Everything You Need To Know About Hemorrhoids

So what are Hemorrhoids?

Hemorrhoid Classification

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Hemorrhoids, which are also commonly know as ‘piles’ in some countries, are vascular structures in the anal canal. Everyone has them, they’re basically cushions that help with stool control. When they become irritated and inflamed they can cause:

  • pain or discomfort
  • itching
  • burning
  • noticeable lumps or swelling near your anus

When most people talk about hemorrhoids, they are talking about the inflamed state. Throughout this article when I refer to hemorroids, I’ll be referring to them in their irritated hemorrhoid state. There are four kinds of hemorrhoids:

  • internal
  • external
  • prolapsed
  • thrombosed

Often these types are experienced as a combination, making for a very painful experience.


Internal hemorrhoids are found inside your rectum. They’re not always seen because they’re too deep in your anus to be visible. Internal hemorrhoids aren’t normally as serious and tend to go away on their own. They can become more irritated and swell and therefore might stick outside of your anus. This is known as a prolapsed hemorrhoid.

Faeces traveling through your rectum may also irritate an internal hemorrhoid. This can cause the bleeding that you may notice on your toilet tissue.


A prolapsed hemorrhoid happens when internal hemorrhoids swell and stick out of your anus. There are different grades of internal prolapsed muscles and they go as follows:

  • Grade one: Not prolapsed at all.
  • Grade two: Prolapsed, but will retract by themselves. These may only prolapse when you put pressure on your anal or rectal area, such as by straining when you have a bowel movement, and then return to their normal position soon afterwards.
  • Grade three: Prolapsed, and you have to push it back in yourself. These may need to be treated so that they don’t become too painful or infected.
  • Grade four: Prolapsed, and you can’t push it back in without a lot of pain. These will usually need to be treated to prevent pain, discomfort, or further complications.

Prolapsed hemorrhoids will look like swollen red lumps or bumps on the outside your anus. If you use a mirror to examine the area you may be able to see them. Prolapsed hemorrhoids sometimes have no other symptom than the protrusion, or they may cause pain or discomfort, itchiness, or burning. In some cases, you may need surgical treatment to remove or correct a prolapsed hemorrhoid so that they don’t cause you any pain or complications. I generally had grade four hemorroids, which was a definite pain in the ass.


External hemorrhoids occur at the entrance of your anus, directly on the surface of where your bowel movements come out. They may not always be visible, but are sometimes seen as lumps on the anal surface.

The symptoms of external hemorrhoids are effectively the same as those of internal ones. But since they’re located on the outside of your rectal area, it’s possible that you could feel more pain or discomfort when you sit down, do physical activities, or have a bowel movement.

External hemorrhoids are easier to see when they swell, and the bluish colour of the dilated veins is visible beneath the anal skin surface.


A thrombosed hemorrhoid contains a blood clot (thrombosis) inside of the hemorrhoid tissue. Symptoms often show as lumps or swelling around your anus. Thrombosed hemorrhoids are essentially a complication of a hemorrhoid, where a blood clot has formed. Blood clots can occur in both internal and external hemorrhoids, and the symptoms may include:

  • intense pain and itchiness
  • swelling and redness
  • bluish colour around area of hemorrhoid

So now we know what they are let’s look at what can cause them.

Causes of Hemorrhoids

Anything that puts strain or pressure on your anus or rectum can result the veins dilating. Common causes and risk factors of hemorrhoids include:

  • being overweight
  • straining while having a bowel movement
  • having diarrhea or constipation
  • not having regular bowel movements
  • sitting for a long time
  • being pregnant or giving birth
  • not eating enough fibre in your diet
  • using too many laxatives
  • certain exercises or over exercising
  • stress
  • getting older, as tissues lose strength and elasticity as you age
  • hypertonic pelvic floor

There are general things to check first like health, diet and exercise when finding the cause of your hemorrhoids, but every single human is different. In some cases, similar to mine, you might be trying to treat hemorrhoids but find out that they keep coming back because they are a symptom of a larger health issue. Either way seek medical advice if they persist and become a higher grade of hemorrhoid.

Seeking Medical Advice

You should see your doctor if you notice pain and discomfort around your anus, particularly when you sit or have a bowel movement. Seek emergency medical attention if you notice any drastic worsening of your symptoms, especially if they’re interfering with your day to day activities:

  • feeling extremely itchy around your anus
  • burning around your anus
  • noticeable lumps or swelling near your anus
  • bluish discoloration of your skin near areas of swelling

Often people delay seeking medical advice for hemorrhoids because of embarrassment or feeling uncomfortable about the area that it occurs in. Just know that 1 in 20 people experience hemorrhoids, so you’re not alone and it is more important to look after your health. When I was younger I ignored them until I was in excruciating pain due to embarrassment. I regret this because I could have tried to solve to problem before it became too aggressive.


Now you know what hemorrhoids are and the different stages and symptoms, it becomes a lot easier to figure out how to treat them.

medical advice to help hemorrhoids

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