From the Guidelines
Yes, hemorrhoids can be visible or palpable in the rectal area, with external hemorrhoids appearing as swollen lumps around the anus and internal hemorrhoids sometimes protruding through the anus during bowel movements. Hemorrhoids are defined as internal or external according to their position relative to the dentate line, with external hemorrhoids becoming symptomatic only when thrombosed or when skin tags are large enough to cause hygiene issues 1. Internal hemorrhoids, which develop inside the rectum, may not be visible but can cause symptoms like bleeding, protrusion, itching, and pain 1.
Some key points to consider about hemorrhoids include:
- External hemorrhoids can be seen or felt as swollen, sometimes bluish lumps around the anus 1
- Internal hemorrhoids may not be visible but can protrude through the anus during bowel movements, appearing as moist, pink bumps that can be pushed back inside 1
- Hemorrhoids often cause symptoms like pain, itching, bleeding during bowel movements, or a feeling of fullness in the rectal area 1
- Treatment options include over-the-counter creams, sitz baths, increasing fiber intake, drinking plenty of water, and avoiding straining during bowel movements 1
- If hemorrhoids are persistent or severe, medical treatments like rubber band ligation, sclerotherapy, or surgical removal may be necessary 1
It's essential to note that hemorrhoids develop when the veins in the rectal area become swollen due to increased pressure, often from straining, pregnancy, chronic constipation, or prolonged sitting 1. A directed physical examination, including anoscopy and proctosigmoidoscopy, should be performed to diagnose hemorrhoids and rule out other conditions with similar symptoms 1. Care depends on the extent of hemorrhoidal disease, with first-degree hemorrhoids often treated with medical management alone or nonoperative outpatient therapies, and surgery generally reserved for more severe cases 1.
From the Research
Hemorrhoids Visibility and Palpability
- Internal hemorrhoids are typically not visible or palpable on the rectum, but their presence can be assessed through a physical examination and medical history 2.
- The visibility and palpability of hemorrhoids depend on their size, thrombosis, and location, with external hemorrhoids being more likely to be visible and palpable than internal ones 2.
- External hemorrhoids, especially thrombosed ones, can be palpable and visible on the rectum, and excising them can greatly reduce pain if performed within the first two to three days of symptoms 2.
Diagnosis and Examination
- A physical examination and medical history are essential in assessing the presence and severity of hemorrhoids, including their size, location, and degree of prolapse 2.
- The examination should also assess for risk factors and clinical signs indicating more concerning disease processes, such as bleeding, discomfort, and comorbidities 2.
Note on Relevance of Studies
- The study from 1976 3 is not relevant to the question of hemorrhoids visibility and palpability, as it discusses proteinemia in young cattle during nutrition-induced muscular dystrophy.