AMITA Health Endoscopy Center Lincoln Park

Internal Hemorrhoids

Overview

Internal hemorrhoids are veins inside the lower rectum that have become swollen and inflamed. They are similar to varicose veins, but at the end of the digestive tract. Nearly three out of four adults will have hemorrhoids (internal or external) from time to time.

Since internal hemorrhoids form inside the end of the rectum, you likely won’t see or feel anything unusual. They are inside the body. And the inside of the rectum doesn’t have normal sensory nerve endings, so you won’t feel pain from internal hemorrhoids. If you have pain in the area of the anus, it may be from external hemorrhoids or anal fissures (small tears in the tissue that lines the anus).

If an internal hemorrhoid prolapses, you may feel discomfort from itching and swelling. A prolapse is when a part of the body is displaced from its normal position, usually downward or outward. So, a prolapsed internal hemorrhoid moves down and out of the anus. Telling the difference between a prolapsed internal hemorrhoid and an external hemorrhoid may require an experienced physician.

Causes of internal hemorrhoids may include straining to have a bowel movement, unhealthy, low fiber diet, sitting on the toilet for long periods, pregnancy, obesity, regular heavy lifting, aging, or chronic constipation or diarrhea.

Symptoms

  • Pain is unlikely with internal hemorrhoids
  • Prolapsed internal hemorrhoids may cause discomfort from itching and swelling in the anal region
  • Bleeding – blood in toilet or on toilet paper
  • *Rectal bleeding may come from a more serious intestinal issue, such as colorectal cancer, and you should always consult your physician

Treatments

Symptomatic treatments. These treatments only really work for external hemorrhoids and work temporarily. That is, they are not cures. They will not help internal hemorrhoids. They include over-the-counter creams and ointments, sitz baths and other homemade remedies.

Coagulation. Usually performed with an infrared light directed at the internal hemorrhoid. The heat will scar the tissue, which cuts off its blood supply. The dead tissue will later fall off.

Sclerotherapy. Similar to coagulation, but a chemical agent is used to scar the hemorrhoid.

Endoscopic banding. Banding involves using an endoscope (a tube with a light and camera) to see the internal hemorrhoids. Then a rubber band is tightened around the base of the hemorrhoid to scar the tissue.

Surgery. Either hemorrhoid removal (hemorrhoidectomy) or hemorrhoid stapling.

Prevention

Eat high-fiber foods. Fruits, vegetables and whole grains soften and bulk up your stool to help you avoid straining.

Consider fiber supplements. Fiber supplements such as psyllium can improve symptoms and bleeding from hemorrhoids. Drink plenty of water if you take fiber supplements.

Drink plenty of fluids. Fluids will help keep your stools soft.

Avoid long periods of sitting. Sitting in a chair can increase the pressure in the anal veins, but sitting on a toilet for long periods is even worse.

Don’t strain. Whether lifting heavy objects or on the toilet, great amounts of pressure are placed on the veins in the lower rectum.

Empty your bowels as soon as possible after you feel the urge.