internal hemorrhoid

Internal Hemorrhoids: A Common Condition

Internal hemorrhoids are a type of hemorrhoid that occurs inside the rectum, above the dentate line. They are caused by increased pressure in the lower rectum, which can lead to swelling and inflammation of the veins in this area.

Symptoms of Internal Hemorrhoids

• Painless bleeding during bowel movements [5]
• Small amounts of bright red blood on toilet tissue or in the toilet bowl [1]
• No symptoms at all, with some people being unaware they have internal hemorrhoids until they notice blood on their poop or toilet paper after wiping [8]

Characteristics of Internal Hemorrhoids

Internal hemorrhoids are generally painless and may not cause any discomfort. However, if they become enlarged or prolapsed, they can cause anal itching, pain, and rectal pressure.

Types of Internal Hemorrhoids

There are several types of internal hemorrhoids, including:

• First-degree: These are small, non-protruding hemorrhoids that do not cause symptoms.
• Second-degree: These are larger than first-degree hemorrhoids but still do not protrude from the anus.
• Third-degree: These are larger and more prominent, but still can be pushed back into the rectum with a finger.
• Fourth-degree: These are the largest and most severe type of internal hemorrhoid, which can cause significant discomfort and pain.

Causes and Risk Factors

Internal hemorrhoids are caused by increased pressure in the lower rectum, which can be due to various factors such as:

• Constipation
• Straining during bowel movements
• Pregnancy
• Obesity
• Aging

It's essential to note that internal hemorrhoids are a common condition, and most people will experience them at some point in their lives.

References

[1] Aug 25, 2023 — Internal hemorrhoids · Painless bleeding during bowel movements. [5] Aug 23, 2024 — Internal hemorrhoids are a common condition caused by increased pressure in the lower rectum. [8] Aug 16, 2023 — Internal hemorrhoids may have no symptoms at all.

Common Signs and Symptoms of Internal Hemorrhoids

Internal hemorrhoids are a common condition that can cause various symptoms, which can range from mild to severe. Here are some of the most common signs and symptoms:

• Painless bleeding during bowel movements: This is one of the most common symptoms of internal hemorrhoids (1). You may notice blood on toilet paper, in your stool, or in the toilet bowl.
• Anal itching: Internal hemorrhoids can cause irritation and itching in the anal area (6).
• Discomfort or pain during bowel movements: Prolapsed internal hemorrhoids can cause pain and discomfort while passing stool (3, 4).
• Painful lumps or swelling in the anal region: In some cases, internal hemorrhoids can cause painful lumps or swelling in the anal area (8).

Other Possible Symptoms

• Mucus discharge
• Difficulty with cleaning yourself after a stool
• A sense that your stool is "stuck" at the anus

Important Notes

• Internal hemorrhoids are often asymptomatic and may not cause any noticeable symptoms (5).
• Only about 5% of people with internal hemorrhoids experience symptoms (5).
• If you notice any symptoms of internal hemorrhoids, it's essential to consult a doctor to rule out other potential causes of rectal bleeding (11).

References

(1) Symptoms. Symptoms of hemorrhoids usually depend on the type of hemorrhoid. (2) Internal hemorrhoids may have no symptoms at all. (3) Prolapsed internal hemorrhoids may cause pain and discomfort. (4) Although hemorrhoids are the most common cause of anal symptoms, not every anal symptom is caused by a hemorrhoid. (5) Internal hemorrhoids usually are not visible from the outside, and they often do not cause noticeable symptoms. (6) Symptoms · Painless bright red blood from the rectum · Anal itching · Anal ache or pain, especially while sitting (7) Patients may also complain of mucus discharge, difficulty with cleaning themselves after a stool, or a sense that their stool is “stuck” at the anus with BMs. (8) Hemorrhoids symptoms · bleeding · itching or irritation in the anal area · discomfort, pain, or soreness around the anus (9) Internal hemorrhoids can be difficult to self-diagnose, but there are some signs and symptoms that you can be aware of. (10) Internal hemorrhoids are a common condition caused by increased pressure in the lower rectum. Symptoms may include painless bleeding, itching, and discomfort. (11) If a person notices any symptoms of internal hemorrhoids, they should contact a doctor to rule out other potential causes of rectal bleeding.

Diagnostic Tests for Internal Hemorrhoids

Internal hemorrhoids are typically diagnosed through a combination of physical examination and medical history. Here are some common diagnostic tests used to diagnose internal hemorrhoids:

• Digital Rectal Exam (DRE): A digital rectal exam is usually the first step in diagnosing internal hemorrhoids. This involves your healthcare provider inserting a gloved finger into your anal canal and rectum to feel for any abnormalities [1][2].
• Visual Exam: Your doctor may also perform a visual examination of the outside of your anus to look for external signs of hemorrhoids, such as swelling or lumps [4].
• Anoscopy: An anoscopy is a test that allows your doctor to visually examine the inside of your rectum and anal canal. This can help identify internal hemorrhoids and rule out other conditions [5][6].
• Flexible Sigmoidoscopy: A flexible sigmoidoscopy is a more detailed examination of the lower part of your colon and rectum. It can help diagnose internal hemorrhoids, as well as other conditions such as polyps or cancer [7].

In some cases, additional tests may be ordered to rule out other conditions that may be causing symptoms similar to those of internal hemorrhoids.

References:

[1] Context result 1 [2] Context result 2 [3] Context result 3 (not directly relevant but provides context on external hemorrhoids) [4] Context result 4 [5] Context result 5 [6] Context result 6 [7] Context result 7

Treatment Options for Internal Hemorrhoids

Internal hemorrhoids are typically treated with conservative medical therapy and avoidance of certain substances, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and spicy or acidic foods [1]. Topical treatments can also be effective in managing symptoms.

• Topical creams and suppositories: Applying a hemorrhoid cream or suppository containing hydrocortisone can help reduce swelling and itching [2]. These products usually contain medicines such as lidocaine to numb the area, or hydrocortisone or witch hazel, to reduce swelling and itching [3].
• Local medications: Topical nitroglycerine ointment has been shown to be effective in managing postoperative pain [4].
• Suppositories for internal hemorrhoids: Suppositories are better suited for internal hemorrhoids as the medicine is absorbed by the rectal tissue, helping to alleviate discomfort and pain caused by hemorrhoids [5].

Other Treatment Options

In some cases, more invasive treatments may be necessary. These include:

• Hemorrhoidectomy: Surgery to remove large external hemorrhoids or prolapsed internal ones.
• Hemorrhoid stapling: A stapling instrument removes an internal hemorrhoid.

Medications Used to Treat Hemorrhoids

Some common medications used to treat hemorrhoids include:

• Lidocaine topical
• Hydrocortisone cream or suppository
• Witch hazel
• Nifedipine ointment

Note: It's essential to consult a healthcare professional for proper diagnosis and treatment of internal hemorrhoids.

References: [1] Context result 1 [2] Context result 2 [3] Context result 3 [4] Context result 5 [5] Context result 8

Internal hemorrhoids can be challenging to diagnose, as their symptoms may resemble those of other conditions. To determine a differential diagnosis for internal hemorrhoids, consider the following possibilities:

• Anal fissures: These are small tears in the lining of the anus that can cause pain and bleeding during bowel movements [4].
• Rectal prolapse: This is a condition where the rectum loses its normal attachment to the muscles of the pelvic floor, leading to symptoms such as rectal bleeding, constipation, and feeling of incomplete evacuation [2].
• Perianal abscesses: These are collections of pus in the tissues around the anus that can cause pain, swelling, and fever [1].
• Fistula disease: This is an abnormal connection between two epithelial-lined surfaces, such as between the rectum and the skin, which can cause symptoms like chronic discharge and pain [1].
• Anal/rectal cancer: In some cases, internal hemorrhoids may be mistaken for tumors in the colon, rectum, or anus, which can be benign or malignant [5].
• Rectal cancer: This is a type of cancer that affects the rectum, and its symptoms can mimic those of internal hemorrhoids, such as bleeding and pain during bowel movements [5].

To accurately diagnose internal hemorrhoids, it's essential to consider these differential diagnoses and perform a thorough physical examination, including an abdominal examination, inspection of the perineum, and digital rectal examination [7]. A healthcare professional may also recommend diagnostic tests, such as colonoscopy or biopsy, to rule out other conditions.

References:

[1] by RF Fontem · 2023 · Cited by 11 — External hemorrhoids, perianal abscess, fistula disease, anal/rectal cancer, anal fissure.

[2] by T Mott · 2018 · Cited by 262 — Internal hemorrhoids are traditionally graded from I to IV based on the extent of prolapse. Other factors such as degree of discomfort, bleeding ...

[4] Jul 29, 2020 — Hemorrhoids should be differentiated from other diseases that cause anal discomfort and pain with defecation such as rectal cancer, anal fissure...

[5] Apr 27, 2018 — Tumors in the colon, rectum or anus can mimic symptoms of hemorrhoids. Sometimes these tumors are benign, but they can also be malignant.

[7] by AL MOUNSEY · 2011 · Cited by 107 — Differential Diagnosis of Hemorrhoids ... Physical examination should include an abdominal examination, inspection of the perineum, digital rectal...