What Are the Types of Hemorrhoids?

Internal Hemorrhoids:

These are found inside the rectum and are usually painless. They may bleed or come out (prolapse) during passing stool.

External Hemorrhoids:

These are under the skin around the anus and can be painful, especially if a blood clot forms inside them (thrombosis). Sometimes they look like small bulges around the anus.

Mixed Hemorrhoids:

These are a combination of both internal and external hemorrhoids.

What Are the Symptoms?

Bleeding

The most common symptom is bright red blood during or after a bowel movement.

Prolapse

Hemorrhoids may come out of the anus, especially while passing stool.

Pain or Thrombosis

External hemorrhoids can be painful, especially if a blood clot forms. Internal hemorrhoids are usually painless unless they become thrombosed or strangulated.

Itching and Discharge

Hemorrhoids can cause itching, irritation, and sometimes a slimy discharge.

Feeling a Lump

You may feel a lump or swelling around your anus, especially if the hemorrhoids are prolapsed or thrombosed.

Why Do Hemorrhoids Happen?

The main cause is straining during bowel movements, often due to constipation. Other reasons include:

  • Sitting for long periods on the toilet
  • Low-fiber diet
  • Chronic diarrhea or constipation
  • Pregnancy
  • Obesity
  • Family history

How Are Hemorrhoids Diagnosed?

Your doctor will ask about your symptoms and examine your bottom. In some cases, a small device called a proctoscope may be used to look inside the rectum. Most of the time, no advanced tests are required to make the diagnosis.

How Can Hemorrhoids Be Treated?

Lifestyle and Diet Changes
  • Eat more fiber (fruits, vegetables, whole grains, oats, lentils, flax seeds, prunes, broccoli, spinach, figs, pears, grapes, oranges, papaya).
  • Drink plenty of water.
  • Avoid straining or sitting too long on the toilet.
  • Exercise regularly.
Medicines and Home Remedies
  • Over-the-counter creams or ointments can reduce pain and swelling.
  • Sitz bath: Sit in warm water for 15–20 minutes to ease pain and itching.
  • Painkillers if needed.
Minimally Invasive and Office Procedures

If symptoms do not improve, your doctor may suggest simple, minimally invasive treatments that are quick and usually painless:

  • Infrared Coagulation (IRC): Uses light to shrink hemorrhoids. Painless and quick. Best for grade 1 and 2 hemorrhoids.
  • Sclerotherapy: A chemical is injected to shrink the hemorrhoids. Best for grade 1 and 2 hemorrhoids.
  • Rubber Band Ligation (RBL):A small rubber band is put around the hemorrhoid to cut off its blood supply. The hemorrhoid falls off in a few days. Used for grade 1, 2, and some grade 3 hemorrhoids.
Advanced Minimally Invasive Procedures

For more severe or persistent hemorrhoids, especially grades 2 to 4, the following advanced, minimally invasive procedures are available:

  • Doppler-Guided Hemorrhoidal Artery Ligation (DGHAL): A special probe is used to find and tie off the blood vessels supplying the hemorrhoids. This reduces blood flow and shrinks the hemorrhoids. It is painless, has quick recovery, and is suitable for grade 2 to 4 hemorrhoids.
  • Transanal Hemorrhoidal Dearterialization (THD): Similar to DGHAL, this technique uses Doppler to locate and tie off arteries. Sometimes, it is combined with a mucopexy (lifting the tissue) for better results.
  • Stapled Hemorrhoidopexy (PPH):This procedure uses a special stapling device to remove a ring of tissue above the hemorrhoids, pulling them back into place and cutting off their blood supply. This is used for internal hemorrhoids (mainly grade 3 and 4) and offers less pain and faster recovery than traditional surgery.
  • Laser Hemorrhoidoplasty (LHP):A laser is used to shrink the hemorrhoidal tissue from inside, without cutting the skin. This is gentle, effective, and involves less pain and faster healing than traditional surgery.
  • Finger-Guided Hemorrhoidal Artery Ligation (FGHAL) with Laser Hemorrhoidoplasty:In this hybrid procedure, the feeding arteries are tied off by feeling them with the finger, followed by laser treatment to shrink the hemorrhoids. This combination offers very low pain and quick recovery.
  • Transanal Suture Rectopexy:Stitches are placed to lift and fix the hemorrhoids, blocking the blood vessels and preventing recurrence. Suitable for grades 2 to 4.

Surgical Treatments

Surgery is only needed for severe or persistent cases, such as:

  • Grade 3 and 4 hemorrhoids not responding to other treatments
  • Thrombosed or strangulated hemorrhoids
  • Mixed (interno-external) hemorrhoids

Surgical options include:

  • Conventional Hemorrhoidectomy:Surgical removal of hemorrhoids.
  • Excision of Thrombosed External Hemorrhoids: For painful, swollen external hemorrhoids with clots, surgery may be needed to remove the clot or the entire hemorrhoid.

Special Situations

  • Thrombosed Hemorrhoids: When a blood clot forms inside a hemorrhoid, causing severe pain and swelling. Can be treated with clot removal, sometimes followed by laser for faster healing.
  • Strangulated Hemorrhoids: When blood supply is cut off to a hemorrhoid, causing severe pain, swelling, and sometimes infection. Surgery is usually needed.

Frequently Asked Questions (FAQs)

Most often, constipation, straining during bowel movements, sitting for long periods, pregnancy, and a low-fiber diet.

No, they are not dangerous but can be uncomfortable. Rarely, heavy bleeding or complications may need medical attention.

Yes, mild cases often improve with home care and lifestyle changes.

If you have bleeding, severe pain, or if symptoms do not improve with home treatment.

Avoid spicy foods, processed foods, and low-fiber diets. Focus on fruits, vegetables, and whole grains.

No, most people get better with simple treatments. Surgery is only for severe or persistent cases.

They cause less pain, allow faster recovery, and usually do not need hospital admission.

Yes, gentle exercise like walking can help prevent constipation and improve symptoms.

Eat a high-fiber diet, drink plenty of water, avoid straining, and stay active.

No, hemorrhoids do not cause cancer. However, if you have bleeding, always get checked to rule out other causes.

If you have more questions or need help, feel free to contact Dr. Kamal Gupta at www.drkamalgupta.com . You are not alone-help is available and treatment is effective!

Contact Information

ADDRESS 408-A, Adarsh Nagar, Near Jain Bhawan,
Kapurthala Road, Jalandhar, INDIA (144008)
EMAIL info@karanhospital.com
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