Hemorrhoids are a common yet often misunderstood medical condition. Many people experience discomfort, itching, or pain in the anal region but remain unsure about the cause. One of the most frequently asked questions is: What does a hemorrhoid look like? Understanding the appearance of hemorrhoids can help individuals identify symptoms early and seek appropriate treatment.
In this in-depth article, we’ll explore what hemorrhoids look like, the types, their causes, symptoms, how they differ from other rectal issues, and what you can do about them. Whether you’re experiencing symptoms yourself or simply seeking knowledge, this guide provides a clear and professional overview.
What Are Hemorrhoids?
Hemorrhoids, also known as piles, are swollen veins located in the lower rectum or around the anus. They are similar to varicose veins and can occur inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids).
They result from increased pressure in the lower rectum due to factors such as:
Straining during bowel movements
Sitting for long periods
Chronic constipation or diarrhea
Obesity
Pregnancy
A low-fiber diet
Understanding what they look like requires knowing their classification and physical features.
Types of Hemorrhoids and Their Appearance
There are four main types of hemorrhoids, each with unique visual and symptomatic characteristics:
1. External Hemorrhoids
Location: Under the skin around the anus.
Appearance:
Small to large lumps or bumps near the anus
Often bluish or purplish due to pooled blood
May appear swollen, inflamed, or tender to the touch
In severe cases, it may resemble a grape-like mass
Can become thrombosed, forming a hard, painful lump
Pain Level: Often painful, especially when sitting, walking, or during bowel movements.
Common Signs:
Itching or irritation
Pain or discomfort
Swelling around the anus
Bleeding
2. Internal Hemorrhoids
Location: Inside the rectum, not visible unless they prolapse.
Appearance:
Typically not visible unless they extend out (prolapse)
If prolapsed, they may appear as moist, pink or red bulges at the anal opening
In advanced cases, prolapsed hemorrhoids may resemble reddish masses protruding from the anus
Pain Level: Usually painless due to the lack of pain-sensitive nerves inside the rectum.
Common Signs:
Painless rectal bleeding (bright red blood on toilet paper or in the toilet bowl)
A feeling of fullness or incomplete evacuation
Mucous discharge
Mild itching or irritation
3. Prolapsed Hemorrhoids
Location: Begin internally but extend outside the anus.
Appearance:
Soft, moist lumps that may be pink, red, or purplish
May be visible during bowel movements, straining, or prolonged sitting
It can often be pushed back inside manually
In severe cases, they remain protruding
Pain Level: Can range from mild discomfort to significant pain if strangulated (when blood flow is restricted).
Common Signs:
A visible bulge during defecation
Leaking feces or mucus
Painful swelling
4. Thrombosed Hemorrhoids
Location: Usually external.
Appearance:
Very hard, swollen, and painful lump
Often dark blue or purple due to blood clot formation
The lump may feel like a pea-sized ball under the skin
Pain Level: Intense pain, particularly during movement or bowel movements.
Common Signs:
Sudden swelling
Severe tenderness
Potential rupture and bleeding if left untreated
How to Identify Hemorrhoids: Symptoms Beyond Appearance
Knowing what hemorrhoids look like is one thing, but identifying them early also depends on other symptoms. These include:
Bright red bleeding during or after bowel movements
Itching or irritation in the anal area
Pain or discomfort, especially while sitting
Swelling or a lump near the anus
Leaking feces or mucus
Sensation of incomplete evacuation
If you notice any of these signs, it’s best to consult a medical professional for a definitive diagnosis.
What Hemorrhoids Are Often Mistaken For
Hemorrhoids can sometimes resemble other conditions. Misdiagnosis is common without medical expertise. Here’s what they’re often mistaken for:
1. Anal Fissures
These are small tears in the anal lining and cause sharp pain during bowel movements. They don’t form lumps like hemorrhoids but can bleed.
2. Skin Tags
These are soft, painless flaps of skin near the anus and are often remnants of a healed external hemorrhoid.
3. Anal Abscesses or Fistulas
Painful lumps filled with pus due to infection. These are more serious and require immediate medical attention.
4. Rectal Prolapse
Part of the rectal wall protrudes through the anus and can resemble a prolapsed hemorrhoid, but it’s a more severe condition requiring surgical treatment.
5. Colon or Rectal Cancer
Persistent rectal bleeding or growths could also indicate something more serious. Any irregular bleeding or lump should be examined by a physician.
How Are Hemorrhoids Diagnosed?
Doctors use a variety of methods to determine whether you’re experiencing hemorrhoids:
Physical examination: Visual inspection for external hemorrhoids
Digital rectal exam (DRE): Finger inserted into the rectum to feel for abnormalities
Anoscopy or proctoscopy: A small tube is inserted to view the internal rectal lining
Sigmoidoscopy or colonoscopy: Recommended if rectal bleeding is unexplained or persistent
Treatment Options for Hemorrhoids
Treatment depends on the severity and type. Common treatments include:
1. Home Remedies
Warm sitz baths (10–15 minutes, several times a day)
Over-the-counter creams (witch hazel, hydrocortisone)
Cold compresses
A high-fiber diet and increased water intake
Avoid straining during bowel movements
2. Medical Procedures
Rubber band ligation (for internal hemorrhoids)
Sclerotherapy (injection to shrink the hemorrhoid)
Infrared coagulation
Hemorrhoidectomy (surgical removal)
Stapled hemorrhoidopexy (for prolapsed hemorrhoids)
Prompt treatment improves comfort and prevents complications such as anemia or strangulation.
Prevention: How to Avoid Developing Hemorrhoids
Prevention is key to avoiding the discomfort of hemorrhoids. Here are some strategies:
Eat a high-fiber diet: Fruits, vegetables, whole grains
Stay hydrated: Drink 6–8 glasses of water daily
Avoid straining during bowel movements
Use the bathroom as soon as the urge arises
Exercise regularly
Avoid prolonged sitting on the toilet
Maintain a healthy weight
Conclusion
So, what does a hemorrhoid look like? In short, it depends on the type. External hemorrhoids appear as swollen, often discolored lumps near the anus. Internal hemorrhoids are less visible but may protrude as pink or red bulges. Prolapsed and thrombosed hemorrhoids are more severe and visible conditions requiring closer attention.
Recognizing the visual and symptomatic cues early can help you manage the condition more effectively. If you’re ever in doubt about what you’re seeing or feeling, don’t rely solely on appearance—consult a healthcare provider for a proper diagnosis and treatment plan.
Frequently Asked Questions (FAQs)
1. Are hemorrhoids always visible?
No. Internal hemorrhoids are often not visible unless they prolapse. External hemorrhoids, however, can typically be seen or felt as lumps around the anus.
2. Can hemorrhoids go away on their own?
Mild hemorrhoids often resolve on their own with lifestyle changes. However, persistent or severe cases may require medical treatment.
3. What color are hemorrhoids?
External hemorrhoids can appear skin-colored, bluish, or purplish. Prolapsed internal hemorrhoids tend to look pink or red.
4. How can I tell the difference between a hemorrhoid and an anal fissure?
Hemorrhoids are swollen veins, often appearing as lumps. Anal fissures are small tears in the skin and usually cause sharp pain during bowel movements but no visible lump.
5. Should I worry if I see blood in the toilet?
While hemorrhoids are a common cause of rectal bleeding, blood in the stool can also signal more serious conditions like colorectal cancer. Always consult a doctor if bleeding persists.
