Can Hemorrhoids Stop You from Defecating?

Hemorrhoids are swollen veins in the rectal or anal area, often caused by straining during bowel movements, chronic constipation, or increased pressure in the lower rectum due to factors like pregnancy. While they are usually associated with discomfort, pain, or bleeding, one question commonly arises: Can hemorrhoids actually stop you from defecating?

The short answer is that hemorrhoids themselves do not physically block the process of defecation. However, their symptoms can indirectly lead to challenges with bowel movements. Let’s delve into the relationship between hemorrhoids and defecation and explore how to manage related difficulties.

How Hemorrhoids Affect Bowel Movements

While hemorrhoids can cause bowel discomfort, their symptoms can create physical and psychological barriers that make defecation difficult or painful.

Pain and Discomfort
Pain is a primary symptom of hemorrhoids, especially external ones or prolapsed internal hemorrhoids. When bowel movements are painful, individuals may consciously or subconsciously delay defecation to avoid discomfort. This delay can lead to harder stools and worsen the condition.

Rectal Pressure and Fullness
Internal hemorrhoids, particularly when prolapsed, can create a sensation of fullness in the rectum, making it feel as though the bowels are not completely emptied. This sensation can confuse individuals about whether they need to defecate or are experiencing a blockage.

Bleeding and Fear of Worsening Symptoms
The sight of blood during bowel movements can be alarming and cause individuals to avoid going to the bathroom. However, this avoidance often exacerbates the condition, as hard stools from delayed defecation can worsen hemorrhoids.

Can Hemorrhoids Physically Block the Anus?

In rare cases of severe prolapsed hemorrhoids, where internal hemorrhoids protrude outside the anus and cannot be pushed back, there can be temporary physical obstruction. This condition may make it difficult for stool to pass comfortably.

Additionally, large thrombosed external hemorrhoids (blood clots within hemorrhoids) can cause significant swelling around the anal opening, leading to difficulty initiating or completing a bowel movement.

Distinguishing Between Hemorrhoids and Other Causes of Obstruction

While hemorrhoids can make defecation uncomfortable, true physical obstruction is usually caused by other medical conditions, such as:

  • Fecal impaction: Hardened stool stuck in the rectum.
  • Rectal or anal strictures: Narrowing of the anal canal due to scar tissue or inflammation.
  • Tumors or polyps: Abnormal growths in the rectum or anus.

If you experience persistent difficulty in passing stool or feel blocked, it’s essential to consult a healthcare provider to rule out these conditions.

How to Manage Bowel Movements with Hemorrhoids

Soften Stools
Softening stools reduces the strain during bowel movements and minimizes irritation to hemorrhoids.

  • Increase dietary fiber intake with fruits, vegetables, whole grains, and supplements.
  • Stay hydrated by drinking plenty of water throughout the day.
  • Consider over-the-counter stool softeners if recommended by a doctor.

Relieve Hemorrhoid Symptoms

  • Use sitz baths (warm water baths for the anal area) to reduce swelling and pain.
  • Apply over-the-counter hemorrhoid creams or suppositories for temporary relief.
  • Avoid using dry toilet paper; instead, use moistened wipes or rinse with water.

Avoid Straining

  • Respond to the urge to defecate promptly.
  • Use proper posture by leaning forward slightly with feet elevated on a stool.
  • Take your time to avoid unnecessary pressure on the rectal area.

Seek Medical Help
If hemorrhoid symptoms persist or worsen, consult a doctor. Treatments like rubber band ligation, sclerotherapy, or minimally invasive procedures such as hemorrhoid artery embolization can provide long-term relief.

When to See a Doctor

If you experience any of the following, consult a healthcare professional immediately:

  • Persistent difficulty in passing stool.
  • Severe pain or swelling in the anal area.
  • Large amounts of blood during bowel movements.
  • A feeling of complete obstruction or prolapsed hemorrhoids that won’t go back in.

FAQs About Hemorrhoids and Defecation

Can hemorrhoids cause constipation?
Hemorrhoids don’t cause constipation directly, but pain and fear of discomfort can lead to delaying bowel movements, contributing to constipation.

Why does it feel like I can’t completely empty my bowels with hemorrhoids?
Prolapsed internal hemorrhoids can create a sensation of fullness, making it feel as though stool is still present even after defecation.

Should I avoid defecating if it’s painful with hemorrhoids?
No. Avoiding defecation can lead to harder stools and worsen hemorrhoids. Use treatments to manage pain and soften stools instead.

What’s the best position for defecation with hemorrhoids?
Squatting or leaning forward with knees elevated (using a stool) helps reduce strain on the rectum.

When is surgery needed for hemorrhoids?
Surgery may be necessary for severe, prolapsed, or thrombosed hemorrhoids that don’t respond to other treatments.

Can hemorrhoids go away on their own?
Mild hemorrhoids may improve with dietary changes and symptom management, but more severe cases often require medical treatment.

Internal vs. External Hemorrhoids: What’s The Difference?

Are you having issues with rectal bleeding, itching, pain, or other common hemorrhoid symptoms? If so, you might wonder if those symptoms are a sign of internal or external hemorrhoids. 

Hemorrhoids are swollen blood vessels in the rectum or under the skin surrounding the anus. Where they form determines whether they are external or internal hemorrhoids. 

Although both types of hemorrhoids have the same cause, they can produce different symptoms. There are also varying treatments for internal vs. external hemorrhoids

Understanding the differences can help you determine what to do next and when to see a hemorrhoid specialist. This guide will answer all your questions about how internal and external hemorrhoids differ, including symptoms and treatment options.

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What Are Hemorrhoids?

Hemorrhoids are swollen clusters or ‘piles’ of blood vessels, smooth muscle, and connective tissue. They can be very painful and physically uncomfortable—and even a little embarrassing to talk about. 

However, the reality is that most people have hemorrhoids at some point in their lives. One study found that roughly 11% of the adult population suffers from hemorrhoids at any point in time. (1) It’s estimated that by age 50, one in two adults in the US has dealt with hemorrhoid symptoms, such as anal itching, bleeding during bowel movements, or pain. (2)

Hemorrhoids develop because of excess pressure from straining during bowel movements, often due to constipation. A lack of blood flow from prolonged sitting can also cause hemorrhoids, as clusters of blood vessels and connective tissue become swollen and enlarged. Additionally, lifestyle factors, such as diet, weight, and exercise, can also lead to hemorrhoids. It’s important to consult a hemorrhoid specialist to ensure an accurate diagnosis for the cause, type, and management plan for hemorrhoids. 

Depending on whether the hemorrhoids are external or internal, you might experience different symptoms. Regardless, it’s important not to leave hemorrhoids untreated.

Internal Hemorrhoids

Internal hemorrhoids occur in the lower rectum, inside the anal cavity, making them invisible from the outside.

A person with an internal hemorrhoid might notice bright red blood on their toilet paper or in their stool. They may not experience pain as there are fewer sensory nerves in the rectal area. 

However, an internal hemorrhoid can cause pain or irritation if it pushes through the anal opening, a condition known as prolapse. A prolapsed hemorrhoid occurs when the connective tissue holding the blood vessels in place can no longer support them, causing a small lump to form at the anus.

External Hemorrhoids

External hemorrhoids develop around the anus. Compared to internal hemorrhoids, external ones are more likely to cause pain and discomfort because there are more pain-sensing nerves under the skin near the anus. 

Other possible symptoms include:

  • Swelling around the anus
  • Itching
  • Bleeding
  • Lumps
  • Pain or discomfort

External hemorrhoids can cause severe pain if a clot develops  A hemorrhoid with a blood clot is called a thrombosed hemorrhoid. This can also occur with internal hemorrhoids but is not as common. It looks like a hard lump near the anus and can cause swelling and inflammation that makes sitting extremely uncomfortable. 

Diagnosing External vs. Internal Hemorrhoids

A hemorrhoid doctor will review your medical history to determine whether external or internal hemorrhoids are causing symptoms. They will ask about your eating and toilet habits and any existing medical conditions.

An interventional radiologist, also known as a hemorrhoid doctor, will also perform an exam:

  • To diagnose external hemorrhoids, the doctor will examine the area around the anus, assessing any existing lumps to make a diagnosis.
  • Diagnosing internal hemorrhoids is more complex because they occur inside the rectum and are not visible. The doctor will perform a digital rectal exam using ultrasound imaging technology.

Treating External vs. Internal Hemorrhoids

Treatment for internal hemorrhoids differs from the treatment for external hemorrhoids. 

External hemorrhoids are often easier to treat. Home treatments can often provide temporary relief from hemorrhoids within a couple of weeks, such as:

  • Sitting in a warm bath can relieve pain and discomfort. 
  • Eating more fiber and drinking more water can help loosen your stool, preventing further straining. 
  • Topical creams or ointments for hemorrhoids can ease itching and swelling. 

Internal hemorrhoids are more likely to require medical treatment. Some mild hemorrhoids can be temporarily relieved through home remedies, but a medical diagnosis and treatment plan from a hemorrhoid specialist are recommended. If you still notice symptoms after a few days, it’s important to see a hemorrhoid doctor.

There are several treatments for internal hemorrhoids, including surgical removal and non-surgical procedures that can effectively relieve symptoms.

  • Hemorrhoid artery embolization (HAE) is a non-surgical procedure that shrinks existing hemorrhoids by stopping blood flow to the pile. It’s a good option for people who want to avoid the pain and discomfort associated with other treatments. 
  • Hemorrhoidectomy is surgical hemorrhoid removal. This procedure does come with some risks, including bleeding post-treatment, so it’s usually only recommended for severe cases. 
  • Rubber band ligation involves tying rubber bands around internal hemorrhoids, which causes them to fall off. This procedure can be painful, and some may experience post-treatment discomfort. 
  • Sclerotherapy involves injecting a medical solution into the hemorrhoids, which stops blood from reaching the hemorrhoid, causing it to shrink. 

When to See a Doctor for Hemorrhoids

If hemorrhoid symptoms persist for more than one week or if you have severe pain or bleeding, you should see a doctor for a diagnosis and to learn about your treatment options.

USA Hemorrhoid Centers is a leading network of outpatient hemorrhoid treatment centers. We offer non-surgical hemorrhoid treatment and personalized treatment plans. Schedule a consultation at a location near you today and find out how we can help you get back to living hemorrhoid-free.

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FAQs

How do you know if you have an internal or external hemorrhoid?

If a hemorrhoid is under the skin around your anus and is painful, it’s likely an external hemorrhoid.

An internal hemorrhoid is more difficult to identify. You can’t see or feel the lump. Also, blood in the stool could be caused by a more serious health condition, such as inflammatory bowel disease or colon cancer. It’s not always clear whether bleeding is related to hemorrhoids.

To find out for certain if you have internal hemorrhoids, external hemorrhoids, or both, schedule a consultation with a hemorrhoid specialist near you. 

Can external hemorrhoids become internal?

External hemorrhoids can’t become internal hemorrhoids. However, a prolapsed hemorrhoid, which is an internal hemorrhoid that bulges outside of the anus, may go back inside on its own. 

Can you have both internal and external hemorrhoids at the same time?

Yes, you can have internal and external hemorrhoids at the same time. That can make it more difficult to figure out if your symptoms are caused by one type of hemorrhoid or another. A hemorrhoid doctor can give you an accurate diagnosis and recommend a treatment plan for the specific types of hemorrhoids you have. 

Internal vs. external hemorrhoids: which are worse?

External hemorrhoids can cause more discomfort. They can lead to itching, swelling, and pain, as well as bleeding. Internal hemorrhoids aren’t always painful. However, they can be harder to get rid of. People with moderate to severe internal hemorrhoids may require medical treatment to help alleviate their symptoms. 

Are external or internal hemorrhoids more common?

External hemorrhoids are more common than internal hemorrhoids. 

 

References:

  1. Sheikh, Parvez et al. The prevalence, characteristics and treatment of hemorrhoidal disease: results of an international web-based survey.Journal of Comparative Effectiveness Research. DOI: 10.2217/cer-2020-0159
  2. LeWine, Howard E. MD. Hemorrhoids and what to do about them. Harvard Health Publishing. www.health.harvard.edu/diseases-and-conditions