The Difference Between Internal and External Hemorrhoids: How to Distinguish Them?

Introduction:

Hemorrhoids are one of the most common anal diseases among people, and they are a health problem that directly affects the daily quality of life of those who suffer from them. Although hemorrhoids are a well-known condition, many people do not distinguish between their different types, especially the difference between internal and external hemorrhoids. Understanding this difference greatly helps in early diagnosis and choosing the appropriate treatment to avoid complications.

In this article, we will clarify the difference between internal and external hemorrhoids in terms of location, symptoms, causes, degrees of severity, and the different treatment methods for each type.

First: What are Hemorrhoids?

Hemorrhoids are a swelling or inflammation of the veins located in the anal and lower rectal area. They occur as a result of excessive pressure on these veins, leading to their stretching and protrusion. Hemorrhoids can affect anyone, but the likelihood of developing them increases with age, pregnancy, or due to chronic constipation, and prolonged sitting.

Second: Types of Hemorrhoids

Hemorrhoids are divided into two main types:

1. Internal Hemorrhoids
2. External Hemorrhoids

Each type has its own characteristics and symptoms that distinguish it from the other.

Internal Hemorrhoids:

• Location: Located inside the rectum and are not visible outside the anal opening in the early stages.
• Symptoms:
  • Painless bleeding during bowel movements (blood is usually noticed on toilet paper or in the toilet).
  • A feeling of incomplete bowel evacuation.
  • Sometimes, these hemorrhoids may prolapse outside the anal opening during defecation, and are then known as "prolapsed hemorrhoids".
  • They do not cause pain unless they become inflamed or ulcerated.
• Grades:
  • Grade I: Do not prolapse from the anus.
  • Grade II: Prolapse during bowel movements but retract spontaneously.
  • Grade III: Prolapse and must be manually reinserted.
  • Grade IV: Remain outside the anus and cannot be reinserted.

External Hemorrhoids:

• Location: Located under the skin around the anal opening and can be seen or felt.
• Symptoms:
  • Itching or irritation in the anal area.
  • Anal pain, especially when sitting or during bowel movements.
  • Obvious swelling around the anal opening.
  • Sometimes, a blood clot forms inside the hemorrhoid, leading to severe pain and significant swelling (known as "thrombosed hemorrhoids").

The Difference Between Internal and External Hemorrhoids:

Common Causes of Hemorrhoids:

• Chronic constipation or recurrent diarrhea.
• Prolonged sitting, especially on the toilet.
• Lifting heavy weights.
• Pregnancy and childbirth.
• Obesity.
• Low-fiber diet.
• Aging.
• Genetic factors.

How are Hemorrhoids Diagnosed?

Diagnosis relies on:

1. Physical examination: Examining the anal area to identify external or prolapsed hemorrhoids.
2. Internal rectal examination: Using an anoscope to identify internal hemorrhoids.
3. Additional tests: Such as a colonoscopy if there is severe bleeding or suspicion of other diseases.

Treatment Methods for Internal and External Hemorrhoids:

First: Non-Surgical Treatment

Usually used for mild to moderate hemorrhoids:

• Lifestyle changes:
  • Increase fiber intake.
  • Drink sufficient amounts of water.
  • Exercise.
  • Avoid straining during bowel movements.
  • Use laxatives when needed.
• Medication:
  • Use of topical creams or ointments.
  • Anti-inflammatory drugs and suppositories.
  • Sitz baths (sitting in warm water).

Second: Non-Surgical Medical Interventions

• Rubber band ligation: To cut off blood flow to internal hemorrhoids until they fall off.
• Sclerotherapy: Injecting a chemical to shrink hemorrhoids.
• Laser or infrared coagulation: To reduce the size of hemorrhoids.

Third: Surgery

Used for advanced hemorrhoids or those unresponsive to treatment:

• Hemorrhoidectomy: Surgical removal of hemorrhoids.
• Stapled Hemorrhoidopexy: To fix internal hemorrhoids in place.

With the advent of laser techniques, it has become possible to perform the operation almost painlessly and without deep wounds, which speeds up healing and reduces complications.

When Should You See a Doctor Immediately?

• If rectal bleeding persists.
• If there is severe pain that does not improve.
• If sudden swelling appears in the anal area.
• If there is a discharge of mucus or pus.
• If there is no response to home treatment.

Hemocure Tip:

If you experience any uncomfortable symptoms in the anal area, do not wait until the condition worsens. Early diagnosis and appropriate treatment are the key to quick comfort and recovery. At Hemocure, we rely on the latest diagnostic and treatment technologies, carried out by a selection of specialists to ensure the best results.

Conclusion:

Internal and external hemorrhoids can be annoying, but they are not an embarrassing matter that calls for postponement. Distinguishing between the two types facilitates diagnosis and leads to better treatment outcomes. Always choose a specialized and reliable center like Hemocure to receive comprehensive care, accurate diagnosis, and effective treatment with minimal intervention and the highest safety standards.