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What Type of Doctor Treats Hemorrhoids?

Discover how interventional radiologists treat hemorrhoids using hemorrhoid artery embolization (HAE), a minimally invasive and effective procedure.

Exploring Interventional Radiologists and Hemorrhoid Artery Embolization

Hemorrhoids, though common, can be a source of significant discomfort and embarrassment for many. They can manifest as internal or external swellings in the rectal or anal area due to inflamed or swollen veins. While general practitioners, gastroenterologists, and proctologists are commonly sought for their treatment, a lesser-known but highly effective option involves interventional radiologists and a procedure called hemorrhoid artery embolization (HAE). This blog dives into the role of interventional radiologists, the advantages of HAE, and how this innovative treatment is reshaping the landscape of hemorrhoid care.

Understanding Hemorrhoids and Their Treatment Needs

Hemorrhoids occur when the blood vessels in the rectum or anus become swollen due to factors like straining during bowel movements, chronic constipation, or pregnancy. While mild cases can often be managed with dietary changes or topical treatments, more severe cases, such as prolapsed or bleeding hemorrhoids, require specialized medical intervention. Traditionally, treatments such as rubber band ligation, sclerotherapy, or surgical procedures like hemorrhoidectomy were the go-to solutions. However, these methods can involve considerable discomfort and longer recovery times. This is where interventional radiology shines, offering a less invasive and highly targeted treatment option.

Who Are Interventional Radiologists?

Interventional radiologists are medical specialists who use imaging technology like X-rays, CT scans, and ultrasound to perform minimally invasive procedures. Their expertise lies in treating various conditions by targeting affected blood vessels or tissues with precision. In the context of hemorrhoid treatment, interventional radiologists perform hemorrhoid artery embolization (HAE), an advanced procedure that addresses the root cause of the problem—excessive blood flow to the hemorrhoidal vessels.

What Is Hemorrhoid Artery Embolization (HAE)?

Hemorrhoid artery embolization is a minimally invasive technique designed to reduce the blood supply to the hemorrhoids. By cutting off this blood flow, the hemorrhoids shrink and symptoms like bleeding and pain are significantly alleviated.

How HAE Works:

  1. Imaging and Access: The procedure begins with a tiny incision, usually in the groin or wrist, to access the blood vessels.
  2. Targeting the Hemorrhoidal Arteries: Using fluoroscopy (real-time X-ray guidance), the interventional radiologist identifies the arteries supplying blood to the hemorrhoids.
  3. Embolization: Tiny particles or coils are delivered into the arteries to block the blood flow. This reduces the size of the hemorrhoids and alleviates symptoms.

Advantages of Hemorrhoid Artery Embolization

HAE offers several benefits over traditional hemorrhoid treatments:

  • Minimally Invasive: Unlike surgery, HAE involves no large incisions, resulting in minimal scarring and quicker recovery.
  • Outpatient Procedure: Most patients can return home the same day.
  • Reduced Pain: The procedure is relatively painless compared to hemorrhoidectomy or band ligation.
  • Short Recovery Time: Many individuals resume normal activities within a few days.
  • Effective for Severe Cases: HAE is particularly beneficial for those with chronic bleeding or severe hemorrhoids resistant to other treatments.

When Should You Consider Seeing an Interventional Radiologist?

You should consider consulting an interventional radiologist if:

  • You have persistent symptoms despite traditional treatments.
  • You are seeking a minimally invasive option.
  • Surgical treatments are contraindicated or undesirable for you.
  • You experience chronic bleeding or prolapsed hemorrhoids that severely affect your quality of life.

Collaborative Care with Other Specialists

Interventional radiologists often work in collaboration with gastroenterologists and proctologists. These specialists may initially diagnose and manage your hemorrhoids and refer you to an interventional radiologist for HAE when appropriate. This multidisciplinary approach ensures comprehensive care tailored to your condition.

What to Expect During the HAE Procedure?

Patients undergoing HAE can expect the following steps:

  1. Pre-Procedure Assessment: Your interventional radiologist will review your medical history and imaging results to confirm that you’re a good candidate for HAE.
  2. Procedure Day: The procedure typically lasts 30–60 minutes under local anesthesia and sedation.
  3. Post-Procedure Recovery: Most patients experience mild discomfort for a day or two and can return to normal activities shortly after.

FAQs About Interventional Radiologists and Hemorrhoid Treatment

What is the success rate of HAE for hemorrhoids?
Studies indicate a high success rate, with symptom improvement in 80–90% of patients.

Is HAE painful?
Most patients report minimal discomfort during and after the procedure.

Are there risks associated with HAE?
As with any medical procedure, there are risks, but complications like infection or vessel injury are rare when performed by skilled specialists.

Can HAE treat all types of hemorrhoids?
HAE is most effective for internal hemorrhoids, especially those associated with chronic bleeding.

Do I need a referral to see an interventional radiologist?
In most cases, you may need a referral from a primary care physician, gastroenterologist, or proctologist.

How long do the effects of HAE last?
The results of HAE are long-lasting, especially when combined with lifestyle changes to prevent recurrence.

Connect with USA Hemorrhoid Centers

Interventional radiologists and the innovative hemorrhoid artery embolization procedure represent a transformative approach to treating internal hemorrhoids. Offering a minimally invasive, effective, and pain-reducing option, HAE is ideal for patients seeking relief from chronic or severe symptoms without undergoing surgery. If traditional treatments have failed, consulting an interventional radiologist could be your pathway to lasting comfort and improved quality of life. Would you like to know more about HAE or schedule a consultation? Reach out to USA Hemorrhoid Centers to learn more and see our locations near you.

How Do I Know What Stage Hemorrhoid I Have?

Most adults aren’t strangers to hemorrhoids, which are ‘piles’ of veins and connective tissue around the anus that have become swollen and inflamed. Roughly 20% of the US population has been diagnosed with them.1 Depending on the hemorrhoids’ stage, some people may experience no symptoms while others may suffer from chronic pain and discomfort.

Knowing which stage of hemorrhoids you have can help determine when and how they should be treated.

Doctors use a grading system to categorize hemorrhoids by their severity. These hemorrhoid stages, also known as hemorrhoid grades, are used to determine whether medical treatment is necessary and what type of procedure to use to treat them. 

You can’t necessarily confirm the hemorrhoid grading you have at home. A hemorrhoid doctor will need to give you a diagnosis after an exam.

However, you can get a good idea of how serious your hemorrhoids are by understanding the stages of hemorrhoids and what symptoms to expect with each one. 

What Is the Hemorrhoid Grading System?

The hemorrhoid grading system assigns a grade to internal hemorrhoids based on their severity. This system does not categorize external hemorrhoids. 

It’s important to first learn about the dentate line to better understand hemorrhoid grading and the difference between internal and external hemorrhoids.

The dentate line is where the rectum becomes the anal canal.2 It’s a zig-zagging line that separates the two regions. The upper section — the rectum — is supplied by different nerve cells and has a different type of tissue lining than the lower section — the anal canal. 

  • Internal hemorrhoids develop in the rectum or above the dentate line. 
  • External hemorrhoids form under the skin along the anal canal or below the dentate line. 

The different grades of hemorrhoids relate to whether an internal hemorrhoid slips below the dentate line and protrudes outside of the anus and how difficult it is to move it inside again. This level of prolapse or slippage dictates what type of hemorrhoid treatment will be effective for alleviating symptoms and treating the hemorrhoid. 

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Understanding the 4 Grades of Hemorrhoids

Internal Hemorrhoid Grades

Internal hemorrhoids are classified into four grades, also referred to as stages. 

Here’s an overview of the symptoms of each stage and possible treatment options based on the grading. 

Grade 1 Hemorrhoid

A grade 1 hemorrhoid is an enlarged hemorrhoid that isn’t visible outside of the anus. They can fall below the dentate line into the anal canal, but they don’t protrude outside of the anus. These hemorrhoids aren’t usually painful but can cause uncomfortable symptoms, such as bleeding and anal itching. 

Treatment for grade 1 hemorrhoids can include adding fiber to the diet and over-the-counter hemorrhoid creams to relieve the swelling, itching, and irritation. 

If a grade 1 hemorrhoid causes persistent symptoms after making lifestyle changes, your doctor might recommend a minimally invasive procedure to treat the hemorrhoids, such as hemorrhoid artery embolization (HAE). This treatment is a painless procedure that is effective for grades 1 through 3. 

Grade 2 Hemorrhoid

A grade 2 hemorrhoid will prolapse or come out of the anus during straining from passing a stool or exercise. It then retracts to its original position on its own. 

This type of hemorrhoid can cause the same symptoms as a stage 1 hemorrhoid, including blood in the stool and itching or burning. It can also cause pain and discomfort when bulging outside of the anus, although this discomfort is temporary.

Treatment options for stage 2 hemorrhoids include non-surgical procedures, such as HAE, infrared coagulation, rubber band ligation, and sclerotherapy.

Your doctor might also recommend conservative treatment to start, such as using stool softeners, eating more fiber, or taking over-the-counter or prescription-strength hemorrhoid creams. The recommended treatment depends on the size of the hemorrhoid and the severity of symptoms, which is why it is suggested to consult a specialist

Grade 3 Hemorrhoid

A grade 3 hemorrhoid slips out of the anus due to straining, but it has to be manually returned to its position. It won’t go back inside the anal canal unless it’s pushed back inside. 

A stage 3 hemorrhoid can cause similar symptoms as stage 1 and 2 hemorrhoids, but it’s also more likely to be painful, especially when sitting down. 

Hemorrhoid treatment options include the same non-surgical procedures that are effective for grade 2 hemorrhoids. A doctor will assess your size to recommend the best treatment for you and see if you are a candidate for HAE.

Grade 4 Hemorrhoid

This type of hemorrhoid is permanently prolapsed. It’s always outside of the anus, which can cause severe pain, discomfort, and stress. A large grade 4 hemorrhoid can make even something as simple as sitting down difficult. 

A grade 4 hemorrhoid is more challenging to treat and typically requires a hemorrhoidectomy. This surgical option can be the most effective in serious cases — the recurrence rate after a hemorrhoidectomy is between 5 and 10%.3 However, it can cause complications, such as severe pain and loss of continence. Consulting a medical doctor is the best way to receive an accurate diagnosis for your hemorrhoid grade and to determine the best course of action for treating Stage 4 hemorrhoids.

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How to Determine Your Hemorrhoid Stage

Recognizing the typical symptoms of each stage can help you determine the grade of your hemorrhoids, while a doctor will be able to confirm and provide a treatment plan.

  • Grade 1 hemorrhoids often cause bleeding, and they can cause anal itching.
  • Grade 2 hemorrhoids will slip out of the anal canal, usually during a bowel movement. At that point, they might cause pain in addition to other internal hemorrhoid symptoms.
  • Grade 3 hemorrhoids require manual replacement. If an internal hemorrhoid has fallen out of the anal canal and you can push it back in, it’s likely a grade 3. 
  • Grade 4 hemorrhoids are always outside of the anus and can be very painful. 

When to Seek Treatment for Hemorrhoids

When to Seek Treatment for Hemorrhoids

If you have symptoms of internal hemorrhoids, including blood in the stool, itching, and pressure when passing a stool, schedule a consultation with a hemorrhoid doctor near you. For symptoms that don’t go away after a few days of lifestyle changes to relieve hemorrhoids, consulting a doctor is recommended.

At USA Hemorrhoid Centers, our doctors will evaluate your symptoms and develop a personalized treatment plan to help relieve hemorrhoid symptoms. We offer hemorrhoid artery embolization (HAE), which is a safe and effective treatment for grade 1, 2, and 3 hemorrhoids. Leaving hemorrhoids untreated can increase the risk of further progression and more intensive treatment, so it’s important to address hemorrhoids in the early stages. 

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Frequently Asked Questions

How can you tell the difference between a prolapsed internal hemorrhoid and an external hemorrhoid?

A prolapsed internal hemorrhoid will feel like a soft lump that’s visibly hanging outside of the anus. An external hemorrhoid develops under the skin in the anal canal and feels like a hard lump.

Do hemorrhoids get progressively worse?

Hemorrhoids that are left untreated can get progressively worse, causing more severe symptoms. They’re also less likely to respond to conservative treatments, such as changing your diet to include more fiber and stool softeners. 

At what stage should hemorrhoids be treated?

It’s best to treat hemorrhoids early on because they’re more responsive to treatment when they are at one of the earlier hemorrhoid stages. Schedule a consultation with a hemorrhoid doctor if you have symptoms of stage 1 or 2 hemorrhoids for more than a few days to prevent more severe symptoms from developing. 

Sources

  1. Sandler, R. S., & Peery, A. F. (2019). Rethinking What We Know About Hemorrhoids. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 17(1), 8–15. 
  2. Lawrence A, McLaren ER. External Hemorrhoid. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. 
  3. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Overview: Enlarged hemorrhoids. [Updated 2021 Dec 9]. 

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.

What Happens When Hemorrhoids Are Left Untreated?

Most people will develop hemorrhoids at some point in their lives. They’re the fourth most diagnosed issue affecting the gastrointestinal system, and they can affect almost anyone — men, women, the young, and old. In many of those cases, hemorrhoids will go away without treatment. In the United States, roughly 10 million people have hemorrhoids, yet only 60% of those are even symptomatic.1

However, that doesn’t mean hemorrhoid symptoms should be overlooked. Leaving hemorrhoids untreated or delaying treatment can lead to worsening symptoms and potentially serious complications. Untreated hemorrhoids can also cause emotional stress and affect your quality of life. 

If you have hemorrhoids, it’s important to understand what can happen when they go untreated and when to see a doctor.

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What Are the Short-Term Effects of Untreated Hemorrhoids?

In the short term, untreated hemorrhoids can cause increased discomfort and pain. The inflammation and swelling can get worse, making the hemorrhoids larger and more uncomfortable.

It might also become more and more challenging to do everyday activities, like sitting down to work, eat a meal, or use the bathroom. Even walking around can become uncomfortable if a large external hemorrhoid exists or an internal hemorrhoid becomes prolapsed (falls out of the anus). 

What Are the Long-term Risks of Leaving Hemorrhoids Untreated?

What Are the Long-term Risks of Leaving Hemorrhoids Untreated

In the long term, untreated hemorrhoids can also put a person at risk for complications. 

Anal Fissures

An anal fissure is a tear in the tissue lining the anal canal. Hemorrhoids don’t directly cause anal fissures, but the chronic irritation to anal tissue from an untreated hemorrhoid can lead to a tear. This complication can cause sharp pain and bleeding, making dealing with hemorrhoids even more challenging. 

Thrombosis

A thrombosed hemorrhoid is a hemorrhoid with a blood clot. Thrombosed hemorrhoids can cause excruciating pain and become very swollen. If it keeps filling with blood and other fluids, it can burst and lead to intense bleeding. A burst hemorrhoid can also cause nausea, dizziness, and abdominal pain. 

Anemia

The main symptom of internal hemorrhoids is blood in the stool. Over time, this blood loss can become more frequent and severe, increasing the risk of anemia. 

With anemia, there aren’t enough healthy red blood cells to transport oxygen to the body’s tissues. This can cause weakness and fatigue. 

Infection

Another major risk of untreated hemorrhoids is an infection. Hemorrhoids that persist for years can develop open sores and become infected. Thrombosed hemorrhoids can also become infected if the blood supply is cut off. An infection caused by hemorrhoids might require antibiotics or other medical treatment. 

Leaving a hemorrhoid untreated can also cause psychological distress. Having a large, swollen lump near the anus can make someone feel self-conscious. The persistent pain and discomfort can be stressful, and the feeling of embarrassment can lead to social withdrawal. 

It’s important to know that hemorrhoids aren’t something to be ashamed of. With today’s medical technology, there are safe, effective, non-surgical ways to treat hemorrhoids, allowing people to get relief without having to remove rectal tissue or undergo a painful surgical procedure.

At USA Hemorrhoid Centers, we offer hemorrhoid artery embolization (HAE), a non-surgical procedure with a short recovery time and low risk of complications. 

When to See a Hemorrhoid Doctor

When to See a Hemorrhoid Doctor

If symptoms like itching, bleeding, and pain from hemorrhoids don’t decrease after one week, it’s a good idea to schedule a consultation with a specialist. Hemorrhoids can last for months or even years, and they can affect your health and your self-esteem. They can also be more challenging to treat as they become more severe, so getting treatment early is recommended. 

USA Hemorrhoid Centers is a leading network of hemorrhoid centers specializing in internal hemorrhoid treatment. Our team of expert doctors takes the time to determine the best treatment for each individual and develops a personalized treatment plan to help them experience symptom relief and prevent future hemorrhoids. 

We have locations nationwide. Find a clinic near you today and schedule a consultation, or call 855.805.4247. Our treatment centers accept most types of insurance.

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Frequently Asked Questions

How long do hemorrhoids last if untreated?

Minor hemorrhoids can take a few days to heal and respond well to at-home remedies like increasing fiber intake, drinking more water, and topical creams or ointments. Moderate to severe hemorrhoids can persist for weeks, months, or longer. Once they’ve become enlarged and more severe, they’re less likely to go away without medical treatment.

Are untreated hemorrhoids dangerous?

In minor cases, untreated hemorrhoids aren’t dangerous. However, serious health issues resulting from hemorrhoids do happen — they are responsible for 3.3 million ambulatory visits in the US each year.2

These swollen veins, if ignored for too long, can lead to potentially dangerous complications and cause serious symptoms, including severe pain, discomfort, and blood loss.

Do untreated hemorrhoids cause colon cancer?

Hemorrhoids don’t cause colon cancer. However, there are studies suggesting that people with hemorrhoids are at a higher risk for colon cancer.3

Are untreated hemorrhoids likely to reoccur?

Hemorrhoids can reoccur if there’s more pressure on the veins near the anus and rectum. Straining during bowel movements, pregnancy, and pressure from being overweight can also contribute to the development of new hemorrhoids.

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Sources

  1. Sun, Z., & Migaly, J. (2016). Review of Hemorrhoid Disease: Presentation and Management. Clinics in colon and rectal surgery, 29(1), 22–29. 
  2. Kibret, A. A., Oumer, M., & Moges, A. M. (2021). Prevalence and associated factors of hemorrhoids among adult patients visiting the surgical outpatient department, in the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. PloS one, 16(4), e0249736. 
  3. Wu, E. B., Sung, F. C., Lin, C. L., Wu, K. L., & Chen, K. B. (2021). Colorectal Cancer Risk in Patients with Hemorrhoids: A 10-Year Population-Based Retrospective Cohort Study. International journal of environmental research and public health, 18(16), 8655.

Difference Between Hemorrhoids & Anal Fissures

Bleeding during a bowel movement and anal discomfort are symptoms of two common and seemingly similar conditions: hemorrhoids and anal fissures. 

It’s easy to confuse the two if you look at symptoms alone. Often, a medical exam is the only way to determine for sure if anal bleeding, irritation, and other issues are caused by anal fissures or hemorrhoids. Knowing the difference can determine what treatment will offer relief and what prevention strategies will help you avoid future problems. 

USA Hemorrhoid Centers is an expert in non-surgical hemorrhoid treatment. This guide explains the difference between hemorrhoids and anal fissures and what to do if you think you have symptoms caused by one of these conditions.

What’s the Difference Between Hemorrhoids and Anal Fissures?

The difference between hemorrhoids and anal fissures is that hemorrhoids impact veins in or near the anus, and anal fissures are tears in the anal tissue. 

Hemorrhoids are swollen veins in the anus or lower part of the rectum

What’s the Difference Between Hemorrhoids and Anal Fissures

The veins in this region expand and widen as the tissue in the rectum and anus stretches and contracts to hold and eliminate stool. Excessive stretching of these blood vessels due to pressure and straining can weaken the vein walls, causing them to become swollen and inflamed. 

Common causes of hemorrhoids include:

  • Straining during a bowel movement
  • Straining from heavy lifting
  • Excess weight
  • Pressure from a growing uterus during pregnancy

These swollen piles of veins can cause serious discomfort or bleeding. They can occur internally or externally.

Anal fissures are tiny cuts on the inner lining of the anus.

Like hemorrhoids, they can occur after straining from constipation or while passing a large or hard stool. Other possible causes include:

  • Tight sphincter muscles
  • Straining while giving birth
  • Anal intercourse
  • Chronic diarrhea

Hemorrhoid Symptoms vs. Anal Fissure Symptoms

Some hemorrhoid symptoms overlap with the symptoms of an anal fissure. Both conditions can cause the following:

  • Bright red blood in the stool, on the toilet paper, or in the toilet bowl after pooping
  • Anal pain

The main difference between anal fissures and hemorrhoids is when that pain occurs. 

Anal fissures cause pain during a bowel movement. The pain can be severe, especially while pushing, and it can linger for minutes or hours after using the bathroom. 

Hemorrhoid pain only occurs with an external hemorrhoid or an internal hemorrhoid that is prolapsed (a prolapsed hemorrhoid has fallen outside of the rectum). The pain occurs while sitting, whether on the toilet to have a bowel movement or in a chair. 

With the types of hemorrhoids that cause pain (external and prolapsed hemorrhoids), it’s usually possible to feel a lump near the anus. An external hemorrhoid will feel like a hard lump. A prolapsed hemorrhoid is a soft lump that protrudes from the anus.

Pain during a bowel movement without a lump is more likely to be an anal fissure.

A non-prolapsed internal hemorrhoid may bleed, but it won’t create a lump you can feel or cause the intense pain associated with an anal fissure. 

Another way to spot the difference is to look for other symptoms. Hemorrhoids can also cause irritation and itching around the anus and a feeling of pressure in the lower rectum. 

Is It Possible to Have a Hemorrhoid and an Anal Fissure at the Same Time?

Is It Possible to Have a Hemorrhoid and an Anal Fissure at the Same Time

It is possible to have both at once, making it even more confusing to recognize if hemorrhoids or anal fissures are the cause of symptoms. 

Straining and pressure can lead to swollen veins and tears in the lining of the anus. These conditions can also both be exacerbated by poor blood flow to the anal area.

The tearing from an anal fissure can cause intense pain, causing the muscles in this area to spasm, which decreases blood flow. 

Studies show that people with chronic constipation and hemorrhoids are also more likely to have chronic venous insufficiency, a condition that causes varicose veins and poor blood flow.1

Poor circulation slows down the movement of oxygen and nutrients to tissue throughout the body, inhibiting the healing process.2

That’s one reason why a proper diagnosis, treatment, and lifestyle changes to prevent future problems are so important. If either one of these anal issues becomes chronic, healing can take longer, and recurrences are more likely, which means more bleeding, pain, and discomfort. 

Hemorrhoid vs. Anal Fissure Treatment and Prevention Strategies

Many cases of hemorrhoids or anal fissures resolve after a few days without medical treatment. Although the causes are different between hemorrhoids and anal fissures, they both can improve from some of the same strategies. Usually, lifestyle changes help speed healing and prevent future issues. 

  • Eating a high-fiber diet and drinking more water can soften the stool and prevent constipation, resulting in less straining. 
  • Getting regular exercise increases circulation, helping to heal a tear or a swollen vein. Exercise also prevents constipation. 
  • Soaking in warm baths can also increase blood flow to the anal region, helping to relieve discomfort, speed healing, and prevent hemorrhoids and anal fissures. 

Sometimes, internal hemorrhoids don’t go away on their own and require medical treatment. They can last for weeks or longer. 

Generally, hemorrhoid symptoms that don’t go away after a week should be checked out by a doctor. They can determine if someone has hemorrhoids, anal fissures, or other conditions that can cause rectal bleeding and anal discomfort, like irritable bowel syndrome (IBS) or ulcerative colitis. A hemorrhoid doctor can also recommend the best treatment for the individual.

While colorectal surgeons and gastroenterologists are more commonly associated with treating hemorrhoids, Interventional Radiologists (IR) can offer effective treatments for these conditions. 

IRs use minimally invasive imaging techniques to guide procedures, often providing a less invasive and faster recovery time than traditional surgical approaches.

If you’re considering treatment for hemorrhoids, it’s a good idea to discuss your options with both an IR and a colorectal surgeon or gastroenterologist to determine the best approach for your specific situation.

Hemorrhoid treatment can relieve bleeding, swelling, and other symptoms. USA Hemorrhoid Centers offers a non-surgical treatment called hemorrhoid artery embolization (HAE). This minimally invasive procedure is less painful and has a lower risk of complications than other treatments like hemorrhoid surgery and rubber band ligation, making it a good option for most people who need treatment. 

Anal fissures usually go away with a high-fiber diet and drinking more water. Over-the-counter stool-softening products and fiber supplements can also help. When anal fissures are chronic, they can be treated with a sphincterotomy, a procedure that relaxes the muscles around the anus. 

How to Tell if You Have Hemorrhoids or Anal Fissures?

If you’re dealing with bleeding, pain, and discomfort during or after a bowel movement, it could be hemorrhoids or anal fissures. Knowing the differences between the symptoms can help you understand what type of anorectal issue you’re dealing with. However, a proper diagnosis is the only way to know for sure and to get access to treatment for problems that won’t go away.

Why Choose USA Hemorrhoid Centers

Our doctors are experienced IR hemorrhoid specialists who can evaluate your symptoms, determine the cause, and how to treat them. We offer hemorrhoid consultations and treatment to help our patients return to living hemorrhoid-free.

If you suspect you have hemorrhoids and your symptoms don’t clear up in a few days, schedule a consultation at a location near you. We have clinics nationwide, and all of our locations accept a wide range of insurance

Schedule a consultation with one of our expert hemorrhoid doctors and get a personalized treatment plan to help you get relief.

Sources

  1. Ekici, U., Kartal, A., & Ferhatoglu, M. F. (2019). Association Between Hemorrhoids and Lower Extremity Chronic Venous Insufficiency. Cureus, 11(4), e4502. 
  2. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Overview: Chronic wounds. [Updated 2022 Aug 8].

Do Internal Hemorrhoids Go Away On Their Own?

If you are struggling with internal hemorrhoids, you are likely seeking relief and hoping for a solution. Internal hemorrhoids can be difficult to get rid of. They can also be extremely uncomfortable and put you at risk of concerning health issues, such as blood loss or an infection. 

Hemorrhoids sometimes go away on their own with a few simple lifestyle changes.

However, that doesn’t mean you should ignore symptoms of internal hemorrhoids and hope for the best. 

Knowing when to see a doctor about your symptoms is important if they don’t go away. Seeing an Interventional Radiologist can be valuable because they have an in-depth knowledge of blood vessels and their associated conditions, including hemorrhoids. They specialize in performing minimally invasive procedures that offer a less invasive and often more effective approach to treating hemorrhoids.

If you have internal hemorrhoids, understanding how to manage them effectively and when to consult a doctor is essential. Discover tips for relieving painful hemorrhoid symptoms and when you need to seek professional medical attention.

What Are Internal Hemorrhoids?

Internal hemorrhoids are swollen cushions of veins and other tissue inside the rectum. Unlike external hemorrhoids, which are located outside the rectum, you can’t see or feel internal hemorrhoids. 

Internal hemorrhoids are less likely to resolve on their own compared to external hemorrhoids and can lead to more serious symptoms if left untreated. For this reason, most medical treatments for hemorrhoids are designed to target internal hemorrhoids rather than external ones.

Symptoms of Internal Hemorrhoids

Internal hemorrhoids aren’t always painful. However, they can cause itching, irritation, and a feeling of pressure in the rectum when you have a bowel movement.

The most common symptom of an internal hemorrhoid is bleeding.1 You may notice blood in the stool or toilet paper after using the bathroom. Minor blood loss from an internal hemorrhoid that goes away isn’t usually a problem, but an untreated hemorrhoid that doesn’t disappear can lead to an increased risk of complications.

When an internal hemorrhoid pushes through to the outside, it’s called a prolapsed hemorrhoid. This type of internal hemorrhoid is visible and, like an external hemorrhoid, can cause pain. Prolapsed hemorrhoids might make it uncomfortable to sit down, especially for extended periods.

If you experience these symptoms, seeking medical advice is important to receive an accurate diagnosis. Early treatment can prevent complications and provide relief from the discomfort associated with hemorrhoids.

Can Untreated Internal Hemorrhoids Disappear?

Can Untreated Internal Hemorrhoids Disappear

While untreated internal hemorrhoids sometimes resolve, it’s important to resolve symptoms promptly to prevent further complications and ensure proper healing. 

Risks of Internal Hemorrhoids

Although Internal hemorrhoids are not immediately dangerous, neglecting them can lead to more severe complications. Here are some of the key risks associated with internal hemorrhoids:

Prolapse

Internal hemorrhoids can prolapse, meaning they extend beyond the anus. This can lead to discomfort and complications, as prolapsed hemorrhoids may become trapped and require medical intervention.

Strangulation

In some cases, the blood supply to a prolapsed internal hemorrhoid can be cut off by the anal muscles, leading to strangulation. This condition can cause severe pain and may result in tissue death if not treated promptly.

Thrombosis

Internal hemorrhoids can develop blood clots, leading to thrombosed hemorrhoids. This can cause significant pain and swelling and may require surgical intervention.

Infection

If internal hemorrhoids become prolapsed and collect mucus or stool particles, they can lead to irritation and infection. This can result in conditions such as pruritus ani (itching around the anus)

Bleeding

Internal hemorrhoids can cause bright red bleeding during bowel movements. While this is often not life-threatening, it can be alarming and may indicate more serious conditions, such as colorectal cancer, necessitating further investigation.

Chronic Discomfort

Persistent symptoms such as pain, itching, and discomfort can significantly affect quality of life and lead to avoidance of certain activities, including exercise and social engagements.

Straining

Individuals with internal hemorrhoids may experience increased straining during bowel movements, which can exacerbate the condition and lead to further complications, including worsening hemorrhoids or the development of anal fissures.

When Should You See a Doctor About Hemorrhoid Symptoms?

When Should You See a Doctor About Hemorrhoid Symptoms

If internal hemorrhoid symptoms don’t go away after a week or accompany other symptoms, such as bleeding, it’s a good idea to have an experienced hemorrhoid specialist evaluate your symptoms.

See a doctor immediately if you notice severe symptoms, such as dark red blood, severe pain, or more than a small amount of blood loss. These symptoms could be a sign of a more serious health issue, such as colorectal or anal cancer, inflammatory bowel disease, or large anal fissures.

Treatments for Internal Hemorrhoids

When internal hemorrhoid symptoms persist or worsen, treatment may be necessary to alleviate discomfort and prevent further complications. Depending on the severity, various treatment options are available, from non-invasive approaches to surgical procedures. Here are some of the most common treatments:

  • Over-the-Counter Medications: Creams and ointments that reduce inflammation and ease discomfort.
  • Rubber Band Ligation: A minimally invasive procedure where a band is placed around the base of the hemorrhoid to cut off blood flow.
  • Sclerotherapy: A chemical solution is injected into the hemorrhoid to shrink it.
  • Coagulation Therapy: Laser or infrared light hardens and shrinks the hemorrhoid.
  • Hemorrhoidectomy: A surgical procedure to completely remove large or prolapsed hemorrhoids.
  • Stapled Hemorrhoidopexy: This surgery repositions the hemorrhoids and reduces blood flow, causing them to shrink.
  • Hemorrhoidal Artery Embolization (HAE): A non-surgical procedure that blocks blood flow to the hemorrhoidal arteries, causing the hemorrhoids to shrink.

Hemorrhoidal Artery Embolization (HAE) for Internal Hemorrhoids

If a conservative approach isn’t relieving symptoms, a more advanced hemorrhoid treatment should be considered to address internal hemorrhoids. 

Hemorrhoidal artery embolization (HAE) is a non-surgical treatment for internal hemorrhoids. It offers fast relief from bleeding and other symptoms and is extremely safe. Studies have found no serious complications after hemorrhoid embolization.2

Most people with internal hemorrhoids that won’t go away can benefit from HAE. It’s less invasive than surgery and doesn’t cause rectal wounds or issues with anal incontinence. Other treatment options include infrared coagulation, rubber band ligation, and hemorrhoid surgery. 

Why Choose USA Hemorrhoid Centers 

USA Hemorrhoid Centers is a trusted national network of specialized, non-surgical hemorrhoid treatment centers dedicated to providing effective relief. Our experienced team of hemorrhoid doctors tailors treatments to each individual’s needs, ensuring a personalized and comfortable experience.

Our hemorrhoid specialists are experts in hemorrhoidal artery embolization and are committed to helping patients return to their daily lives free of hemorrhoid symptoms and discomfort.

We also accept most types of insurance and offer affordable payment plans so you can focus on your health without financial stress.

If you’re concerned about hemorrhoid symptoms, schedule a consultation at a clinic near you today.

Frequently Asked Questions

How long do internal hemorrhoids last?

There is no set timeline for hemorrhoids. They can go away in a few days or last for months or years. Some people have recurring hemorrhoids, so it seems like their symptoms never go away. 

If internal hemorrhoid symptoms don’t clear up after a week, schedule an appointment with a hemorrhoid doctor for an evaluation. 

What are the risks of untreated hemorrhoids?

If a clot forms in the hemorrhoid, it can burst, causing serious blood loss and requiring immediate medical attention.

Blood loss that’s dark red or excessive could also indicate a more serious health condition. Rectal bleeding is a symptom of many different conditions, including hemorrhoids, anal fissures, inflammatory bowel disease (IBD) and colorectal cancer, so it’s important to see a hemorrhoid doctor for an evaluation if you notice regular blood in your stool. 

Untreated internal hemorrhoids can also cause anal tears, which can become infected. 

Why do internal hemorrhoids need treatment?

If left untreated for too long, hemorrhoids can push out of the rectum and become prolapsed. These hemorrhoids can be painful and make everyday life more uncomfortable. There’s also a risk of blood loss, infection, and a blood clot if an internal hemorrhoid is left untreated for too long. 

It’s important to seek medical attention if you experience symptoms of hemorrhoids. Early treatment can help prevent complications and improve your quality of life.

Are internal hemorrhoids permanent?

Internal hemorrhoids aren’t permanent. There are safe and effective treatments that will make even severe internal hemorrhoids go away. 

References:

  1. Sun, Z., & Migaly, J. (2016). Review of Hemorrhoid Disease: Presentation and Management. Clinics in colon and rectal surgery, 29(1), 22–29. 
  2. Reza Talaie,, Pooya Torkian, et all. Hemorrhoid embolization: A review of current evidences. Diagnostic and Interventional Imaging. Volume 103, Issue 1, January 2022, Pages 3-11

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