Hemorrhoids can occur in two places: internally and externally. A hemorrhoid that occurs when the tissue inside the rectum becomes inflamed is designated as an internal hemorrhoid, and the external variety occurs when the anal tissue becomes swollen and irritated outside the body.
It is a lot easier to identify external hemorrhoids, as the inflamed areas of anal tissue and the lumps that they produce are outside of the body and can be readily seen and touched. These lumpy, swollen areas are often called "piles", and they can become itchy, raw, and painful. Often, after a bowel movement, you will notice fresh red blood on the toilet paper. With external hemorrhoids you'll usually notice pain when you are sitting, and you'll discover even when they heal that you're never totally rid of them.
Home remedies such as sitz baths and practicing better personal hygiene, as well as over the counter products such as pads, creams, etc., will help in healing external hemorrhoids. They will relieve the associated pain and itching and will usually get rid of the hemorrhoids in three weeks or less.
Most hemorrhoids that occur internally are not particularly painful; in fact, until the individual notices bloody stools or stained toilet paper when wiping after a bowel movement, he or she may be unaware of the problem. However, even when unnecessary, the urge to defecate can be persistent when internal hemorrhoids are present. However, large internal hemorrhoids can be very painful, especially during a bowel movement, and cannot be treated with creams, ointments, and pads because of their internal location.
Very large internal hemorrhoids that swell and protrude through the anal opening are said to be prolapsed hemorrhoids. A heavy discharge of blood and/or mucous is frequently experienced by a person who has prolapsed hemorrhoids, and the seepage can cause acute itching and inflammation of the anal area.
If the swelling isn't too great, it's possible to gently push prolapsed hemorrhoids back up in the rectum to relieve the discomfort and pain when you're sitting or wiping. Prompt medical attention should be sought if you think you may have a prolapsed hemorrhoid. There is always the possibility of a prolapsed hemorrhoid that's too swollen to be pushed back in the rectum becoming strangulated. Strangulated hemorrhoids also occur when a clot has formed in its blood supply, that is, the blood supply to the hemorrhoid has been cut off, resulting in excruciating pain. Emergency treatment by a medical professional is necessary when a strangulated hemorrhoid occurs.
If you're unsure whether you have internal hemorrhoids or external hemorrhoids, it's always best to consult your physician.
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