What are hemorrhoids, what are their most prominent symptoms, and how can they be understood?

Hemorrhoids are defined as a medical condition characterized by swelling and inflammation of the veins located around the anus or in the lower part of the rectum [1]. This problem is very common and arises due to increased pressure on these veins, leading to their enlargement and protrusion. These veins are affected by multiple factors such as persistent straining during bowel movements, sitting for long periods on the toilet, pregnancy, aging, or even regular heavy lifting, in addition to other factors such as chronic constipation or a lack of fiber in the diet [1].

Types of Hemorrhoids and Their Locations

Medically, hemorrhoids are divided into two main types based on their location, with each type having distinct characteristics:

• External Hemorrhoids: These originate and form under the skin surrounding the anus. This type is often more prone to irritation due to friction or excessive cleaning [1].
• Internal Hemorrhoids: These form in the mucous lining of the anus and the lower part of the rectum. In their normal state, internal hemorrhoids are not painful, but they may protrude and prolapse from the anus, which can cause pain and discomfort [1].

How Do Hemorrhoid Symptoms Appear?

Symptoms vary significantly depending on the type of hemorrhoids. External hemorrhoids usually appear as itching in the anal area and pain that increases in severity when sitting, in addition to the appearance of one or more lumps that are hard and painful to the touch near the anus [1]. Conversely, symptoms of internal hemorrhoids include the presence of bright red blood noticed by the patient in stool, on toilet paper, or in the toilet water after bowel movements, which is an indicator that always requires careful medical examination [1] [2].

Diagnosis and Medical Attention

If you are experiencing any of the mentioned symptoms, visiting a doctor is a fundamental step to ensure a proper diagnosis, especially since symptoms like rectal bleeding can resemble other more serious conditions such as Crohn's disease, ulcerative colitis, or even colorectal and anal cancer [1]. The doctor usually performs a physical examination of the area and may resort to a digital rectal exam using a lubricated glove or use an anoscope (Anoscopy) to clearly view the inner lining of the rectum and anus. This is a quick procedure that helps detect hemorrhoids or any fissures or abnormal growths [1] [2].

Managing the Condition and When to Seek Care

In many cases, symptoms of external hemorrhoids disappear automatically within a few days with home care, such as eating a diet rich in fiber, drinking plenty of fluids, avoiding straining during bowel movements, and using warm soaks (Sitz bath) to relieve pain [1]. However, it is necessary to seek medical care if symptoms persist for more than a week despite home treatment attempts, or in the case of persistent bleeding, where the doctor will determine the appropriate procedure, whether it is conservative treatment or other medical interventions to shrink the hemorrhoids in the clinic [1]. For more details on different treatment options, you can review our article on Hemorrhoids: Causes, Symptoms, and Home and Surgical Treatment (Arabic).

Medical references

• Hemorrhoids
• Anoscopy