External vs Internal Hemorrhoids

External Vs Internal Hemorrhoids: How To Identify, Treat, And Prevent

Hemorrhoids or piles are swollen veins in the lower back end that happen either inside or outside the rectum. The condition causes irritating situations with unnecessary problems and even bleeding. In reality, there exist two types of hemorrhoids: internal and external. Although their causes are the same, their symptoms and methods of treatment differ from each other. In this blog, we are going to walk you through the main difference between external and internal hemorrhoids, how to identify them, and the treatment available for them.

Internal Vs External Hemorrhoids

Hemorrhoids are classified into two according to location:

1. Internal hemorrhoids:are found within the rectum. They normally appear above the opening of the anus. This is painless, but it does bleed for the patient upon defecation.
2. External hemorrhoids: occur within the outer skin of the anus. It can be irritating and would cause some discomfort as well as pain and itchiness if it is swollen or has become thrombosed.

Knowing the difference between external and internal hemorrhoids would make all the difference!

External Hemorrhoids

Symptoms of External Hemorrhoids

Due to an abundance of nerve endings present in the area, external hemorrhoids are often painful. Here are some of the most common symptoms for external hemorrhoids:

• Pruritus and pain: Having hemorrhoids outside will cause you to itch at the anus; hence you cannot sit throughout the day.
• Pain: Pain and aching may be experienced when sitting or when you want to defecate because outside hemorrhoid has swelled.
• Swelling: External hemorrhoids are swollen lumps found next to the anus and can be tender to the touch.
• Bleeding: While less common, external piles may bleed whenever they are rubbed or scratched.

Causes of External Hemorrhoids

External piles occur as a result of various reasons, such as:

• Straining during the passage of stool
• Prolonged sitting
• Chronic constipation or diarrhoea
• Obesity or pregnancy
• Malpractice of heavy lifting

Treatment for External Hemorrhoids

Mild external conditions of hemorrhoids could be over-the-counter taken care of by creams, ointments or cold compresses which help to reduce swelling and inflammation. More severe cases include thromboses where internal surgical intervention or a procedure known as haemorrhoidectomy is necessary.

Internal Hemorrhoids

Symptoms of Internal Hemorrhoids

Internal piles are less painful because they do not appear and tend not to feature too much distress during this condition. However, there are some clear symptoms to look out for:

• Painless bleeding: One of the main symptoms of internal piles is the presence of bright red blood on toilet paper that one experienced after a bowel movement. Unlike external piles, it will rarely be painful.

   

• Prolapse: If an internal hemorrhoid is large enough, it may protrude from the anal opening and protrude outside the anus. This is known as a prolapsed hemorrhoid and sitting is very painful.

   

Causes of Internal Hemorrhoids

Similar to external hemorrhoid, internal hemorrhoid may be caused by

• Straining during stools
• Chronic diarrhoea or constipation
• Pregnancy and childbirth
• Prolonged sitting
• A diet low in fiber

Treatment for Internal Hemorrhoids

The prolapsing ones may require a more serious treatment approach - rubber band ligation, in which a small rubber band is placed around the hemorrhoid to prevent its blood supply. Another option is sclerotherapy or injection that causes shrinkage of the hemorrhoid; or surgery to remove the hemorrhoids.

Treatment Options For Hemorrhoids

Treatment for hemorrhoids begins with internal vs external hemorrhoids treatment options. The following are generalised treatment options that help relieve symptoms:

1. High-Fiber Diet: Increased fiber would mean soft stools without straining for bowel movements.
2. Fluid Intake: Increased water intake helps to soften stools and prevent constipation, conditions exacerbating hemorrhoids.
3. Topical Creams: They help alleviate some of the inflammation and itching and discomfort from the hemorrhoids.
4. Sitz Bath - Sit in warm water for 15-20 minutes, several times a day, to reduce swelling and pain.
5. Avoid Prolonged Sitting: If possible, avoid sitting for long periods - especially on hard surfaces - as this increases pressure on the hemorrhoidal veins.
6. Medical Procedures: These include any of the above procedures that a physician may prescribe; either rubber band ligation, sclerotherapy, laser treatment, or even haemorrhoidectomy depending on the severity of the hemorrhoids.

Conclusion

Hemorrhoids are generally painful and uncomfortable to a person. However, hemorrhoids are not life-threatening risks, but it is crucial to rectify the symptoms at an early stage to prevent the complication of coming into force. Again, the level varies widely and hence requires a wide treatment range from a change in lifestyle, home treatment, to even medical treatment. To prevent hemorrhoids all that is required is the consumption of a healthy fiber diet, consumption of enough water, not spending much time sitting, regular exercise, and proper hygiene concerning the bathroom. If it’s chronic or prolapsed/bleeding hemorrhoids, take advice from a doctor on what will work best.

FAQs

What are the common symptoms of external and internal hemorrhoids?

Pain, swelling, itching, and discomfort in the anorectal area are the common symptoms. But internal hemorrhoids are mostly asymptomatic but cause bleeding during defecation.

How can you tell if you have internal or external hemorrhoids?

An external hemorrhoid is one that lies outside of your body, visible to the eye and painful to touch. On the other hand, an internal hemorrhoid is inside your rectum and typically painless but often causes bleeding. Sometimes it may even prolapse.

Are the treatment options different for external and internal hemorrhoids?

For external hemorrhoids, some common treatments are OTC medications, ice packs, and sitz baths. You may also have to have a change in diet, medications for stool softening, and anaesthetic procedures such as banding and sclerotherapy applied. For internal hemorrhoids, you can get a rubber band ligation or sclerotherapy for effective relief from the pain.

Can external and internal hemorrhoids occur at the same time?

Yes, both may exist at the same time. And for treatment, medical professionals might include both of them together.

Wondering how to get rid of hemorrhoids? Get your hands on Dr Vaidya’s combo for piles, designed for effective relief from piles pain. Blended with Ayurvedic herbs like Haritaki, Nageskar and Mahaneemb to shrink pile mass size and promote healing. Eat high-fiber foods for piles like prunes, apples and pears to have a healthy digestive system and reduce the discomfort from hemorrhoids in the long run. Try and feel the change!