Hemorrhoids
proctology · hemorrhoids · rectal bleeding · Gdańsk
Bleeding, itching, pain or a lump near the anus are often associated with hemorrhoids, but they do not always mean hemorrhoidal disease. Similar symptoms may also be caused by an anal fissure, thrombosed external hemorrhoid, inflammation, perianal skin tags, polyps or other diseases of the bowel and anus. That is why the first step is the most important one: a calm proctology consultation and identifying the cause.
If you suspect hemorrhoids, start with a proctology consultation. The doctor will assess whether the symptoms are truly caused by hemorrhoids, whether anoscopy, conservative treatment, hemorrhoid treatment or another diagnostic pathway is needed.
Sara Godyńska
Justyna Szul
diagnosis and treatment of hemorrhoidal disease
the cause of symptoms must be identified first
rectal bleeding requires medical assessment
calmly, with respect for privacy
conservative treatment, banding, laser or procedure
What are hemorrhoids?
Hemorrhoids are normal anatomical structures in the anal canal. A problem appears when they become enlarged, displaced, bleed, prolapse or cause itching, burning, pain and the feeling of a lump near the anus. This is then referred to as hemorrhoidal disease.
Patients often use the word “hemorrhoids” to describe almost any problem around the anus. This is understandable, but not always correct. A lump, pain, bleeding or itching may have many different causes, so the diagnosis cannot be confirmed safely without an examination.
Most important: hemorrhoids are common and usually treatable, but rectal bleeding should not automatically be explained as hemorrhoids. The source of the symptom must be identified first.
The most common symptoms of hemorrhoids
- bright red blood on toilet paper, stool or in the toilet bowl after a bowel movement,
- itching, burning and irritation around the anus,
- a feeling of moisture, discomfort or incomplete bowel emptying,
- a lump near the anus or tissue prolapsing during straining,
- pain, especially in the case of thrombosis or significant swelling,
- worsening symptoms after constipation, long sitting on the toilet or intense straining.
Internal and external hemorrhoids — what is the difference?
Internal hemorrhoids
They are located inside the anal canal. They often cause bleeding, a feeling of prolapse or soiling, but they do not always hurt. In more advanced stages, they may prolapse during bowel movements and require manual reduction.
External hemorrhoids
They are located closer to the skin around the anus. They more often cause pain, swelling, tenderness, itching and the feeling of a lump. A thrombosed external hemorrhoid can be particularly painful and is often described by patients as a sudden, hard, painful lump near the anus.
When should you not assume it is “just hemorrhoids”?
It is worth seeing a proctologist whenever symptoms are new, recurrent, worsening or worrying. Diagnosis is especially important when rectal bleeding, a change in bowel habits, pain, a lump, mucus, weight loss, anaemia or a family history of colorectal disease is present.
Warning symptoms — do not delay consultation:
- rectal bleeding, especially new, heavy or recurrent,
- dark stool, clots or blood mixed with stool,
- a sudden, very painful lump near the anus,
- a change in bowel habits, diarrhoea or constipation without a clear cause,
- weight loss, weakness, anaemia or fever,
- anal pain that does not go away or makes sitting difficult.
What can make hemorrhoids worse?
- constipation and hard stool,
- long sitting on the toilet,
- strong straining during bowel movements,
- low fibre and low fluid intake,
- a sedentary lifestyle,
- pregnancy and childbirth,
- chronic diarrhoea or irritation of the anal area,
- postponing a visit despite recurrent symptoms.
Can hemorrhoids go away on their own?
Mild symptoms may calm down after changing habits, improving stool consistency, reducing straining and using local treatment. This does not mean, however, that every problem disappears permanently. If bleeding, a lump, itching or pain returns, the diagnosis should be confirmed and the stage of hemorrhoidal disease assessed.
In practice, the decision depends on the examination. Small internal hemorrhoids are managed differently from prolapsing hemorrhoids, and differently again from a sudden painful thrombosed external hemorrhoid.
What does the diagnostic and treatment pathway look like?
When hemorrhoids are suspected, diagnosis is the most important step. Only after examination can the doctor decide whether conservative treatment, anoscopy, banding, sclerotherapy, laser treatment or another method is needed.
The doctor asks about symptoms, bleeding, pain, bowel movements, medication and accompanying diseases. Then a proctological examination is performed discreetly.
Book consultation →This examination allows the anal canal to be viewed and helps assess internal hemorrhoids, bleeding, fissure or other possible causes of symptoms.
See anoscopy →For milder symptoms, the doctor may recommend dietary changes, improving stool consistency, local treatment and reducing aggravating factors.
Read more →The Barron method is considered for selected internal hemorrhoids. It involves placing a rubber band at the base of the hemorrhoid.
See banding →In selected cases, the doctor may discuss laser treatment. Qualification depends on the stage of the disease and symptoms.
See laser treatment →The service page describes how treatment methods are selected depending on disease stage and patient symptoms.
See treatment →This page describes symptoms and the patient’s first decision: “could this be hemorrhoids?”. Details of specific methods are available on separate service pages and blog articles to avoid duplicating treatment content.
Who diagnoses and treats hemorrhoids?
surgeon, proctology
Diagnoses and treats hemorrhoidal disease and other anal problems such as pain, lump, bleeding, fissure, abscess or pilonidal cyst. Helps match treatment to the real cause of symptoms.
Doctor profileproctologist
Provides diagnosis and treatment of hemorrhoidal disease, anal fissure, pilonidal cyst and other conditions around the anus. The visit helps distinguish hemorrhoids from other causes of bleeding and pain.
Doctor profileproctologist, surgeon
Consults patients with hemorrhoids, anal pain, bleeding, fissure and other proctological conditions. Particular emphasis is placed on comfort, discretion and clear explanation of next steps.
Doctor profileDo you have bleeding, itching, pain or a lump near the anus?
Do not automatically assume it is “just hemorrhoids”. Book a proctology consultation and identify the cause of symptoms.
Common concerns before seeing a proctologist
The statements below are not real reviews. They are educational examples showing concerns women and men often bring to a proctologist.
This is a very common concern. Bleeding may be caused by hemorrhoids, but it may also have other causes. That is why examination and identifying the source of bleeding are needed.
The visit concerns an intimate area, so discretion and calm explanation of each step are especially important. For the doctor, this is a routine medical procedure.
Local medications may relieve symptoms, but they do not always address the cause. Recurrent bleeding, a lump or prolapse requires assessment of the disease stage.
Not every patient with hemorrhoids requires surgery. Some qualify for conservative treatment, some for minimally invasive methods, and the decision depends on examination.
Frequently asked questions about hemorrhoids
Is every rectal bleeding caused by hemorrhoids?
No. Hemorrhoids are a common cause of bright red blood during bowel movements, but bleeding may also come from other anal or bowel diseases. Every new, recurrent or concerning bleeding requires medical assessment.
Do hemorrhoids hurt?
Internal hemorrhoids often bleed, but they do not always hurt. Severe pain is more common with external hemorrhoids, thrombosis, anal fissure or inflammation. That is why pain requires examination.
Can hemorrhoids go away on their own?
Symptoms may calm down, especially at an early stage and after changing habits. However, if bleeding, a lump, itching or prolapse returns, the diagnosis should be confirmed and treatment selected.
When is anoscopy needed?
Anoscopy is helpful when the anal canal needs to be examined to assess internal hemorrhoids, the source of bleeding, fissure or other changes. The need for this examination is determined by the doctor during consultation.
Is hemorrhoid banding for everyone?
No. Barron banding is used for selected internal hemorrhoids and requires qualification. The doctor assesses the disease stage, symptoms, contraindications and alternative treatment methods.
Are ointments and suppositories enough?
Sometimes they can relieve itching, burning or pain, but they do not always treat the cause. If symptoms return, worsen or bleeding appears, consultation is needed.
Where should I start if I suspect hemorrhoids?
It is best to start with a proctology consultation. The doctor will determine whether the symptoms are caused by hemorrhoids or another condition and suggest further management.
The information on this page is for general educational purposes and does not replace medical consultation. Rectal bleeding, pain, a lump, itching, burning, tissue prolapse or a change in bowel habits requires individual medical assessment. The diagnosis of hemorrhoids and the need for anoscopy, conservative treatment, banding, laser therapy or other treatment are determined by the doctor after examination.