Symptoms of Hemorrhoids

The symptoms of hemorrhoids vary according to whether they are internal or external, and other conditions such as pregnancy, type of physical activity (strain) and diet.

Generally, symptoms of hemorrhoids can include:

• Bleeding — small amounts of blood may appear on undergarments, toilet paper or in the toilet bowl
   
• Itching or irritation in the anal region
   
• Pain or discomfort
   
• Hemorrhoids protruding from the anus
   
• Swelling around the anus
   
• Sensitive or painful lump near the anus
   
• Soiling / leakage of feces (typically from internal hemorrhoids - grade three or four)

Internal hemorrhoids are those which are located inside the body in the lower rectum. These may not be normally visible (unless they protrude to outside the body) and are often not even felt by the person; however, passing a stool can damage the hemorrhoid's delicate surface and cause bleeding. Internal hemorrhoids are not usually painful.

External hemorrhoids are outside of the body, visibly evident but under the skin and around the anus. These can cause pain, itching, burning sensation or bleeding. Sometimes blood may pool in an external hemorrhoid and form a clot that results in considerable pain and swelling.

Hemorrhoids may also seem to go away (go into remission) but later come back (relapse).