Content
Internal hemorrhoids correspond to dilated veins inside the rectum that are not seen in the anus, and are often diagnosed when there is the presence of bright red blood in the stools or on toilet paper when defecating, itching and discomfort in the anus, which makes it difficult to going to the bathroom.
Internal hemorrhoids can be classified into degrees according to the symptoms presented, which also interferes with the treatment recommended by the proctologist. Regardless of the degree of internal hemorrhoids, it is important to change eating habits, giving preference to foods rich in fiber, as this way it is possible to relieve symptoms and reduce pain and discomfort when evacuating.
Main symptoms
Although the internal hemorrhoid is not visible, the signs and symptoms that appear are characteristic, with mainly the presence of bright red blood in the stool. In addition, other signs and symptoms that may be indicative of internal hemorrhoids are:
- Itching in the anus;
- Exit of mucus through the anus;
- Difficulty and pain to defecate;
- Anal discomfort;
- Anal tenesmus, which corresponds to the intense urge to evacuate even though there is no more fecal content to be eliminated;
- Sensation of incomplete emptying of the rectum after evacuation.
In addition, it is also possible to notice the appearance of a small lump in the anus during evacuation and that may or may not return naturally to the initial site, this lump corresponding to the dilated veins that exit through the anus, characterizing the internal hemorrhoid of degrees 2, 3 or 4, depending on the characteristics.
How to confirm the diagnosis
The diagnosis of internal hemorrhoids should be made by the gastroenterologist or by the proctologist through the proctological exam, in which the doctor will assess the anal region in order to identify any changes that are indicative of internal hemorrhoids. To perform the examination, the doctor indicates the position that the person should be in and then does the analysis of the anus, being indicated for the person to make an effort as if he is defecating, as it is thus possible to check for the presence of hemorrhoids or anal fissures.
In addition to the proctological examination, the doctor also evaluates the symptoms presented and the person's history, especially with regard to eating habits and physical activity, because unhealthy eating and physical inactivity favor the appearance of hemorrhoids.
Degrees of internal hemorrhoids
According to the symptoms presented, internal hemorrhoids can be classified into 4 degrees, which influences the treatment recommended by the doctor:
- Grade 1 internal hemorrhoids: only bleeding is seen and the veins do not come out of the anus;
- Grade 2 internal hemorrhoids: the veins come out of the anus during bowel movement, but naturally return to their original position, in addition to bleeding;
- Grade 3 internal hemorrhoids: there is also bleeding and the veins only return to their normal position when they are carefully pushed;
- Grade 4 internal hemorrhoids: there is heavy bleeding and the prolapse is irreducible, that is, they do not return to their original position even when pushed.
According to the symptoms presented and the characteristics verified by the gastroenterologist or proctologist, the degree of the hemorrhoid can be indicated and the treatment started immediately thereafter.
It is important to go to the doctor when any sign or symptom indicative of internal hemorrhoid is observed, as it is thus possible for the doctor to start the diagnostic process. Initially, the diagnosis occurs through the assessment of the symptoms presented and the person's evacuation and eating habits, history of laxative use and history of surgeries and gastrointestinal diseases. Then, a proctological diagnosis should be performed, which consists of observing the anus in order to identify any changes.
Main causes
The appearance of internal hemorrhoids is often related to the person's habits, such as poor fiber intake, frequent use of laxatives, habit of sitting on the toilet for a long time, smoking and physical inactivity. In addition, inadequate nutrition causes intestinal transit to be impaired, in addition to making the stools more dry, which makes it necessary for the person to use excessive force to evacuate, leading to the formation of hemorrhoids.
Internal hemorrhoids can also be related to local infections, be the result of chronic diarrhea or happen during pregnancy, which is very common due to the increase in body weight and the pressure exerted on the pelvic region by the baby. Understand why hemorrhoids arise in pregnancy and how is the treatment.
How treatment should be
Treatment for internal hemorrhoids should be guided by the proctologist according to the degree of the hemorrhoid, and a change in eating habits may be recommended, giving preference to foods rich in fiber, consumption of plenty of fluids during the day, sitz bath, use of analgesics and anti-inflammatory drugs, such as Naproxen, or the use of hemorrhoid ointments, such as Proctyl or Ultraproct. Other treatment options that may be recommended by the doctor according to the degree of the hemorrhoid are sclerotherapy, photocoagulation, cryotherapy and the use of elastic bandages. Understand how the treatment for internal hemorrhoids is done.
In the most severe cases, in which the hemorrhoid gets stuck in the anus, there is a risk of clots that can cause hemorrhoidal thrombosis and, therefore, the doctor can advise surgery to repair dilated veins.
The change in eating habits is important in all types of hemorrhoids, because when consuming more fiber, intestinal transit improves and the stools become softer, being easier to be eliminated and there is no strength to defecate. Check out the following video to learn what to eat to relieve symptoms and prevent further hemorrhoid attacks: