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Internal Hemorrhoids

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Causes, Symptoms & Treatments for Internal Hemorrhoids

What are Internal Hemorrhoids?

Internal hemorrhoids form when blood vessels inside the rectum become swollen and engorged. Although they form in the lowest part of the rectum, internal hemorrhoids are still far enough inside that you may not even know that they’re there. In fact, everyone actually has internal hemorrhoids, but we only notice them once they become a problem! Once they do become an issue, symptoms of internal hemorrhoids vary depending on their severity, but the most common symptom is rectal bleeding.

Because internal hemorrhoids are located in an area without any nerve endings, they do not cause pain. If you are experiencing pain, it may be from a different condition such as external hemorrhoids, anal fissures or spasm.

Many people are able to get temporary relief from sitz baths and ointments/creams, but such remedies are unlikely to cure your hemorrhoids as they do not resolve the underlying issue.Because anal bleeding is a common symptom of internal hemorrhoids as well as colon cancer, it is always recommended that you see a medical professional for diagnosis if you are experiencing such symptoms. Your doctor may recommend a longer lasting treatment for your internal hemorrhoids, such as hemorrhoid banding or hemorrhoidectomy.

What Causes Internal Hemorrhoids?

Hemorrhoids result from an increase in pressure in the veins of the rectum, typically from too much straining. Common causes of internal hemorrhoids include:

  • Constipation and diarrhea – these conditions both put undue stress on the rectal area either by straining too much (constipation) or frequent bowel movements (diarrhea). These issues can often be resolved with diet and lifestyle changes, but may also be associated with other conditions like IBS and IBD
  • Diet high in fat and/or low in fibre – such a diet can affect our bowel movements, causing constipation or diarrhea. As described above, this can put undue pressure on the rectum and increase time sitting on the commode.
  • Pregnancy and childbirth – many women develop hemorrhoids during pregnancy or during childbirth due to the increased pressure of carrying a growing fetus and the straining during childbirth.
  • Obesity – people who are obese are at a higher risk of developing both internal and external hemorrhoids, not only because of increased pressure around the rectum, but also because obesity is often associated with poor diet and a sedentary lifestyle.
  • Long periods of sitting – regular activity is an important aspect to prevent hemorrhoids and other anorectal health issues.

If you want to prevent internal hemorrhoids from forming, making some simple lifestyle changes such as increasing the amount of fiber in your diet and engaging in regular exercise may help. Unfortunately, sometimes there is nothing we can do to prevent internal hemorrhoids.

What are the Symptoms of Internal Hemorrhoids? (Sub Topics = Bleeding Hemorrhoids, Anal Bleeding, Bleeding, Blood, Pain)

Symptoms of internal hemorrhoids vary depending on their severity. Small internal hemorrhoids may only cause some light bleeding, however, when the hemorrhoid tissue begins to prolapse, or protrude outside the anus, you may start to notice itching, swelling, and even soiling (all due to that loosened tissue). The most common symptom of internal hemorrhoids is anal bleeding.

Because internal hemorrhoids are located in an area without any nerve endings, they do not cause pain. If you have internal hemorrhoids and are experiencing pain, it is most likely the result of an associated condition, such as anal fissures.

The Most Common Symptom of Internal Hemorrhoids is Bleeding

Internal hemorrhoids can worsen over time, but since there are very few pain-sensing nerves in the lower rectal area, you are unlikely to feel any pain. In fact, the most common symptoms of mild internal hemorrhoids is bleeding. You can read more about hemorrhoid bleeding on our blog: here. Pain that is associated with internal hemorrhoids is in fact typically caused by an anal fissure or by external hemorrhoids.

Different Kinds of Hemorrhoids Can Cause Similar Symptoms

When internal hemorrhoids do progress, they will often protrude outside the anus, becoming prolapsed hemorrhoids. An internal hemorrhoid that has reached this stage can cause some external hemorrhoid-like symptoms, such as itchiness and swelling. Since prolapsed hemorrhoids and external hemorrhoids can cause similar symptoms, it’s sometimes difficult to know which is which without a doctor’s professional diagnosis. It is also not uncommon for both to be present at once.

Additional reading: You can read about prolapsed hemorrhoids in several of our blog posts: Prolapsed Internal Hemorrhoids, What is a Prolapsed Hemorrhoid, and Rectal Prolapse or Hemorrhoids?.

Do I Have Internal Hemorrhoids?

Only a qualified physician can accurately diagnose internal hemorrhoids. Additionally, because bleeding is a common symptom of colorectal cancer as well as internal hemorrhoids, it is recommended you see a physician right away if you are experiencing any rectal symptoms. If you’re still uncertain about whether you should see a doctor about your symptoms read out blog post titled “Do I have to see my doctor if my hemorrhoids are bleeding?”.

What do Internal Hemorrhoids Look Like?

Internal hemorrhoids are located inside the anal canal, so unless they prolapse (slide) to the point of protruding outside of your anus, you will not see anything.

Symptoms are typically a better indication of internal hemorrhoids. Whether you’re feeling excess tissue around the anus or you’re seeing a small amount of blood on the toilet paper, your symptoms may indicate a hemorrhoid problem.

The only time you may see an internal hemorrhoid is if the disease becomes advanced enough to prolapse or protrude outside the anus. This typically happens during a bowel movement and in many cases the tissue will go back in on its own. In other cases, you may have to push the tissue back in.

The below diagram depicts the location of an internal hemorrhoid:

Since the only way to know if you have internal hemorrhoids is to call a doctor near you and schedule a consultation, we recommend you search our database for a doctor near you that is able to diagnose and, if appropriate, treat your hemorrhoids.

How do You Treat Internal Hemorrhoids?

There are a number of internal hemorrhoid treatment options available to those experiencing symptoms. Common treatments fall into a few categories:

Hemorrhoid Home Remedies

At-home hemorrhoid treatments are often appealing to those suffering from internal hemorrhoid symptoms as they can be discreetly utilized in the comfort of your own home. Some examples include:

Unfortunately, all too often, hemorrhoid sufferers spend endless time and money on home remedies such as creams, suppositories, and warm baths, trying to cure their hemorrhoids but getting nothing but temporary relief from some of their symptoms. Home remedies can keep symptoms in check for a few hours at a time, but without professional treatment, hemorrhoids can continue to get progressively worse. You must resolve the underlying issues to get rid of your hemorrhoids for good.

If you have recurring hemorrhoids, consult a medical professional for alternative options for treating internal hemorrhoids.

Effective But Invasive Professional Hemorrhoid Treatment Options

If you have been unhappy with home remedies such as those described above, it is likely that you have already turned to a medical professional to get rid of your hemorrhoids for good. Unfortunately, you may have been told that your only options for treating your internal hemorrhoids are methods fraught with complications that require you to take time off work, such as:

If you have spoken with a doctor before and been offered only ineffective conservative treatment options (e.g. ointments, sitz baths, etc.) or the above invasive procedures, you’re not alone. This is why so many people suffer their symptoms in silence. It may be time to speak with a physician about other options to get rid of your hemorrhoids.

Minimally Invasive Professional Hemorrhoid Treatment Options

Today, there are a number of non-invasive internal hemorrhoid treatment methods available from medical professionals that do not have the complications and downtime associated with the options above. That is why it’s important to speak with a doctor to learn about your treatment options. Some of these options include:

Many of these minimally invasive methods of internal hemorrhoid treatment, such as infrared coagulation, are only effective on smaller hemorrhoids and while they may provide symptomatic relief for longer than home remedies, symptoms often recur sooner than if treated with more invasive options.

The CRH O’Regan System®, however, provides both the low complication rate of these non-invasive options and the low recurrence rate of surgery.

Learn more about your treatment options >

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