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This article was co-authored by Chris M. Matsko, MD. Dr. Chris M. Matsko is a retired physician based in Pittsburgh, Pennsylvania. With over 25 years of medical research experience, Dr. Matsko was awarded the Pittsburgh Cornell University Leadership Award for Excellence. He holds a BS in Nutritional Science from Cornell University and an MD from the Temple University School of Medicine in 2007. Dr. Matsko earned a Research Writing Certification from the American Medical Writers Association (AMWA) in 2016 and a Medical Writing & Editing Certification from the University of Chicago in 2017.
There are 8 references cited in this article, which can be found at the bottom of the page.
This article has been fact-checked, ensuring the accuracy of any cited facts and confirming the authority of its sources.
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Hemorrhoids are enlarged veins that can be found either externally or internally around the anus. They are caused by increased pressure on the pelvic and rectal veins and are related to constipation, diarrhea, and straining to pass a stool. Internal hemorrhoids can be difficult to self diagnose, but there are some signs and symptoms that you can be aware of.
Steps
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![Step 1 Be aware of bleeding during a bowel movement.]()
Be aware of bleeding during a bowel movement. You might notice some blood on the toilet paper or in the toilet bowl. This is the most common symptom of an internal hemorrhoid.- Blood or mucus in your stools can be a symptom of other illnesses as well. It can signal colorectal cancer or anal cancer, as well as hemorrhoids.[1] Be sure to check with your doctor if you experience these symptoms.
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![Step 2 Notice if you have the sense of a full rectum even after you have passed a stool.]()
Notice if you have the sense of a full rectum even after you have passed a stool. Many people with internal hemorrhoids will describe a sense that they haven’t finished a bowel movement. This is probably because the bulging veins of a hemorrhoid feel similar to stool in the anus.Advertisement -
![Step 3 Be aware that an internal hemorrhoid may exit the anus.]()
Be aware that an internal hemorrhoid may exit the anus. You may feel an internal hemorrhoid that has protruded when you clean around your anus. It will be a pink mass of skin that has poked out of the anus.[2] This is called a prolapse and it can lead to leakage of rectal contents. If you have a prolapse, it can cause some discomfort, but is not usually described as painful.- Internal hemorrhoids are not painful because there are no pain fibers in the veins at that location.
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![Step 4 Suspect a hemorrhoid if you are at risk for one.]()
Suspect a hemorrhoid if you are at risk for one. While hemorrhoids are most often caused by straining during a bowel movement, they can also be caused by obesity, lifting heavy objects, and by pregnancy. In pregnancy, hemorrhoids are due to the extra strain from carrying a baby and the resulting extra pressure on the veins of the lower abdomen.[3] -
![Step 5 Treat...]()
Treat mild hemorrhoids at home. Most internal hemorrhoids can be treated at home by increasing the amount of fiber in your diet and drinking more water. This will soften up and bulk up the stools, making them easier to pass. This will also reduce the internal pressure that can cause hemorrhoids.- Eat more foods high in fiber or take a fiber supplement. Follow the directions on the package if you decide to take a fiber supplement.
- Drink enough water so that you do not become dehydrated and your stool is softened. It is suggested that you drink between 9 and 13 cups of liquid per day. That is usually 6 to 8 full glasses of water.[4]
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![Step 1 Contact your doctor if symptoms don't go away quickly.]()
Contact your doctor if symptoms don't go away quickly. If you think you have an internal hemorrhoid, and that sense doesn’t go away with increased fiber and water after a few days, you should make an appointment with your physician. Your doctor will determine if you have internal hemorrhoids or if there is another medical problem.- Prepare for your exam by writing down your symptoms, making a list of questions you have for your doctor, and continuing to try to soften your stool.
- Classically, hemorrhoids are painless and you can recognize them just from passing bright red blood through your rectum.
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![Step 2 Get a medical exam.]()
Get a medical exam. A physician can diagnose internal or external hemorrhoids by performing a rectal exam. Your doctor will need to look at your anus during this exam, so that he or she will be able to see the hemorrhoid and assess its severity.- Make sure that the doctor does a digital rectal examination. This is when the doctor examines your rectum with a gloved, lubricated finger.
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![Step 3 Be prepared for additional testing.]()
Be prepared for additional testing. If rectal bleeding is not caused by a hemorrhoid, your doctor will likely recommend a more extensive test, called a sigmoidoscopy or a colonoscopy. This is because rectal bleeding is one of the symptoms of colon cancer.[5]- The sigmoidoscopy looks at the rectum and the lower colon, while the colonoscopy looks at the whole colon and rectum.[6] For both of these exams, your doctor will need to insert a scope into your anus.
- Anoscopy and endoscopy can also be used to diagnose internal hemorrhoids. With an anoscopy, the doctor inserts a thin lighted tube just a few inches into your rectum. An endoscopy is similar, but the tube might be inserted further into your rectum or colon.[7]
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![Step 4 Get medical treatment.]()
Get medical treatment. Medical treatments of internal hemorrhoids can be awkward and uncomfortable but they are usually essentially painless. Medical treatments for internal hemorrhoids include:[8]- Ligation: Tying a rubber band around the base of the hemorrhoid to cut off blood flow.
- Injection of a chemical solution designed to shrink the hemorrhoid.
- Cauterization: burning the hemorrhoid.
- Hemorrhoidectomy: surgical removal of the hemorrhoid.
Expert Q&A
Tips
References
- ↑ https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/colon-and-rectal-cancers.html
- ↑ https://muschealth.org/medical-services/ddc/patients/symptoms-and-conditions/hemorrhoids
- ↑ https://www.hopkinsmedicine.org/health/conditions-and-diseases/hemorrhoids
- ↑ https://my.clevelandclinic.org/health/diseases/15120-hemorrhoids
- ↑ https://www.uclahealth.org/medical-services/gastro/colon-cancer-screening/preparing-colonoscopy
- ↑ https://www.nlm.nih.gov/medlineplus/colonoscopy.html
- ↑ https://medlineplus.gov/endoscopy.html
- ↑ https://www.health.harvard.edu/diseases-and-conditions/hemorrhoids_and_what_to_do_about_them
About This Article
Medical Disclaimer
The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.
If you think you might have internal hemorrhoids, look for any bleeding during a bowel movement, as this is the most common symptom. In addition to bleeding either in the toilet bowl or on the toilet paper, check if it feels like you still have a full rectum after you’ve gone to the bathroom. The bulging veins of hemorrhoids feel similar to stool in the anus, so you might have a sense that you didn’t complete your bowel movement. Consider whether or not you’re at risk for hemorrhoids as well, since they are more common in people who are obese, pregnant, or have recently lifted heavy objects. If you notice any symptoms of internal hemorrhoids and they don’t go away after a few days of increased fiber and water intake, make an appointment with your doctor. For more help from our Medical co-author, like how to treat hemorrhoids, read on.
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