Hemorrhoids: Symptoms, Stages, and Related Issues - Surgery

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Hemorrhoid issues


Hello Doctor: I would like to ask a few questions regarding hemorrhoids: 1.
When I strain during bowel movements, I experience rectal bleeding, and after squatting for a while, a lump protrudes from the anus, which I can push back in, but it will protrude again after some time.
What stage of hemorrhoids does this indicate? 2.
I have bowel movements approximately every three days, but I never feel completely empty; I always feel like there is more to pass, and when I strain, it only results in bleeding.
Is this a serious condition? 3.
When I haven't had a bowel movement, I feel that urination is not smooth and that I can't fully empty my bladder.
After having a bowel movement, urination feels more comfortable, but the next day it becomes difficult again.
Is this issue caused by hemorrhoids, or could it be related to inflammation of the bladder or prostate? Thank you in advance for answering my questions.

Xiao P, 20~29 year old female. Ask Date: 2015/12/06

Dr. Yu Mingchang reply Surgery


Hello; there is a higher possibility of anal fissure.
Please consult the Department of Colorectal Surgery at Changhua Hospital, Ministry of Health and Welfare, for your concerns.

Reply Date: 2015/12/06

More Info


Hemorrhoids, commonly referred to as piles, are swollen veins in the lower rectum and anus that can cause discomfort, pain, and bleeding. Understanding the symptoms, stages, and related issues of hemorrhoids is crucial for effective management and treatment.

Symptoms of Hemorrhoids
The symptoms of hemorrhoids can vary depending on their type—internal or external. Common symptoms include:
1. Bleeding: Bright red blood may appear on toilet paper or in the toilet bowl after a bowel movement.

2. Pain and Discomfort: This is particularly common with external hemorrhoids, which can be painful and itchy.

3. Prolapse: Internal hemorrhoids can protrude through the anal opening, especially during bowel movements, leading to a condition known as prolapsed hemorrhoids.

4. Swelling: A lump near the anus, which may be sensitive or painful.


Stages of Hemorrhoids
Hemorrhoids can be classified into four stages based on their severity:
1. Stage I: Hemorrhoids are present but do not protrude outside the anal canal. They may cause bleeding but are generally not painful.

2. Stage II: Hemorrhoids protrude during bowel movements but retract on their own afterward. Bleeding may occur, and some discomfort may be experienced.

3. Stage III: Hemorrhoids protrude during bowel movements and must be manually pushed back inside. Symptoms may include bleeding and pain.

4. Stage IV: Hemorrhoids are permanently prolapsed and cannot be pushed back inside. This stage often involves significant pain and may require surgical intervention.


Addressing Your Questions
1. Regarding your first question: The symptoms you describe—bleeding during bowel movements and the presence of a lump that can be pushed back—suggest that you may be experiencing Stage II hemorrhoids. However, it is essential to consult a healthcare provider for a definitive diagnosis and appropriate treatment.

2. For your second question: The sensation of incomplete evacuation and the need to strain during bowel movements can exacerbate hemorrhoids. Straining increases pressure in the rectal area, leading to further irritation and bleeding. This situation indicates that you may have a more severe case of hemorrhoids, and it is advisable to seek medical advice to explore treatment options, which may include dietary changes, topical treatments, or procedures to reduce the size of the hemorrhoids.

3. Regarding your third question: The feeling of urinary discomfort could be related to several factors. While hemorrhoids can cause discomfort in the pelvic region, urinary issues may also stem from prostate problems or bladder inflammation. It is crucial to discuss these symptoms with a healthcare provider, as they can perform the necessary evaluations to determine the underlying cause and recommend appropriate treatment.


Conclusion
In summary, hemorrhoids can significantly impact quality of life, and understanding their symptoms and stages is vital for effective management. If you are experiencing bleeding, pain, or discomfort, it is essential to consult a healthcare professional for a thorough evaluation and tailored treatment plan. Lifestyle modifications, such as increasing fiber intake, staying hydrated, and avoiding prolonged sitting on the toilet, can also help alleviate symptoms and prevent worsening of the condition. Remember, early intervention can lead to better outcomes and improved quality of life.

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