How to diagnose hemorrhoids

Nov 15, 2025 Source: Cainiu Health

Dr. Li Jingxiang

Introduction

Hemorrhoids are primarily diagnosed based on typical symptoms related to the anus and defecation. Core symptoms include rectal bleeding, anal pain, protrusion of tissue, local itching, and abnormal bowel movements. Initial identification can be made according to the specific characteristics of these symptoms, with slight variations depending on the type of hemorrhoids. In daily life, it is important to maintain regular bowel habits, avoid prolonged squatting on the toilet, and increase dietary fiber intake.

Diagnosis of hemorrhoids is primarily based on typical symptoms related to the anus and defecation. The core symptoms include rectal bleeding, anal pain, protrusion of tissue, local itching, and abnormal bowel movements. These symptoms' specific characteristics allow for preliminary identification, with slight variations in symptom emphasis among different types of hemorrhoids. Detailed analysis is as follows:

1. Rectal bleeding: This is the most common symptom of hemorrhoids, typically presenting as bright red blood dripping during or after bowel movements. The blood does not mix with stool and is usually painless. Internal hemorrhoids are more likely to cause this symptom, which may initially occur only occasionally after constipation or consuming spicy foods.

2. Anal pain: Pain is often associated with external hemorrhoids or prolapsed and incarcerated internal hemorrhoids. When an external hemorrhoid becomes inflamed or develops a thrombosis, there is noticeable swelling and pain at the anal margin, which worsens upon touch or walking. If a prolapsed internal hemorrhoid cannot be reduced promptly, it obstructs local blood circulation, causing severe pain along with a sensation of anal heaviness or fullness.

3. Protrusion of anal mass: A soft mass protruding from the anus during defecation is a classic sign of internal hemorrhoids progressing to an advanced stage. Initially, the mass may spontaneously retract after bowel movement; as the condition worsens, manual reduction becomes necessary. In severe cases, the mass may prolapse even during walking or coughing and becomes difficult to push back.

4. Anal itching: Hemorrhoids can increase secretions around the anal skin, irritating the area and causing itching. Patients often scratch unconsciously, damaging the skin barrier and worsening discomfort, creating a vicious cycle of "itching-scratching-skin damage," which may lead to perianal dermatitis in severe cases.

5. Abnormal bowel habits: Some patients may suppress the urge to defecate due to fear of pain or bleeding during bowel movements, leading to prolonged stool retention in the intestine, excessive water absorption, and subsequent constipation. Additionally, irritation from hemorrhoids may affect the anal sphincter, causing a sensation of incomplete evacuation—frequent urges to defecate without successful passage of stool.

In daily life, maintaining regular bowel habits, avoiding prolonged toilet sitting, increasing dietary fiber intake, and drinking plenty of water to soften stools are essential. If any of the above symptoms occur, lifestyle adjustments should be made promptly—avoid prolonged sitting, staying up late, and consuming spicy foods. Warm sitz baths and similar measures can help relieve local discomfort and maintain anal health.

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What is the best hemorrhoid cream?

There is no such thing as the "best hemorrhoid ointment." Commonly recommended and effective options include Ma Ying Long Musk Hemorrhoid Ointment, Gang Tai Ointment, Yunnan Baiyao Hemorrhoid Ointment, Taisun Compound Carraghenate Cream, and Jiu Hua Ointment. Each of these has specific therapeutic effects and should be selected according to the type and symptoms of hemorrhoids. If symptoms fail to improve or worsen after use, it is advisable to seek medical attention promptly for accurate diagnosis and treatment.

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How long should Ma Yinglong be left on before washing off?

Ma Yinglong usually refers to Ma Yinglong Musk Hemorrhoids Ointment. There is no need to deliberately wash it off after application. This ointment is for external use only; the active ingredients act directly on the affected skin or mucous membranes, gradually penetrating and being absorbed. Residual components will not cause harm, so additional washing is unnecessary. If symptoms such as perianal redness, swelling, worsened itching, or allergic reactions occur after application, medical attention should be sought promptly.

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What is a fleshy growth in the anus?

Anal lumps may be caused by external hemorrhoids, prolapsed internal hemorrhoids, rectal polyps, perianal abscesses, or genital warts. These conditions can be improved through dietary adjustments, maintaining hygiene, medication, or surgical intervention. If the lump increases in size, pain worsens, or bleeding occurs, prompt medical attention is necessary. Prolonged sitting and constipation can lead to congestion and dilation of the anal venous plexus.

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What medications can be used to treat anal fissures?

In general, anal fissure is a small ulcer formed by a full-thickness longitudinal tear in the skin of the anal canal, often accompanied by symptoms such as pain during defecation and rectal bleeding. Patients may follow medical advice to use medications such as nitroglycerin ointment, compound carrageenan cream, lidocaine hydrochloride gel, Ma Yinglong Musk Hemorrhoids Ointment, or erythromycin ointment for treatment. A detailed analysis is as follows: