WHAT IS IT?
Internal hemorrhoids are dilated hemorrhoidal veins (superior hepmorroidal veins) in the submucosal layer of the rectum. They are found above the dentate line and receive visceral innervation and are therefore not painful. Constipation/straining during defecation contributes to their formation.
WHY IS IT A PROBLEM?
While not painful, internal hemorrhoids can bleed.
WHAT MAKES US SUSPECT IT?
Risk factors: liver cirrhosis
Blood in the stool can be present (typically not associated with pain).
Rectal exam can not reveal the presence of internal hemorrhoids (they can not be visualized or palpated).
HOW DO WE CONFIRM A DIAGNOSIS?
Anoscopy is required to visualize and diagnose internal hemorrhoids.
HOW DO WE RULE OTHER DIAGNOSES OUT?
Lack of pain suggests internal hemorrhoids and this can be confirmed on anoscopy.
HOW DO WE TREAT IT?
Stool softeners can reduce straining during defecation
High fiber diet can reduce straining during defecation
Band ligation can be a surgical treatment option for internal hemorrhoids.
HOW WELL DO THE PATIENTS DO?
Patients often do quite well given that this condition is not life threatening or painful.
WAS THERE A WAY TO PREVENT IT?
Avoiding excessive straining during defecation might help prevent this condition from occurring.
WHAT ELSE ARE WE WORRIED ABOUT?
Prolapse: internal hemorrhoids can prolapse and then become palpable on physical exam.
OTHER HY FACTS?
External hemorrhoids are painful and an internal hemorrhoid is painless (generally speaking)
Page Updated: 05.23.2016