① Hematochezia: Painless, intermittent, bright red blood after the stool is its characteristics, and it is also a common symptom of internal hemorrhoids or mixed hemorrhoids in the early stage. Blood in the stool is mostly caused by fecal rubbing of the mucosa or excessive force of defecation, causing rupture and bleeding of dilated blood vessels. The mild cases usually have blood in the stool or stool, followed by dripping blood, the severe cases are jet-like bleeding, and the blood in the stool can often stop on its own after a few days. This has important implications for diagnosis. Constipation, hard stools, drinking alcohol and eating irritating foods are all triggers for bleeding. If bleeding is repeated for a long time, anemia may occur, which is not uncommon in clinical practice and should be differentiated from bleeding disorders.
② Hemorrhoids prolapse: It is often a late-stage symptom, usually with blood in the stool and then prolapse. Due to the enlargement of the hemorrhoids in the late stage, it gradually separates from the muscle layer and is pushed out of the anus during defecation. Mild cases only prolapse during defecation, and can recover on their own after defecation. In severe cases, it needs to be pushed back by hand. In more severe cases, prolapse out of the anus with a little abdominal pressure, or even coughing, walking, etc. Able to escape, difficult to recover, unable to participate in labor. A few patients complain that prolapse is the first symptom.
③Pain: Simple internal hemorrhoids have no pain, and a few have a feeling of falling and bulging. When internal hemorrhoids or mixed hemorrhoids are incarcerated, edema, infection, and necrosis appear, there will be varying degrees of pain (Figure 4).
④ Itching: Late internal hemorrhoids, prolapse of hemorrhoids, and anal sphincter relaxation, often secretion flows out, due to secretion stimulation, there are often itching and discomfort around the anus, and even skin eczema, the patient is extremely unwell.