The Four Stages of Hemorrhoids

Although sometimes embarrassing, hemorrhoids are quite common. Statistics indicate that one in every two people has had hemorrhoids at least once in their lifetime. Both men and women are affected by hemorrhoids.

There are two types of hemorrhoids; internal and external. Internal hemorrhoids, as the name suggests, occur within the anal canal and rectum. External hemorrhoids are under the skin, near the anal opening on the outside of the anal canal.

Hemorrhoids are not serious and not life-threatening unless left untreated for a prolonged period of time, at which point other complications might develop.

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What Are Hemorrhoids and How Do They Form?

Hemorrhoids are swollen and inflamed veins of the anus and lower part of the rectum. When pressure is applied to these veins, they tend to stretch and eventually swell or bulge; thus, becoming a hemorrhoid. This pressure could be caused due to constipation, sitting for long periods of time, pregnancy, poor diet, and lack of physical activity. Obesity is another common risk factor for hemorrhoids.

Hemorrhoids are classified into four stages or grades, depending on the severity of the condition or the stage of development.

Symptoms of Hemorrhoids

Some of the symptoms of hemorrhoids include:

• Blood in the stools
• Bleeding from the anal canal
• Mucus in the stools
• Itching
• Burning sensation
• Pain in the anal area
• Painful swelling around the anus
• A hard lump around the anus
• Anal abscesses
• Feeling full

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Knowing the stage of your condition is important since this decides the treatment procedure of your hemorrhoids. 

The Four Stages

Grade 1

This is the earliest stage of the disorder and necessary lifestyle changes should be made in order to alleviate symptoms. At this stage, the internal hemorrhoid is still inside the anal cavity or above the pectinate line. The swellings have also not protruded, meaning there are no signs and symptoms of the hemorrhoids.

In some cases, the hemorrhoids can even be confused for anal fissures. Usually, one does not experience pain at this stage. However, sometimes, the person may experience some discomfort and itchiness. This is normally very mild. The person may also bleed.

Sometimes this stage of hemorrhoids bulge into the anal canal during a bowel movement.

Grade 2

At this stage, the hemorrhoids have begun to weaken and prolapsed hemorrhoids begin to develop. The collapse of the hemorrhoid tissues causes them to start hanging out the anus; thus, leading to irritation and pain. This is, however, reversible. Unlike more severe stages, the prolapsed hemorrhoids will reverse back into the anus without any effort from the patient. At this stage, bleeding is also quite common.

Prolapse of these hemorrhoids normally occurs after using the toilet.

Because patients have more noticeable symptoms at this stage, it is easier to identify that one is suffering from the condition. Diet and lifestyle modifications at this stage could be very effective in preventing the need for medical intervention later on.

Grade 3

Grade 3 is similar to grade 2 hemorrhoids; however, at grade 3, the hemorrhoids do not reverse back to their position in the anal canal on their own. Instead, they have to be manually pushed back into the anus.

Grade 3 hemorrhoids cause even greater discomfort than grade 2 hemorrhoids and may even bleed. While these hemorrhoids should not be cause for alarm, it is still recommended that individuals suffering from grade 3 hemorrhoids seek medical help at the earliest.

Grade 4

Grade 4 hemorrhoids, also known as protruding hemorrhoids, hang outside of the anus and bleed. Protruding hemorrhoids cause a great deal of discomfort and pain.

Since the hemorrhoids will usually become open wounds at this stage, they can also cause infections. Since the hemorrhoids cannot be reversed back into the anus, they can get strangulated when the sphincter muscles of the buttocks constrict on the hemorrhoids. This causes great pain to the patient and can even lead to thrombosis.

At stage 3 and stage 4, the patient experiences great pain and will require constant treatment to get through this pain. Stage 4 often requires surgical intervention or laser coagulation. It is advisable not to allow the condition to progress to this stage due to other complications that could occur as mentioned above.

How to Prevent Hemorrhoids

• Eating a high-fiber diet: Eating more vegetables, fruits, and whole grains can help soften stools, which will help you avoid the straining that causes hemorrhoids to develop. It is recommended to incorporate fiber into your daily diet slowly so as to avoid issues with gas.
• Drink sufficient fluids: Drinking 6-8 glasses of water and other liquids daily can help maintain softer stools.
• Try fiber supplements: Fiber supplements, such as Citrucel and Metamucil, can improve the overall symptoms caused by hemorrhoids. When using fiber supplements, ensure that you consume at least 8 glasses of water or other fluids each day.
• Avoid straining: Straining or holding your breath while attempting to pass a stool can create greater pressure in the veins of the lower rectum.
• Exercise: Staying active can help prevent constipation and reduce unwanted pressure on the veins.
• Avoid sitting for extended periods: Sitting for an extended period, especially on the toilet, can place increased pressure on the veins of the anus.  

The Bottom Line

Hemorrhoids cause a great deal of pain and discomfort. Educating oneself about the different stages of this condition is necessary since it can help patients understand what treatment procedures are needed.

It is always best to prevent the condition if possible rather than treat it. Eating a diet that is high in fiber can improve digestion and help lead to less strain on the anus and rectum; thus, preventing the development of hemorrhoids.

Since another main culprit in the development of hemorrhoids is pressure in the lower abdomen, it is recommended that individuals avoid sitting or standing for extended periods of time. If an individual’s hemorrhoids are the result of being overweight, a simple diet and exercise routine that would help in weight loss, and improve digestion, would be invaluable to getting rid of hemorrhoids and preventing any recurrence of the condition. When experiencing a hemorrhoid, of any grade, it is advisable to avoid excessive straining while passing stools. It is also recommended that patients avoid rubbing the area harshly or scratching the entrance of the anus. Doing so would only serve to worsen the condition.

Remember, hemorrhoids are preventable, treatable, and nothing to be embarrassed about. It is a common condition that effects many people.