Rectal Issues: Do Hemorrhoids Cause Changes in Stool Shape?

The stool has grooves?

I underwent a colonoscopy in July-August this year, and the doctor said the report showed no significant issues, only internal hemorrhoids, and no polyps.
Prior to the examination, I sometimes noticed a piece of tissue protruding from my anus, which I suspect is my internal hemorrhoid, and I have to push it back in with my hand.
As a result, my stool can occasionally appear slightly flattened, although it is usually cylindrical in shape.
There is no mucus or bleeding, but sometimes I notice that one side of the cylindrical stool has a groove, approximately 0.2 to 0.3 cm in depth and width.
Before the examination, I asked the doctor if hemorrhoids could change the shape of stool, and he replied that they could.
However, at that time, I did not clarify that I sometimes see a slight flattening and often observe a groove.
Therefore, I would like to ask Dr.
Ke if larger internal hemorrhoids could easily compress stool into a flattened shape, and whether small internal hemorrhoids could potentially cause a groove.
Additionally, do I need to undergo any further examinations, or how often should I follow up? Thank you for taking the time to clarify these concerns.

Jen, 40~49 year old female. Ask Date: 2019/10/08

Dr. Ke Fangxu reply Surgery

The shape of the stool can resemble that of whipped cream.
If hemorrhoids are present in the anal canal, it may cause the stool to appear flattened or have grooves.
Since a colonoscopy has already been performed, there is no need for further testing, and follow-up examinations are not required for the next 3 to 5 years.

Reply Date: 2019/10/08

More Info

Hemorrhoids, particularly internal hemorrhoids, can indeed affect the shape of your stool. When hemorrhoids become enlarged, they can protrude into the anal canal and may cause a narrowing of the passage through which stool passes. This can lead to changes in stool shape, such as a flattened or ribbon-like appearance. The presence of a groove or indentation on one side of the stool, as you described, can also be attributed to the pressure exerted by the hemorrhoids on the stool as it passes through the anal canal.

In your case, since you mentioned that you have experienced a protruding mass at the anal opening, it is likely that this is indeed your internal hemorrhoid. When the hemorrhoid becomes engorged with blood, it can push against the stool, leading to the changes in shape you are observing. The fact that your stool is typically cylindrical but occasionally appears flattened suggests that the hemorrhoid may be intermittently affecting the passage of stool.

It is also important to note that while hemorrhoids can cause changes in stool shape, other conditions can also lead to similar symptoms. For instance, strictures in the anal canal, which can be caused by scarring or other factors, can also result in a change in stool shape. Therefore, it is crucial to monitor your symptoms closely.

Regarding your question about the need for further examinations, since you have already undergone a colonoscopy and the results were normal aside from the internal hemorrhoids, it may not be necessary to repeat the procedure immediately. However, if you notice any significant changes in your bowel habits, experience pain, or see blood in your stool, you should consult your healthcare provider promptly. They may recommend follow-up examinations or treatments based on your symptoms.

In terms of management, there are several strategies you can employ to alleviate the symptoms associated with hemorrhoids and potentially improve stool shape. Increasing dietary fiber intake can help soften the stool and make it easier to pass, reducing the strain during bowel movements. Staying well-hydrated is also essential, as it helps maintain stool consistency. Over-the-counter treatments, such as topical creams or suppositories, can provide relief from discomfort and inflammation associated with hemorrhoids.

If your symptoms persist or worsen, or if the hemorrhoids become more prominent, you may want to discuss further treatment options with your healthcare provider. In some cases, procedures such as rubber band ligation or sclerotherapy may be recommended to reduce the size of the hemorrhoids and alleviate symptoms.

In summary, while internal hemorrhoids can cause changes in stool shape, it is essential to monitor your symptoms and maintain regular communication with your healthcare provider. If you have any concerns or if your symptoms change, do not hesitate to seek medical advice. Regular follow-ups may be beneficial, especially if you experience any new or worsening symptoms.

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