Oftentimes they are not noticeable, the anal canal has less nerves in the inside and therefore pain wont be present immediately.
First visible symptoms may include bright red blood in the stool. This can be seen on the toilet paper, the water of the toilet bowl or streaks on the side of your stool.
The doctor may examine your anal canal with a finger to find hemorrhoids higher in the rectum or insert an anoscope, making sure you do not have a more serious conditions like polyps or cancer.
The further the anal cushion of the internal hemorrhoids enlarge the more they are bulging into the anal canal.
Constant constipation can cause the tissue to be detached from its original anchor and protrude from the anus. This condition is called prolapsed internal hemorrhoid.
Within the anal canal the hemorrhoid is unprotected from an upcoming bowl movement. The particular hardness of a constipated stool, can open the skin layers and cause bleeding. The constant moisture can cause irritation, itching and may be associated with pain in some cases.
With increased straining the prolapsed soft tissue can eventually be pushed outside of the anus, where it can be felt as a saggy fleshy tag.
In most cases the hemorrhoid will retract by itself after the bowl movement or can be pushed back in with a finger. Very seldom they will remain outside and cant be returned into the rectum.
Internal hemorrhoids can also remain within the anal canal, were increasing pressure can leave them inflamed and swollen, causing the veins to strangle and thrombose. This can become a very painful and vicious cycle. The pain will increase the cramping of the anal muscles, thereby inflicting pressure and sharp stabbing episodes of agony.
The swollen veins have less chance to recuperate as they remain inflamed, in very rare cases only an emergency surgery can bring release.
If you have internal hemorrhoids it is very important that you reduce the inflammation as soon as possible, thereby promoting blood being able to transport to and from the vessel.
This can be accomplished by avoiding certain foods, known to cause inflammation, as well as the application of anti inflammatory remedies. Be very careful with prescription drugs, as they are often have the site effect of causing constipation.