Anal itching is a common symptom of hemorrhoids, but initial relief of the itching does not necessarily mean the problem goes away. It comes and goes, and it gets worse when hemorrhoids flare up. Continuous scratching or excessive cleaning of the anal area may further harm the sensitive tissues and worsen the symptoms.
Although anal pain is a common sign of anorectal disease, internal hemorrhoids are usually not painful due to being located above the dentate line of the rectum. Hemorrhoid patients may have mild aching pain and discomfort when hemorrhoids flare up. The pain could be more severe when complications develop, such as thrombosis, infection and sphincter spasm (Proctalgia Fugax).
Hemorrhoids are probably the most common reason for having a rectal lump. It can be caused by internal hemorrhoids, but more commonly by external hemorrhoids. If a rectal lump is related to internal hemorrhoids, it usually gets bigger and more prolapsed right after the bowel movement; it could be spontaneously reduced in the early stage of internal hemorrhoids. But it could be non-reducible in the late stage of hemorrhoids. It may be associated with other symptoms such as bleeding, itch or pain. The thrombosed external hemorrhoids usually have very painful lump.
Rectal bleeding is the most common symptom of hemorrhoids. The severity of rectal bleeding varies widely. Besides hemorrhoids, many other conditions also cause rectal bleeding, including ruptured thrombosed external hemorrhoids, fissures, diverticulosis, colon cancer, colitis, polyps and angiodysplasias, however even the slightest amount of bleeding should be taken seriously.