What are the classifications of hemorrhoids? What are the symptoms?

In recent years, the probability of many young people in offices suffering from hemorrhoids has been increasing. The reason why young people get hemorrhoids is mostly due to their lack of physical exercise and irregular diet in life. So what are the categories of hemorrhoids?

1. Internal hemorrhoids

Internal hemorrhoids are common in adults. The main symptom at the beginning is often painless blood in the stool. The blood does not mix with the stool, and often drips or spurts blood during defecation. The bleeding is intermittent and will recur and worsen due to drinking, overwork, constipation or diarrhea. Severe bleeding can cause anemia. During rectal examination, the mucosa above the dentate line is seen to be hemispherical and protrudes, with a bright red, dark red or grayish white color. As the hemorrhoids grow larger, they may protrude from the anus during bowel movements or coughing. If they are not retracted in time, they may become incarcerated internal hemorrhoids, with secretions overflowing and anal swelling. Depending on the severity of the disease, it can be divided into four stages:

1. Stage I: The hemorrhoids are soft, with a bright red or purple surface. The hemorrhoids do not fall out of the anus during bowel movements and are painless.

2. Stage II: The hemorrhoids are larger and can protrude from the anus during defecation, but can return to the anus on their own after defecation. There is intermittent bleeding, heavy dripping, or spurting of blood during defecation.

3. Stage III: The hemorrhoids are larger, some have a slightly grayish white surface, and they protrude from the anus during bowel movements, or even when walking, coughing, or sneezing. It cannot be retracted on its own and must be supported by hands or rested in bed before it can be retracted.

4. Stage IV: Hemorrhoids prolapse and become incarcerated, which may cause erosion, swelling, pain and necrosis.

2. External hemorrhoids

1. Pain and itching: are common symptoms of external hemorrhoids. Patients often complain of pain and discomfort on one side of the anus, restlessness, and difficulty walking. The reason is that the blood vessels at the edge of the anus rupture during defecation, and the blood seeps out and compresses the perianal nerves, causing severe pain in the anus. When the exuded blood coagulates into blood clots and its liquid components are absorbed, the pain gradually subsides, leaving a lump. If too much blood seeps out, the covering skin will become blocked and necrosis will occur. The blood clot can pass through the necrotic area and break, making the pain disappear. Generally, the symptoms of external hemorrhoids are not obvious, but there may be occasional itching or a feeling of incomplete bowel movement. Anal pain only occurs when there is inflammation.

2. Foreign body sensation near the anus: The protrusion of the anal margin is a sign of external hemorrhoids. The irregular protrusions of the anal margin make it uneven, creating a foreign body sensation, and it is difficult to wipe clean during bowel movements, which contaminates underwear and affects people's daily lives.

3. Difficulty in defecation: When the patient has anal pain and is afraid of defecation, he or she will try to prolong the time interval between defecation, which will cause disordered defecation, dry and hard stools, increase the difficulty of defecation, aggravate anal pain, and form a vicious circle.

3. Mixed hemorrhoids

1. Blood in stool: It is characterized by painlessness, intermittentness, and bright red blood after defecation. It is also a common symptom of internal hemorrhoids or mixed hemorrhoids in the early stage. Blood in the stool is mostly caused by feces abrading the mucosa or forceful defecation, which causes dilated blood vessels to rupture and bleed. In mild cases, there is usually heavy bleeding or blood on toilet paper, followed by dripping blood. In severe cases, there is spurting bleeding, which often stops on its own after a few days. This has important implications for diagnosis. Constipation, hard and dry stools, drinking alcohol and eating spicy foods are all causes of bleeding. If bleeding occurs repeatedly over a long period of time, anemia may occur, which is not uncommon in clinical practice and should be differentiated from hemorrhagic diseases.

2. Hemorrhoid prolapse: This is often a late symptom, with blood in the stool occurring first and then prolapse. In the late stage, the hemorrhoids enlarge and gradually separate from the muscle layer, and are pushed out of the anus during defecation. In mild cases, the hemorrhoids will only prolapse during defecation and will return to their original position on their own after defecation. In severe cases, they need to be pushed back by hand. In more serious cases, they will prolapse out of the anus when the abdominal pressure is slightly increased, such as when coughing or walking, and the hemorrhoids will prolapse, making it difficult to return and making it impossible to participate in labor. A few patients report prolapse as the first symptom.

3. Pain: Simple internal hemorrhoids are painless, and a few may have a feeling of heaviness and distension. When internal hemorrhoids or mixed hemorrhoids prolapse and become incarcerated, and edema, infection, and necrosis occur, there will be varying degrees of pain.

4. Itching: In late-stage internal hemorrhoids, prolapsed hemorrhoids and relaxation of the anal sphincter, secretions often flow out. Due to the irritation of the secretions, there is often itching and discomfort around the anus, and even skin eczema, which makes the patient extremely uncomfortable.

5. Mucus overflow: The rectal mucosa is stimulated by hemorrhoids for a long time, resulting in inflammatory exudation and increased secretions. When the anal sphincter relaxes, it can flow out at any time, causing the anal skin to be frequently irritated and cause eczema and itching.