Hemorrhoids: Causes, Symptoms, Types & Tests

Hemorrhoids (also called piles) are swollen and inflamed veins at the end of the rectum or around the anus. They're a common condition and can affect people of all ages. Symptoms can range from bleeding when defecating, itching, discomfort, pain, or a "lump" around the anus.

When more medical investigation is indicated, Molecular Diagnostics and Therapy provides appropriate diagnostic services that help doctors assess symptoms. In this blog, we'll talk about hemorrhoid symptoms, hemorrhoid causes, hemorrhoid types, and hemorrhoid tests, and under what conditions might a medical assessment be required.

Though hemorrhoids are very common, rectal bleeding isn't necessarily a sign of hemorrhoids. Other digestive diseases can present the same symptom, and if bleeding persists should be checked by a healthcare provider.

What Are Hemorrhoids?

Hemorrhoids are swollen and inflamed veins and supporting tissues at or in the lower portion of the rectum and anus. These can emerge due to an increased strain on the veins and tissues in this location. Hemorrhoids can be of two types, the first being internal hemorrhoids and the other being external hemorrhoids. Hemorrhoids can be either internal or external; internal hemorrhoids grow in the lower portion of the rectum or inside the anus, while external hemorrhoids appear beneath the skin around the anus. Hemorrhoids can be painful, itchy, swollen, or bleeding (with or without symptoms).

Types of Hemorrhoids

There are two main hemorrhoids types: internal hemorrhoids and external hemorrhoids.

Internal Hemorrhoids

Internal hemorrhoids occur in the lower part of the rectum or inside the anus. Most often, they are not obvious from the exterior of the body. Usually, the bleeding is bright red and occurs during and after passing stool. Sometimes they will even push through the anal opening, forming a type of hemorrhoid known as prolapsed internal hemorrhoids. 

Whether this causes a hemorrhoid to be either painful or need medical attention depends on how severe it is. Physicians might also identify internal haemorrhoids by how much they have prolapsed. The severity of the prolapse can help determine the treatment.

External Hemorrhoids

External hemorrhoids occur under the skin, around the anus. May lead to itching and irritation, tenderness, swelling, or pain. But occasionally, there may be a clot in an external hemorrhoid. This is known as a thrombosed external hemorrhoid, resulting in the formation of a hard, painful lump on the surrounding skin of the anus.

Hemorrhoids Tests: How Are Hemorrhoids Diagnosed?

Doctors can detect whether you have hemorrhoids by reviewing your medical history, asking questions, and performing a physical examination. The doctor may ask questions about bowel movements, constipation, loose stools, bleeding, stools being painful to pass, diet, and toilet habits. For external hemorrhoids, a doctor may examine the surrounding area for external signs of lumps, swelling, irritation, and changes in the surrounding area.

If a person suspects that the hemorrhoids are internal, a digital rectal exam may be done. During this exam, the doctor inserts a gloved, lubricated finger into the rectum to check for lesions, lumps, or tenderness. The doctor may not need to do any more tests if he thinks the symptom is a hemorrhoid. If symptoms cannot be explained completely by the presence of hemorrhoids, however, or additional tests are needed to rule out other disorders, the doctor may consider ordering the tests.

Anoscopy for Hemorrhoids

Anoscopy is one of the tests that could be done within the anus and lower rectum to look at the interior of the anal area and lower part of the rectum for the symptoms of hemorrhoids. A small instrument called an anoscope is slowly put into the anus during the procedure. This enables the doctor to see if there are abnormalities such as inner hemorrhoids or if there are any other abnormalities in the lower rectum and anus. Anoscopy is usually performed during an office visit, and most patients do not need anesthesia.

Proctosigmoidoscopy and Colonoscopy

In some cases, your doctor may suggest a proctosigmoidoscopy or colonoscopy if there are symptoms or rectal bleeding that require additional testing. During a proctosigmoidoscopy, the doctor can view the lower portion of the colon and rectum. A colonoscopy is a procedure that can be used to examine the rectum and the entire colon. Not everyone who has hemorrhoids requires a colonoscopy. The decision will depend on things like the patient's age, symptoms, medical history, family history, and the doctor's decision. Current clinical advice suggests conducting a full colonoscopy in certain cases of hemorrhoids and rectal bleeding, if there is a suspicion of some other cause of bleeding.

Are Blood Tests Needed for Hemorrhoids?

Blood tests are not usually required to diagnose hemorrhoids. They may be used to assess anemia or the effects/severity of significant bleeding. If it occurs more than a few times and it's more than just mild, the doctor might want to do blood tests to help determine if there is any anemia or to see how bleeding has affected the body. When looking for another cause of gastrointestinal bleeding, blood tests may also be a piece of the puzzle. Blood tests are done if symptoms are present, and the doctor deems it necessary.

Conclusion

Depending on the case, anoscopy, digital rectal examination, or further tests (such as proctosigmoidoscopy or colonoscopy) may be ordered to diagnose hemorrhoids. Blood tests may also be ordered if there is heavy or frequent bleeding. In Molecular Diagnostics and Therapy, the right tests aid the physician in evaluation and investigating other causes as needed. Do not ignore symptoms if rectal bleeding is persistent or the pain is severe or symptoms keep recurring; see a healthcare provider.