The following symptoms and complaints may indicate hemorrhoids:
Leading symptoms
- Anal protrusion
- Painless bright red bleeding peranal or transanal bleeding (bleeding from the anus (anus)):
- Blood during defecation or after defecation / defecation (eg, on the toilet paper).
- Phases of bleeding can sometimes alternate with weeks or months of no symptoms.
- Dull pain in the area of the anus or a kind of foreign body sensation in the anus (regardless of bowel movement)Note: If stabbing or sharp pain occurs, so there is at the same time a small fissure (tear) (in hemorrhoids II degree in up to 70% of cases).
Accompanying symptoms
- Impaired fine continence, i.e., air- and moisture-tight closure of the anal canal in the context of fecal continence (ability to arbitrarily retain his bowel movements or winds) [in prolapsing hemorrhoids (stage: II degree or III degree)]:
- Secretion of mucus and/or feces (stool).
- Stool smearing (soiling) and stool soiled laundry.
- Pain* due to concomitant fissures or thrombosis (vascular occlusion) in the hemorrhoids.
- Feeling of incomplete defecation
- Anal eczema with itching* * possibly also itching, burning, oozing in the area of the anus.
* A hemorrhoidal condition is not in itself accompanied by pain, because hemorrhoids are not located in the sensitive innervated distal rectum (end of the rectum). However, in the presence of incarcerated hemorrhoidal prolapse (incarcerated prolapsed hemorrhoids; grade IV hemorrhoids), severe pain occurs. Differential diagnoses of pain: perianal vein thrombosis (thrombus (blood clot) in one of the subcutaneous (“under the skin“) veins of the caudal haemorrhoidal plexus in the region of the anus), acute anal fissure (anal tear), abscess (encapsulated collection of pus)* * Further differential diagnoses of itching: chronic anal fissure, perianal tumors.
