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Hemorrhoids (cont.)

What are the signs and symptoms of an internal or prolapsed hemorrhoid?

Most often, internal hemorrhoids have no symptoms but are only found if there is bleeding with a bowel movement or if the hemorrhoid prolapses so that it can be felt outside of the anus. This may lead to itching and pain as well as the bleeding.

Prolapse of an internal hemorrhoid occurs when the internal hemorrhoids swell and extend from their location in the rectum through the anus. A prolapsed internal hemorrhoid:

  • Can be felt as a lump outside the anus
  • Can be gently pushed back through the anus, this may resolve the location of the hemorrhoid, but does not fix the hemorrhoid itself
  • May enlarge and swell even more if it cannot be pushed back
  • May become entrapped, which requires more urgent medical attention

Hemorrhoids may also cause anal itching (pruritus ani), and a constant feeling of needing to have a bowel movement (tenesmus).

Internal hemorrhoid severity can be graded:

  • Grade I: Prominent blood vessels with no prolapse
  • Grade II: Prolapse with bearing down but with spontaneous reduction
  • Grade III: Prolapse with bearing down but requiring manual reduction
  • Grade IV: Prolapse with inability to manual reduction

What are the signs and symptoms of an external or thrombosed hemorrhoid?

Thrombosed external hemorrhoids are a painful condition. These occurs when a blood clot develops in a hemorrhoidal blood vessel causing swelling and inflammation.

  • When a blood clot occurs in a hemorrhoid, the hemorrhoid will become even more swollen. This swelling leads to increased pain.
  • The pain is usually worse with bowel movements and may increase with sitting.

A thrombosed external hemorrhoid may resolve on its own; however, this condition often needs medical care. Bleeding with a bowel movement is never normal and should prompt a visit to a health-care professional. While hemorrhoids are the most common cause of bleeding with a bowel movement, there may be other reasons for bleeding including inflammatory bowel disease, infection, and tumors.

Medically Reviewed by a Doctor on 6/6/2016
Medical Editor:

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