What are the symptoms of hemorrhoids?

Hemorrhoids are a common anorectal condition caused by varicose or congested perianal venous plexuses. Symptoms are primarily localized and include rectal bleeding, prolapse of hemorrhoidal tissue, anal pain, perianal itching, and a sensation of heaviness or fullness in the anus. The specific symptoms vary depending on the type and stage of the disease. A detailed analysis is as follows:

1. Rectal bleeding: This is the most common early symptom of hemorrhoids, typically occurring during defecation. It presents as bright red blood on the stool surface, dripping after bowel movements, or blood on toilet paper, with blood not mixed into the stool. It usually results from mechanical friction between feces and the mucosa of hemorrhoidal tissue, causing minor tears. The amount of bleeding is generally small and stops spontaneously after defecation.

2. Prolapse of hemorrhoidal tissue: Commonly seen in patients with internal or mixed hemorrhoids. In early stages, hemorrhoids protrude from the anus during bowel movements but can spontaneously reduce afterward. As the condition progresses, manual reduction may be required. In severe cases, even activities such as walking or coughing—actions that increase intra-abdominal pressure—can cause prolapse, which cannot be reduced spontaneously.

3. Anal pain: More prominent in patients with external hemorrhoids, often due to edema, thrombosis, or irritation of the hemorrhoidal tissue. Pain may present as aching or sharp discomfort, worsening during defecation or prolonged sitting. Internal hemorrhoids are typically painless unless they become prolapsed and incarcerated, leading to impaired circulation and severe, persistent pain.

4. Perianal itching: Prolapsed hemorrhoids or inflammatory irritation can increase anal secretions. These secretions continuously irritate the perianal skin, compromising the skin barrier and triggering itching. Unconscious scratching may lead to skin damage and infection, potentially resulting in perianal eczema and further exacerbating the itch.

5. Sensation of anal heaviness or fullness: Patients often feel a dull, dragging discomfort in the anal area, particularly noticeable after prolonged sitting, standing, or defecation. This sensation arises from compression of perianal tissues by dilated venous plexuses and inflammation-induced irritation of local nerves. Some patients may also experience a feeling of incomplete evacuation.

In daily life, it is important to develop healthy dietary and bowel habits—such as consuming more dietary fiber, drinking sufficient water, avoiding prolonged sitting or standing, and maintaining good perianal hygiene. These measures can effectively relieve symptoms and reduce the frequency of hemorrhoid flare-ups.