The left eye is looking at the cell phone’s consultation page, and the right eye is glancing at the eye-catching blood in the toilet bowl. The answers on the cell phone are varied and confusing; the blood in the toilet bowl is shocking to the eye and makes you feel uneasy. So is this hemorrhoids? When you suspect you have hemorrhoids and can’t go to the doctor right away, how do you make an initial judgment on yourself? Look at the symptoms! Here are the typical symptoms of hemorrhoids and the performance of different kinds of hemorrhoids, you can judge against. The 5 typical symptoms of hemorrhoids, after reading the heart blood in the stool: color bright red, hand paper with blood or drip blood, ejaculation of blood. Prolapse: hemorrhoidal nucleus prolapse when stool, there is a sense of foreign body prolapse, serious cases can not be returned. Pain: internal hemorrhoids painless, when the internal hemorrhoids prolapse outside the anus there is pain, embedded when the pain is aggravated. Perianal itching: anal secretion overflow, stimulate perianal skin, cause itching. Constipation: Habitual constipation due to the fear of blood in stool and artificial control of bowel movement. Prolapse, blood in stool symptoms schematic diagram Internal hemorrhoids, external hemorrhoids, mixed hemorrhoids, what are the symptoms of each? The main clinical manifestations of internal hemorrhoids are bleeding and prolapse, while intermittent fresh blood after stool is a common symptom of internal hemorrhoids. There are 3 forms of bleeding, including anal blood dripping during defecation, spraying blood, only seeing blood on the feces, bright red in color, long-term bleeding can be secondary to anemia. No thrombosis, embedded, infection when the internal hemorrhoids without pain, some patients may be accompanied by defecation difficulties. Hemorrhoids can be larger with the stool out, initially can be self-retracted, over time will be embedded, such as shrinking back or thrombosis, it is easy to infection and inflammation, so that the anal sphincter spasm, swelling, severe pain, ulceration or necrosis. If too much secretion often out of the anus, irritating the skin and itching. Anal microscopy can be seen above the dentate line there are one or more purplish red mucous membrane elevation, heavy can be strung into a ring, called ring hemorrhoid. The main clinical manifestations of external hemorrhoids are anal swelling, pain, and foreign body sensation. Connective tissue external hemorrhoids (dermatomes) and inflammatory external hemorrhoids are common, and when inflammation is formed, there is secretion oozing and itching sensation. After rest, anal hot compresses, warm water bath, can reduce the pain. If acute thrombosis occurs, it can be accompanied by anal swelling, severe pain, dark purple lumps can be seen on the anal edge, called thrombosed external hemorrhoids, the degree of pain and the size of the thrombus and the relationship with the anal sphincter. Mixed hemorrhoids manifested as internal hemorrhoids and external hemorrhoids symptoms can exist at the same time, internal hemorrhoids developed to more than Ⅲ degree when the formation of mixed hemorrhoids. Mixed hemorrhoids gradually aggravated, was ring-like out of the anus, out of the hemorrhoid block in the perianal area in the plum or ring-shaped, known as ring-shaped hemorrhoids. If the prolapsed hemorrhoids are embedded by the spastic sphincter, and cannot be effectively returned to the anus, so that edema, bruising or even necrosis, clinically known as embedded hemorrhoids or strangulated hemorrhoids. References [1] Chen Xiaoping, Wang Jianping, Zhao Jizong, eds. Surgery (9th ed.). Beijing:People’s Health Publishing House,2018:404-405. [2]Jin Zhao,Jin Chun,Wang Chen,editors-in-chief;Guo Xutian,Liang Hongtao,Chen Zhiye,associate editors;Lu Jingen,Cao Yongqing,reviewer. Minimally invasive surgical techniques for hemorrhoids and anal fistulas [M]. Shanghai:Shanghai Science and Technology Press,2016(06):27.