Hemorrhoids and Symptoms
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Your description is certainly reminiscent of hemorrhoids, although there are a couple of other potential causes.
1- Hemorrhoids - These are enlarged veins (hemorrhoidal veins) that have enlarged, much like varicose veins, and protrude into the anus, potentially even coming out through the sphincter. They usually are bothersome, can be painful, bleed, but are in no way life-threatening. Individuals who spend much time in the toilet or those who strain excessively due to constipation are a risk of developing them and of having them progress. Usually hemorrhoids can improve with time, only to return later on. Sitz baths and local analgesic and anti-inflammatory creams can be helpful.
Occasionally, a hemorrhoid will “thrombose”, or clot, and will produce extreme pain that needs to be addressed right away. There are three groups of hemorrhoids, basically surrounding the entire anal sphincter.
There are two main types of hemorrhoids, internal & external; both pretty common. The most common type are the internal. Internal hemorroids are inside above the “dentate line”, an anatomical landmark within the anorectum. We grade hemorrhoids based on how they behave. Type 1 hemorrhoids don’t protrude through the anus. Type II hemorrhoids protrude through the anus with coughing or straining but then return right back up. Type III hemorrhoids protrude continuously but can be manually returned into the anus. Finally, type IV hemorroids cannot be reduced and should be removed with surgery.
Other potential conditions are also possible, such as rectal prolapse, which is a very painful condition in which your rectum folds upon itself and telescopes through the anus. This is commonly seen in individuals with cystic fibrosis, the elderly, etc.
A rectal/anal abscess is a local inflammation due to infection near the anus. It will be a hard, painful swollen mass that causes extreme pain when touched.
An anal fissure is basically a cut along on of the margins of the rectum, it is incredibly painful and is much worsened with a bowel movement. Treatment is with Sitz Bathsand bulking agents.
The best approach in your case, is to have your likely hemorrhoids looked at by a your PCP or a general surgeon and get their opinion. They usually will not opt to do surgery unless significant or if it has failed medical therapy. MEDICAL THERAPY CAN TREAT HEMORRHOIDS. Surgery is usually only a last resort if therapy has failed. Surgery includes placing a band around the hemorrhoids, letting them necrose and die. Alternatively, surgery to remove the three hemorrhoidal vein complexes can be performed, but usually only in cases where there is significant type IV prolapse outwards causing significant fecal incontinence. Good luck minimizing this annoying condition’s impact on your regular life.
