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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Bhupinder Anand, MD

Hemorrhoid Symptoms

The most common symptom and sign from hemorrhoids is painless bleeding. There may be bright red blood on the outside of the stools, on the toilet paper, or dripping into the toilet. The bleeding usually is self-limiting.

Bleeding with a bowel movement is never normal and should prompt a visit to a health care practitioner. While hemorrhoids are the most common cause of bleeding with a bowel movement, there may be other reasons to have bleeding including inflammatory bowel disease, infection, and tumors.

Prolapsed Internal Hemorrhoids

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 problem of prolapse but does not fix the hemorrhoid itself;
  
  
• may enlarge and swell even more if they cannot be pushed back;
  
  
• may become entrapped, which requires medical attention.

Hemorrhoids may also cause pruritus ani or itching around the anus, and a constant feeling of needing to have a bowel movement.

Thrombosed External Hemorrhoids

Thrombosed external hemorrhoids are a painful condition. These occurs when a blood clot develops in the hemorrhoid 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.
  
  
• Thrombosed external hemorrhoids often need medical care and treatment.