Understanding the Difference Between External and Internal Hemorrhoids

It’s true that the symptoms you’re having help identify which type of hemorrhoid you’re experiencing. The good news is that treatment exists for all types, and it may be easier than you believe to get rid of the pain and bleeding that often accompany this fairly common problem.

Betsy Clemens, MD, is a specialist who leads our team here at Midwest Hemorrhoid Treatment Center in Creve Coeur, Missouri. She shares insight about hemorrhoid types, their symptoms, and the therapy available to help resolve your discomfort.

Hemorrhoids and their symptoms

Hemorrhoids occur when blood vessels in your rectum or under the skin around your anus become swollen. They’re very common. Some studies estimate that three out of every four people will experience problems with hemorrhoids at some point in their life.

Hemorrhoids can be painful and may bleed as the wall of the affected blood vessel thins and becomes irritated. Just as frequently, however, you may not have any discomfort but notice bright red blood with a bowel movement. It really all depends on the type of hemorrhoid you’re struggling with.

Internal versus external hemorrhoids

Internal hemorrhoids occur within the rectum. They aren’t usually visible and don’t typically cause discomfort. They can bleed, however, and are the most common cause of bright red blood noted with bowel movements. They can also begin to interfere with bowel movements as they become larger.

Sometimes excessive straining can push an internal hemorrhoid outside of the anal opening. This straining can occur during a bowel movement but may be related to childbirth, heavy lifting, or certain sports activities. When an internal hemorrhoid falls (prolapses) outside the anus, it can cause significant discomfort and may bleed frequently.

External hemorrhoids occur in the sensitive anal region and often cause pain and bleeding with bowel movements. Because these hemorrhoids are exposed to external friction, they can also become itchy, irritated, and painful with routine activities such as sitting or walking.

Blood can sometimes pool in an external hemorrhoid and cause a clot (thrombus). Thrombosed hemorrhoids can become extremely painful due to inflammation and swelling. You may notice a hard lump near the anal opening that’s quite tender to touch.

Treatment for hemorrhoids

Treatment always begins with a thorough exam to identify the nature and type of hemorrhoid you’re experiencing. Otherwise, the treatment we recommend is based on the symptoms you’re experiencing and the severity of the hemorrhoid. We typically, for instance, treat an internal hemorrhoid differently than an external thrombosed hemorrhoid.

One practical and simple step you can take in helping to prevent hemorrhoids from occurring or returning after treatment is to follow a nutritious, high-fiber diet that helps keep your stools soft and regular.

This preventive measure is beneficial for either internal or external hemorrhoids. Introduce fiber gradually if you aren’t used to it, though, since too much can lead to diarrhea, which is another cause of hemorrhoidal flare-ups.

For internal hemorrhoids and some external hemorrhoids, Dr. Clemens prefers infrared coagulation treatment (IRC). It’s a painless therapy that uses infrared light to decrease blood flow to the hemorrhoid. This causes the involved blood vessel to shrink back to normal size and effectively resolves the symptoms you’ve been experiencing. Possibly best of all, IRC can eliminate the need for hemorrhoid surgery.

For a painful thrombosed external hemorrhoid, Dr. Clemens may recommend a thrombectomy, during which she creates a very small incision in the hemorrhoid that allows the pooled blood to drain. This simple procedure requires no anesthetic and is best performed within three days of the clot formation, which is another reason to not put off seeing Dr. Clemens for hemorrhoid treatment.

For relief from your hemorrhoid symptoms that doesn’t include painful surgery, make an appointment today with Dr. Clemens at Midwest Hemorrhoid Treatment Center. Call our office or click the “request a call back” button while you’re here on the website.