Three Types of Hemorrhoids and How to Identify Them

Hemorrhoids are, quite literally, a pain in the behind, affecting as many as half of Americans over age 50 and leading to millions of emergency room visits each year. Most people think all hemorrhoids are the same, but they can be very different. That means your treatment can vary, too, depending on which type you have.

At his practice in Deerfield Beach, Florida, Michael H. Tarlowe, MD, helps patients with hemorrhoids get relief from painful symptoms and prevent future symptoms, too. Here’s what he wants you to know about the different types of hemorrhoids and how they’re treated.

Hemorrhoids: causes and types

Hemorrhoids are swollen, inflamed blood vessels that occur in your rectum or anus. Researchers aren’t sure what causes them, but they do know that they’re more common among people who:

• Are chronically constipated
• Strain a lot during bowel movements
• Are overweight
• Are pregnant
• Spend a lot of time sitting or standing

Because hemorrhoids tend to run in families, there may also be a genetic component involved.

Hemorrhoids can cause a variety of symptoms, including burning and itching. Some hemorrhoids bleed, especially after a bowel movement or when cleaning yourself afterward. Others can increase your risk of fecal leakage, while a few cause no symptoms at all.

Hemorrhoids are divided into three main types: internal, external, and thrombosed.

Internal hemorrhoids

Internal hemorrhoids are inside your rectum. Although you usually can’t see them, they can cause considerable pain, especially during bowel movements. 

Sometimes, an internal hemorrhoid becomes very swollen and distended. This is called a prolapsed hemorrhoid, and it can swell so much that it extends outside your anus. Some prolapsed hemorrhoids only extend beyond the anal opening during a bowel movement, retracting back inside afterward.

External hemorrhoids

External hemorrhoids form outside the anus. These are hemorrhoids that you can usually feel as lumps or bumps around the anal opening. 

They may be very tender or sore, especially if you’ve been constipated or straining. Typically, they’re more painful than internal hemorrhoids. It’s important to note that tumors can also feel like lumps, so if you feel a lump or bump, do not ignore it, even if it’s not causing pain.

Thrombosed hemorrhoids

A thrombosed hemorrhoid is usually an external hemorrhoid that contains a blood clot. These hemorrhoids can be exceptionally painful, especially when they occur externally.

Treating hemorrhoids

Dr. Tarlowe recommends treatment based in part on the type of hemorrhoid you have. While conservative options may be effective for very mild symptoms, many people benefit from the four approaches listed below.

Rubber band ligation

This is one of the most common treatments for hemorrhoids. Dr. Tarlowe places a surgical rubber band around the base of the hemorrhoid. Over the next few days, blood supply to the hemorrhoid is cut off. Eventually the hemorrhoid falls off, leaving a healed scar behind. 

Rubber band ligation can be a good choice for bleeding hemorrhoids that haven’t responded to stool softeners or other conservative treatments.

Injections

Dr. Tarlowe typically uses this approach for internal hemorrhoids that bleed. The injections contain special solutions that block off symptomatic vessels to stop the bleeding. Injections are a good solution for people with bleeding disorders because there’s no additional bleeding afterward.

Clot removal

If you have very painful thrombosed hemorrhoids, Dr. Tarlowe may recommend removing the clot that’s causing your pain. First, he numbs the area with a local anesthetic, then he carefully removes the clot. This technique is best when used within about three days of symptoms appearing.

Hemorrhoid removal

Also called hemorrhoidectomy, hemorrhoid removal uses surgical techniques to remove the hemorrhoid permanently. Prior to your treatment, you’ll receive both local anesthesia and sedation to keep you comfortable. Healing takes about 2-3 weeks.

Find relief for painful hemorrhoids

The new year is a perfect time to commit to better health and greater comfort. If you have symptomatic hemorrhoids, call 954-210-7127 or book an appointment online with Dr. Tarlowe today.