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Hemorrhoids are clusters of veins, smooth muscles, and connective tissues located around the anus. Also known as piles, hemorrhoids are present in everyone — healthy people and those who have hemorrhoid disease. When they become enlarged and inflamed, they cause uncomfortable symptoms that can impact one’s quality of life.
Swollen anal veins can either be external or internal.
Internal hemorrhoids are located in the upper anal canal and lower rectum. In many cases, internal hemorrhoids will go away without medical treatment. However, if they don’t respond to initial therapies like dietary changes and over-the-counter medical management, hemorrhoid treatment can offer relief.1
Understanding what internal hemorrhoids are and how they are graded can help people make better-informed decisions about their health and know when to seek treatment for their symptoms.
Internal hemorrhoids are swollen veins inside the anus, so they aren’t visible like external hemorrhoids are. They can develop inside the anal canal or in the lower rectum, which is the lowest part of the lower intestine.
These hemorrhoids are covered by mucosa, which is a moist, thin membrane. This mucous membrane can discharge a small amount of mucus, creating moisture on the skin around the anus, which can cause itching and irritation.
Internal hemorrhoids, however, usually aren’t painful. That’s because they’re inside the anal canal, where there are very few pain nerves. So they don’t usually hurt, even during a bowel movement.
In many cases, the only noticeable symptom of internal hemorrhoids is blood in the stool. The pressure from straining during a bowel movement can cause the swollen blood vessels to bleed. As a result, someone with internal hemorrhoids might notice bright red streaks of blood on their stool or their toilet paper.
Other internal hemorrhoid symptoms include:
A prolapsed hemorrhoid is an internal hemorrhoid that has pushed through the opening of the anus. How much an internal hemorrhoid protrudes is how these hemorrhoids are classified.
Internal hemorrhoids are classified as grade 1, grade 2, grade 3, or grade 4.2 The grading is based on where they are located and helps doctors determine how to treat the hemorrhoids.
A grade 1 or first-degree internal hemorrhoid is not prolapsed. These hemorrhoids usually respond well to lifestyle changes like eating more fiber, drinking more water, and taking sitz baths. Over-the-counter hemorrhoid creams can also help relieve itching and discomfort.
Chronic grade 1 hemorrhoids can be treated with procedures that can be performed in an outpatient clinic, like hemorrhoid artery embolization (HAE) or sclerotherapy.
A second-degree internal hemorrhoid protrudes outside of the anal canal during a bowel movement. Then, it retracts on its own after straining. Grade 2 internal hemorrhoids respond well to non-surgical procedures like HAE, rubber band ligation, and infrared coagulation.
A grade 3 internal hemorrhoid prolapses outside of the anal canal. It doesn’t retract without manual intervention — but it can be pushed back in. Third-degree hemorrhoids can be treated with advanced treatments, including HAE and rubber band ligation. In some cases, a doctor may recommend more invasive procedures, such as hemorrhoid stapling or hemorrhoid removal surgery.
Stage 4 internal hemorrhoids can’t be pushed back inside the anal canal. They are the most at risk of forming a blood clot and can be painful. Usually, hemorrhoid surgery is required to treat this type of hemorrhoid.
Hemorrhoids are rarely dangerous. However, symptoms can impact everyday life, making sitting down or using the bathroom uncomfortable.
Hemorrhoid symptoms like anal itching and irritation can also be embarrassing. If left untreated, internal hemorrhoids are more likely to become thrombosed (a blood clot can form in the hemorrhoid). When that happens, they can become extremely painful, bleed a lot, and may require surgery.
Staying aware of symptoms and managing hemorrhoids with a high-fiber diet and at-home therapies like sitz baths and over-the-counter creams can help people stay healthy. However, if internal hemorrhoids are persistent, set up a consultation with a hemorrhoid specialist. A doctor can diagnose your symptoms and determine the best treatment to help you get relief.
USA Hemorrhoid Centers is home to highly skilled, empathetic hemorrhoid specialists. Set up a consultation with one of our doctors at a clinic near you. We treat internal hemorrhoids with hemorrhoid artery embolization (HAE) and offer personalized treatment plans to help our patients experience lasting relief. Our treatment centers participate with most types of insurance.
Internal hemorrhoids are only visible if they prolapse. A prolapsed internal hemorrhoid looks like a small red to dark-red lump protruding from the anal canal.
Internal hemorrhoids are very common. It’s estimated that 10 million adults in the US have hemorrhoid disease, and many of these people have internal hemorrhoids.2
Internal hemorrhoids can go away on their own in a few days. Eating a high-fiber diet, drinking plenty of water, and taking sitz baths to increase circulation to the anal region may help hemorrhoids heal more quickly.
However, some hemorrhoids last for weeks, months, or even years. If hemorrhoids don’t go away, see a doctor about hemorrhoid treatment.
Internal hemorrhoids are located inside the anal canal, where external hemorrhoids are under the skin around the anus.
While they both cause anal discomfort, internal hemorrhoids are more likely to cause bleeding and not be painful.
I am so glad to have gone to USA Hemorrhoid Centers. My experience has been amazing. The staff are all so friendly but professional. The doctor is wonderful and in his professional manner makes you very comfortable and explains anything you have questions about. So very happy.
USA Hemorrhoid Centers all staff were incredible. They communicated throughout and checked in frequently to ensure I was as comfortable as possible. I am happy I chose to get the treatments and look forward to the improvements.
I am so glad to have gone to USA Hemorrhoid Centers. My experience has been amazing. The staff are all so friendly but professional. The doctor is wonderful and in his professional manner makes you very comfortable and explains anything you have questions about. So very happy.
USA Hemorrhoid Centers all staff were incredible. They communicated throughout and checked in frequently to ensure I was as comfortable as possible. I am happy I chose to get the treatments and look forward to the improvements.
Skip the wait times! Scheduling at your fingertips, 24/7. Our doctors who perform Hemorrhoid artery embolization are experienced interventional radiologists with expertise in vascular anatomy.
USA Hemorrhoid Centers
USA Hemorrhoid Centers are accredited for providing high-quality outpatient care. Our doctors who perform Hemorrhoid artery embolization are experienced interventional radiologists with expertise in vascular anatomy.
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