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Symptoms & Treatment of Internal & External Hemorrhoids


What Are Hemorrhoids?

Contrary to popular belief, people do not “get” hemorrhoids. They are a normal ever-present part of the anorectal anatomy. Hemorrhoids are normal blood vessels under the anal canal lining that have the ability to swell. If this swelling becomes large or persistent, then symptoms can occur.  


What Causes the Symptoms of Hemorrhoids?

Obesity, constipated hard stools that require repeated straining during bowel movements, sometimes the frequency of diarrhea, sitting too long on the toilet (even without straining), pregnancy, heavy lifting are many of the conditions or behaviors that can cause hemorrhoid symptoms.


Symptoms of Hemorrhoids


Symptoms of Internal Hemorrhoids include painless bleeding or prolapse and protrusion. The blood may be visible on the toilet paper, or covering the stool, or seen in the toilet bowl. People with large internal hemorrhoids can sometimes feel the protruding tissues occurring during a bowel movement or persistent during clean-up.  Internal hemorrhoids do not normally cause sharp pain. While the majority of painless bright bleeding is caused by internal hemorrhoids, it is important to see your family doctor or a colon & rectal specialist as this symptom can also be due to other potentially more serious causes.


Symptoms of External Hemorrhoids include a sudden painful anal lump known as a thrombosed hemorrhoid. This occurs when a hemorrhoid blood vessel develops one or more blood clots. Overstraining with bowel movements or vigorous physical activity can cause thrombosed hemorrhoids. The generous tissues of prominent hemorrhoids can also cause anal itching, and anal moisture or soiling.

Hemorrhoid Treatment Options

Options include both office and surgery based solutions. People often delay treatment of their hemorrhoids because they fear that surgery is the only option and it will be a painful and difficult surgery.
In fact, the majority of hemorrhoid management involves non-surgical painless office management. Using rubber band ligation or sclerotherapy the bulk of internal hemorrhoid and painless bleeding problems can be resolved in one or two office visits. For people with painful thrombosed external hemorrhoids, office management aids in rapid resolution of the painful condition.


Surgical management is required for more extensive or severe hemorrhoid conditions. Hemorrhoidectomy has a reputation for a painful recovery, however with our comprehensive pain management plan, including the use of Exparel, we are often told that the surgical recovery was “not as bad as I feared”. We also utilize the PPH (Procedure for Prolapse and Hemorrhoids) surgical technique which generally results in less post-operative pain and a quicker return to normal activities. 

Hemorrhoids During Pregnancy


Hemorrhoids are especially prevalent in pregnant women. You can learn more regarding hemorrhoids during pregnancy and what you can do to treat this condition.



Pictured: Left side is a normal Internal Hemorrhoid. On the right side is the anatomy of an engorged Hemorrhoid, both Internal and External.

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