Understanding the Differences Between Internal and External Hemorrhoids

M. Rodwan Hiba, MD and the team at Premier Gastroenterology in Brooksville, Florida, diagnose and treat a broad range of digestive-related conditions, including hemorrhoids. 

Hemorrhoids are a common problem. The swollen veins inside or outside the rectum can cause pain, anal itching, and rectal bleeding. Symptoms often improve with at-home treatments, but you may need to see a digestive specialist. This article will discuss the distinctions between both types of hemorrhoids, as well as symptoms and treatment options.

Hemorrhoids: internal vs. external

There are a couple of primary differences between Internal and external hemorrhoids. Internal hemorrhoids form inside the rectum. Although they are less common than external hemorrhoids, they don’t always cause symptoms, but when they do, bleeding is common. 

As the name suggests, external hemorrhoids form around the anus. They are more common than internal hemorrhoids. External hemorrhoids are typically visible because they are swollen and red around the anus. They can also cause discomfort, itchiness, and bleeding. 

What causes hemorrhoids?

Hemorrhoids have traditionally been associated with chronic constipation, straining during bowel movements, and prolonged sitting on the toilet — all of which disrupt blood flow to and from the area, causing blood to pool and enlarging the vessels. This also explains why hemorrhoids are so common during pregnancy, as the uterus expands and presses on the veins.

Recent research indicates that patients with hemorrhoids have a higher resting anal canal tone — that is, the smooth muscle of the anal canal is tighter than usual. Constipation exacerbates this problem by increasing pressure in the anal canal and pushing the hemorrhoids against the sphincter muscle. As you get older, the connective tissues that support and hold hemorrhoids in place weaken, causing hemorrhoids to bulge and prolapse.

Hemorrhoid treatment

You can do a few things to help relieve the symptoms of internal or external hemorrhoids. Internal hemorrhoids can be treated with over-the-counter medications such as hemorrhoid cream or suppositories. You can also try applying a cold compress to the affected area to help reduce swelling.

External hemorrhoids can be treated with a cold compress or an ice pack, as well as over-the-counter pain medication.

Preventing hemorrhoids

Eating more fiber and ensuring that you drink plenty of water throughout the day lower the risk of hemorrhoids. Avoiding excessive straining when going to the bathroom can also help with external hemorrhoids.

Sitting or standing for long periods of time is another common cause of hemorrhoids. Get up and move around as much as you can. This will improve blood flow and reduce the likelihood of hemorrhoids developing.

The Premier Gastroenterology team is here to address any concerns you may have. If you have symptoms of hemorrhoids or experience chronic constipation, we can help you get to the root of the problem and find the most appropriate and effective solution for restoring your digestive health. 

To get started, call or message to schedule an appointment with Dr. Hiba. To help you stay connected to top-quality care, we offer in-person and telehealth appointments.