What are the symptoms of prolapsed internal hemorrhoids? What are the hazards?

Hemorrhoids protrude outside the anus without pain or itching. Some patients believe that there is no need to worry too much about small hemorrhoids, as long as the small flesh protrudes and does not affect life. But is this true? What are the dangers of prolapsed internal hemorrhoids?

Symptoms

1. Blood in stool: Bleeding during or after defecation, bright red in color, sometimes with a small amount of blood on the surface of the stool, or staining toilet paper red, sometimes dripping or spurting blood. Because feces abrades the mucosa, or because of excessive force during defecation, the pressure in the blood vessels increases, causing varicose veins to rupture, resulting in spurt-like bleeding during defecation.

2. Prolapse: As the volume of hemorrhoids increases, they are squeezed by feces during defecation, causing them to gradually separate from the muscle layer and prolapse out of the anus. Sometimes 1-2 hemorrhoids prolapse at the same time, and sometimes all hemorrhoids and rectal mucosa prolapse together. Initially, it only comes out during defecation and can return to its original position after defecation. For those with more severe symptoms, the prolapse must be pushed back by hand or rest in bed before it can be restored. If the symptoms are severe, in addition to prolapse during defecation, it may also occur with any exertion, walking, coughing, sneezing, squatting, etc.

3. Pain: Simple internal hemorrhoids are generally painless, and sometimes only cause a feeling of heaviness in the anus or difficulty in defecation. If the hemorrhoids are inflamed and swollen, there may be thrombosis or incarceration inside, which will cause pain; if they are prolapsed and not repositioned in time, the pain will worsen; if incarceration occurs, there is ulceration and necrosis, causing inflammation and edema of the anal margin, the pain will be severe and the patient will be restless.

4. Mucus outflow: The rectal mucosa is stimulated by hemorrhoids for a long time, causing increased secretions. In the late stage of internal hemorrhoids, secretions often flow out of the anus due to relaxation of the anal sphincter. In mild cases, it will flow out during bowel movements, and in severe cases, it will flow out naturally even when not having a bowel movement, contaminating the underwear and causing great inconvenience to the patient. When internal hemorrhoids prolapse, the discharge is greater.

5. Itching: Due to the stimulation of secretions or prolapsed hemorrhoids, the area around the anus becomes wet and unclean, causing eczema and itching. The itching is sometimes caused by the reflex action of prolapsed internal hemorrhoids.

harm

Prolapse of internal hemorrhoids is a major symptom of hemorrhoids. Internal hemorrhoids that protrude outside the anus are clamped by the sphincter, and venous return is blocked, but arterial blood continues to flow in, causing the hemorrhoids to increase in size until the arteries are compressed and closed, causing thrombosis. The hemorrhoids then become hard and painful, and are difficult to push back into the anus. Corresponding pathological changes often occur in the later stage:

Necrosis: Hemorrhoids are incarcerated outside the anus. Due to a series of pathological changes, local metabolic products accumulate, further aggravating local edema of the anus and aggravating the incarceration of hemorrhoids. This is a vicious cycle. Therefore, if internal hemorrhoids are incarcerated for a long time, necrosis will inevitably occur. At this time, necrosis is often limited to the mucosal part of the hemorrhoids, but it may also invade other parts of the human body. There have been reports from abroad that blood clots in hemorrhoids spread upward and the necrotic area extended to the rectal wall, resulting in severe sepsis in the pelvic cavity. Although this situation is rare, it must be taken seriously by clinicians.