Internal hemorrhoids are a common condition caused by increased pressure in the lower rectum. Symptoms may include painless bleeding, itching, and discomfort.

An internal hemorrhoid occurs when the veins inside the rectum become swollen. This swelling is typically due to increased pressure in the lower rectum, often caused by factors such as straining during bowel movements due to constipation.

Let’s discuss the causes, symptoms, diagnosis, possible treatments, and prevention of internal hemorrhoids.

Internal hemorrhoids develop when increased pressure in the lower rectum causes the veins in the rectal area to swell, enlarge, or weaken the surrounding tissue.

Causes of this increased pressure may include:

  • chronic constipation or diarrhea
  • prolonged sitting, especially on the toilet
  • eating a diet low in fiber
  • chronic coughing or regularly lifting heavy objects

Certain factors may also increase your chances of developing an internal hemorrhoid, such as:

An internal hemorrhoid may not cause noticeable symptoms. However, you may experience painless bleeding during bowel movements. This often appears as bright red blood in the toilet or on toilet paper after wiping.

Internal hemorrhoids are not visible from above the skin.

Sometimes, an internal hemorrhoid may become prolapsed, which can lead to additional symptoms, including:

  • discomfort or pain
  • swelling near the anus
  • itching or irritation around the anus
  • mucus in your stool
  • a lump near the anus that may be tender or painful
  • a feeling of fullness or incomplete bowel movements

Possible complications of internal hemorrhoids may include:

  • Thrombosed hemorrhoid: Sometimes, a clot (thrombus) can form in a hemorrhoid, leading to severe pain, swelling, inflammation, and a hard lump near the anus.
  • Severe pain: This can occur particularly with thrombosed hemorrhoids.
  • Prolapsed hemorrhoid: This is when an internal hemorrhoid swells and stretches the surrounding muscle, protruding outside the anal sphincter.
  • Bleeding: You may see bright red blood at the end of a bowel movement, which can lead to significant blood loss over time.

Consider seeking medical help if you experience any of the following symptoms associated with an internal hemorrhoid:

Early medical intervention can help prevent further complications and ensure the internal hemorrhoid is properly managed.

Diagnosing an internal hemorrhoid typically starts with a doctor taking a thorough medical history and performing a physical examination to understand your symptoms.

They may perform a digital rectal exam, where they insert a gloved, lubricated finger into your rectum to check for swollen veins, which would suggest the presence of an internal hemorrhoid.

For a closer look, your doctor may perform an anoscopy. In this procedure, they will insert a small, tubular instrument called an anoscope into your rectum to get a detailed view of the internal hemorrhoid.

If you have more severe symptoms or other types of hemorrhoids are suspected, your doctor may recommend additional procedures like a rigid proctosigmoidoscopy or colonoscopy to visualize the entire colon.

These procedures help identify and assess the extent of the internal hemorrhoid and check for any rectal bleeding or rule out other possible causes of symptoms, such as anal fissures and abscesses.

Several treatment options are available for managing internal hemorrhoids, depending on the severity of the condition:

  • Sitz baths: Taking a warm bath or sitz bath several times a day can help reduce irritation and swelling in the anal area.
  • Over-the-counter medications: Suppositories, creams, and ointments can relieve pain and reduce inflammation.
  • High fiber diet: Increasing your fiber intake can soften stools, making them easier to pass. It can also reduce strain on the internal hemorrhoid.
  • Minimally invasive procedures: Treatments like rubber band ligation or sclerotherapy can effectively shrink an internal hemorrhoid.
  • Surgery: In severe cases, a doctor may recommend surgeries for internal hemorrhoids to remove or reduce the internal hemorrhoid.

Choosing between home treatments and medical procedures will depend on the severity of your internal hemorrhoid and whether complications are present.

The outlook for someone with an internal hemorrhoid is generally good, especially with proper treatment and management. Simple changes — like improving your diet and bowel habits — can often relieve your symptoms.

If these aren’t helping enough, outpatient procedures like rubber band ligation can effectively manage internal hemorrhoid symptoms. While recurrence is possible, many people successfully manage their condition and maintain a higher quality of life.

Some lifestyle changes can help lower your risk of developing internal hemorrhoids, such as:

  • drinking plenty of fluids, especially water, to keep stools soft and reduce the strain on your rectum
  • avoiding prolonged sitting, particularly on the toilet, to minimize the risk of an internal hemorrhoid
  • eating high fiber foods to prevent constipation, which is a major cause of internal hemorrhoids
  • limiting caffeine and alcohol, as these can lead to dehydration and worsen hemorrhoid symptoms
  • maintaining a healthy weight for your body to decrease pressure on the pelvic area
  • avoiding lifting heavy objects frequently

What do internal hemorrhoids feel like to touch?

Internal hemorrhoids are typically not felt by touch since they’re located inside the rectum unless they are large or prolapsed.

Will internal hemorrhoids go away on their own?

The National Institute of Diabetes and Digestive and Kidney Diseases notes that most cases of prolapsed hemorrhoids can go away on their own. However, severe cases may require medical treatment.

While many cases of internal hemorrhoids can be managed with habit changes and home remedies, severe cases may require medical treatment.

If you experience persistent symptoms, consider speaking with a healthcare professional to discuss the best treatment options for your internal hemorrhoid.