorrhoids, doctor treatment may be required.

Symptomatic hemorrhoids that are painful, continually bleeding, or long-lasting may indicate the need for medical treatment.

Some hemorrhoids are accompanied by bleeding, a lump in the anus, and rectal pain.

These symptoms may become severe.

Regardless of severity, these types of hemorrhoids require medical supervision because they may be a sign of a more serious condition.

Hemorrhoids that display any of the following symptoms should be followed by a medical professional, because they are considered severe:

  • Any type of rectal bleeding
  • Severe pain or discomfort
  • Persistent symptoms despite use of over-the-counter hemorrhoid creams or remedies
  • Passing stool that is maroon or tarry in color

If you experience symptoms of severe hemorrhoid pain or discomfort that doesn’t resolve with at-home treatment or over-the-counter hemorrhoid medication, or you experience rectal hemorrhoid bleeding, contact your medical provider immediately.

They will be able to provide you with more information and hemorrhoid treatment options that can help to relieve the symptoms of bad hemorrhoids.


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