There are many different symptoms for hemorrhoids, often depending on the type of hemorrhoid, but bleeding during bowel movements, itching and rectal pain are the most common. Other symptoms can include swelling and hard tender lumps near the anus.

Symptom: Bleeding

Bleeding during bowel movements, along with itching, is the most common sign of hemorrhoids. Bleeding from swollen hemorrhoidal tissues will be a bright red in color and can appear on the toilet paper, the toilet bowl, or within the stool. Some hemorrhoids can be recognized when the stool is exceptionally smelly and accompanied by bleeding. Mucus discharge and bleeding from internal hemorrhoids can also cause further irritation of the anus.

Rectal bleeding can occur with other diseases, including colorectal cancer and anal cancer, so don’t assume that bleeding is coming from hemorrhoids without consulting a doctor.

Symptom: Itching

Itching is a frequent complaint, because internal hemorrhoids often seep mucus, which can irritate the anal skin and cause itching. This manifests most commonly as a sensation of burning and itching around the anus. Sometimes, inflammation appears as a rash with bumps and swelling on the anal area.

Symptom: Rectal Pain

Hemorrhoids can cause considerable discomfort, often because you feel the urge to pass a stool even immediately after having had a bowel movement. You may have a persistent, vague feeling of discomfort in and around the anal and rectal regions.

Rectal pain occurs mainly with external hemorrhoids. Blood may pool under the skin, forming a hard, painful lump. The medical term for this is a thrombosed or clotted hemorrhoid. The pain is most noticeable while sitting, standing or walking, and especially when having a bowel movement.

Most internal hemorrhoids are not painful. But large hemorrhoids that bulge from the anus may become painful if they swell and are squeezed by the muscles that control the anus. Severe pain may be a sign that the blood supply to the hemorrhoid is being cut off (strangulated hemorrhoid) and may require emergency treatment.

Symptom: Swelling

Swelling is another common hemorrhoid symptom, namely in the anal veins and partly due to increased friction and pressure during defecation. Other reasons that could lead to increased swelling of veins include lifting heavy weights, being overweight or obese, and pregnancy.

Symptom: Hard Tender Lumps

The appearance of hemorrhoids is another indicator. While you cannot see or feel internal hemorrhoids, external ones may feel like a small lump on the anal area the size of a pea. Prolapsed hemorrhoids appear as a bunch of grapes and can extend some way from the anal area. Thrombosed hemorrhoids are generally large in size and can vary in color.

When to contact the doctor?

If your hemorrhoid symptoms began along with a marked change in bowel habits or if you’re passing black or maroon stools, or blood clots, consult your doctor immediately. These types of stools can signal more extensive bleeding elsewhere in your digestive tract. Seek emergency care if you experience large amounts of rectal bleeding, lightheadedness, dizziness or faintness.

Always be aware that similar symptoms to the more severe ones experienced with hemorrhoids could be a sign of rectal or anal cancer. Be sure to check with your doctor, especially if you are older than 50 or have a family history of colon or other cancer.

Similar symptoms could also be attributed to conditions such as anal fissures, anal fistulas, colon polyps and inflammatory bowel disease.