The common symptoms

Most patients experience one or more of the following: bright red bleeding, itching around the anus, a feeling of fullness or incomplete emptying, mucus discharge, swelling, or a lump at the anal margin. Which of these dominates depends largely on the type of hemorrhoid.

Why internal and external feel different

Internal hemorrhoids sit where there are few pain nerves, so they tend to bleed and prolapse rather than hurt. External hemorrhoids sit in pain-sensitive skin, so they more often cause soreness and a palpable lump. Bleeding deserves its own attention and is covered on the bleeding hemorrhoids page, while persistent itching has its own page too.

Symptoms that should not be ignored

Certain signs need timely assessment rather than home care: bleeding that is new, heavy or persistent; a change in bowel habit; a lump that becomes suddenly very painful; or symptoms that do not settle within a couple of weeks. The reason for caution is simple, the same symptoms can be produced by conditions that need entirely different treatment, so a diagnosis should never be assumed.

What a proctologist looks for

An examination confirms the type and grade of hemorrhoid and excludes other causes. Grading in particular shapes the plan, and is explained on the hemorrhoid grades page.

From symptoms to relief

Once the diagnosis is clear, most early symptoms respond to conservative care, with procedures reserved for persistent or advanced disease as set out on the hemorrhoid treatment page. The full overview lives in the complete hemorrhoid guide.