Symptoms

The symptoms in the presence of hemorrhoids are fairly uniform in most people. One problem, however, is the fact that these symptoms are initially quite uncharacteristic and can be assigned to a number of diseases in the rectum. Furthermore, the typical symptoms depend on both the stage and the extent of the disease.

However, some signs can be observed at all stages and therefore provide a first indication of the presence of hemorrhoids. Most affected patients complain about the repeated occurrence of anal bleeding at the beginning of the disease. The intestinal bleeding can be slight or severe.

Other typical symptoms of hemorrhoids include anal weeping (the secretion of secretions from the anus) and severe itching in the anal region. Pain is rarely described in connection with early-stage hemorrhoids and, if present, is more likely to be explained by manipulation of the anus caused by itching. The extent of symptoms in hemorrhoids correlates with the stage of the disease.

For example, affected patients with 1st-degree hemorrhoids have less symptoms than patients with 4th-degree hemorrhoids. The most harmless form of this disease manifests itself in the presence of 1st-degree hemorrhoids. In addition, anal weeping (the secretion of secretions from the anus) and severe itching in the anal region are typical symptoms of hemorrhoids.

Pain is very rarely described in connection with early-stage hemorrhoids and, if present, is more likely to be explained by manipulation of the anus caused by itching. The extent of symptoms in hemorrhoids correlates with the stage of the disease. For example, affected patients with 1st-degree hemorrhoids have less symptoms than patients with 4th-degree hemorrhoids.

The most harmless form of this disease manifests itself in the presence of 1st-degree hemorrhoids. With 1st degree hemorrhoids, the anal region of the affected person usually appears completely inconspicuous when viewed from the outside. The hemorrhoids are therefore not visible from the outside.

During the medical examination, however, the nodular changes can be felt by the finger and can thus be detected. As a rule, the nodules only bulge slightly into the intestinal tube and hardly restrict the passage of faeces. In contrast to the other degrees of hemorrhoids, the nodular changes are still completely reversible at this point in time and can therefore recede.

Surgical correction is usually not necessary despite symptoms. In most cases, the presence of pain cannot be reported at this stage of the disease either. In 1st degree hemorrhoids, light red bleeding from the anus is the main symptom.

Most affected persons notice these bleedings as deposits on the surface of the stool (haematochecia) or on toilet paper. Dark blood in the stool indicates a disease that is located in higher sections of the gastrointestinal tract. Dark blood in stool is therefore not a symptom of hemorrhoids.

However, a 1st degree hemorrhoid does not bleed continuously. In most cases, periods in which blood is secreted alternate with periods without bleeding. Also the intensity of bleeding can vary from day to day without changing the severity of the nodular intestinal protrusion.

Another, but rather rare, symptom of 1st degree hemorrhoids is the development of anemia. This symptom can be explained by bleeding from the intestinal tube. In order to actually trigger anemia, however, these bleedings must assume enormous proportions.

In contrast to first-degree haemorrhoids, second-degree haemorrhoids can be squeezed out during the medical examination by strong pressing. The nodular changes protrude into the anal canal during pressing and retract by themselves after a short time. Furthermore, at this stage the hemorrhoids are no longer able to regress without surgical intervention, they are considered irreversible.A typical symptom of second-degree hemorrhoids is the temporary occurrence of impaired fine incontinence and an associated increase in intestinal mucus secretion.

This means that the stool cannot be held completely or its discharge is difficult. Affected patients often describe a feeling of incomplete evacuation after defecation. In addition, some patients refer to the occasional occurrence of a foreign body sensation in the anal region.

This feeling can be caused by the sometimes very large nodular changes in the intestinal wall. Due to the increased secretion, haemorrhoids at this stage also become noticeable through irritation of the skin in the anal region. It is precisely these skin irritations that cause the typical severe itching that most sufferers suffer from as a symptom of hemorrhoids.

In addition, hemorrhoids at this time can promote the formation of an anal fissure. An anal fissure is a small tear in the skin and/or mucous membrane of the anal region. Pain, if it occurs at all, is a typical symptom of secondary hemorrhoids.

Patients suffering from 3rd degree hemorrhoids often report severe pain. The nodular changes typically become clearly visible with each bowel movement and cannot regress without support. It is usually necessary for the affected patients to push the hemorrhoids back into the anal canal on their own.

Any kind of physical exertion can cause the hemorrhoids to shift and cause severe pain. The characteristic feature of the symptoms of the third-degree nodules is the fact that the pain phenomena can occur both at rest and under stress. The intensity of the pain is described differently from patient to patient.

Furthermore, severe itching is one of the most common symptoms in hemorrhoids of this stage. Many patients describe this itching as almost unbearable. The use of soothing ointments and creams can help to alleviate the symptoms.

In 4th degree hemorrhoids, the large nodular changes are permanently located outside the anus. At this point, mechanical pushing back (reduction) of the hemorrhoids is no longer possible. Affected patients report symptoms such as severe anal itching and swelling of the anus at this stage.

During the physical examination, the attending physician also notices reddish and/or bluish discoloration in the anal region. The size of the nodules can also vary greatly at this stage. In most patients, however, they assume very large dimensions.

In addition, mucous secretion emerges from the intestinal tube at regular intervals. The anal canal has a deformed structure which can severely impede the passage of stool. In addition, heavy bleeding from the hemorrhoids is one of the typical symptoms of this stage.