How to distinguish internal hemorrhoids from external hemorrhoids

Nowadays, many people have heard that nine out of ten men have hemorrhoids. The main meaning of this sentence is to tell us that the chance of males developing hemorrhoids is many times higher. In fact, hemorrhoids are not only suffered by men, but also by women. Moreover, hemorrhoids can be divided into types. Internal hemorrhoids are painless at the beginning and only show indirect bleeding. As the disease worsens, there will be spurting bleeding. External hemorrhoids can cause pain and itching, bloody stools, and skin infections and ulcers. Be careful to distinguish them.

Internal hemorrhoids

It occurs above the dentate line, with painless intermittent bleeding, bright red bleeding, dripping or spurting blood, and prolapse of hemorrhoids as the main symptom. Hemorrhoidal prolapse is divided into four stages:

Stage I: The patient has mainly painless blood in the stool, the blood is not mixed with the stool, there is no prolapse, and the bleeding stops on its own after defecation.

Stage II: There is dripping or spurting blood during bowel movements, and hemorrhoids may prolapse, but they may retract on their own after bowel movements.

Stage III: There is blood or dripping blood during bowel movements, and the bleeding has decreased. The hemorrhoids need external force to be retracted after prolapse. When the patient stands or squats for a long time, coughs, is tired, or carries heavy weight, the hemorrhoids will prolapse again.

Stage IV: Hemorrhoids prolapse for a long time and cannot be retracted, which may be accompanied by symptoms such as strangulation, incarceration, and pain.

external hemorrhoids

Occurs in the anal canal and anal margin below the dentate line. The surface of external hemorrhoids is covered with skin and can be seen or touched. Hemorrhoids cannot be inserted into the anus and are not easy to bleed. The main symptoms are pain, foreign body sensation, and anal swelling. Clinically, they are divided into four types:

1. Inflammatory external hemorrhoids: often caused by anal skin damage and infection. The skin wrinkles around the anus are like blisters. The swelling and pain are obvious.

2. Thrombosed external hemorrhoids: The anal venous plexus ruptures, blood leaks out of the blood vessels, and forms a blood clot that bulges under the skin. It is characterized by sudden onset, local swelling and severe pain.

3. Connective tissue external hemorrhoids: Due to chronic inflammatory stimulation, repeated inflammation and swelling, the skin folds around the anus become larger, the connective tissue proliferates, and skin tags of varying sizes are formed.

4. Varicose external hemorrhoids: The subcutaneous varicose veins around the anal margin increase abdominal pressure when squatting and increase in size during defecation. The symptoms can be alleviated to varying degrees after returning to normal position.