What are Hemorrhoids?


Introduction

Hemorrhoids are itching, painful, or bleeding masses of swollen tissues and varicose veins located in the anus and rectum. Fortunately, hemorrhoids can be treated easily, and may be prevented in many cases. Since the condition of hemorrhoids almost always tends to get worse over the years, safe, gentle, and effective treatment for hemorrhoids are advocated as soon as they occur. Hemorrhoids bother about 89% of all Americans at some time in their lives. Hemorrhoids caused Napoleon to sit side-saddle, sent President Jimmy Carter to the operating room, and benched baseball star George Brett during the 1980 World Series. Over two thirds of all healthy people reporting for physical examinations have hemorrhoids.

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Pictures: Hemorrhoids and Anal Fissure

Internal hemorrhoids occur higher up in the anal canal, out of sight. Bleeding is the most common symptom of internal hemorrhoids, and often the only one in mild cases.
External hemorrhoids are visible-occurring out side the anus. They are basically skin-covered veins that have ballooned and appear blue. Usually they appear without any symptoms. When inflamed, however, they become red and tender.
Sometimes, internal hemorrhoids will come through the anal opening when straining to move your bowels. This is called a prolapsed internal hemorrhoid; it is often difficult to ease back into the rectum, and is usually quite painful.
When a blood clot forms inside an external hemorrhoid, it often causes Severe pain. This thrombosed external hemorrhoid can be felt as a firm, tender mass in the anal area, about the size of a pea.
Anal fissure. A thin slit-like tear in the anal tissue, an anal fissure is likely to cause itching, pain, and bleeding during a bowel movement. For more detailed information, view our page on Anal Fissure.

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What Are Hemorrhoids?

The term hemorrhoids refers to a condition in which the veins around the anus or lower rectum are swollen and inflamed. Hemorrhoids may result from straining to move stool. Other contributing factors include pregnancy, aging, chronic constipation or diarrhea, and anal intercourse. Hemorrhoids are both inside and above the anus (internal) or under the skin around the anus (external). Hemorrhoids (piles) arise from congestion of internal and/or external venous plexuses around the anal canal.  Hemorrhoids are classified into four degrees, depending on severity, so that they can more easily be evaluated for possible surgery. For more detailed information, view our page Surgical Classification of Hemorrhoids.

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What Are the Symptoms of Hemorrhoids?

Many anorectal problems, including fissures, fistulae, abscesses, or irritation and itching (pruritus ani), have similar symptoms and are incorrectly referred to as hemorrhoids. Hemorrhoids usually are not dangerous or life threatening. Rarely, a patient can have bleeding so severe, that severe anemia or death may occur. In some cases, hemorrhoidal symptoms simply go away within a few days. But in most cases, hemorrhoidal symptoms eventually return, often worse than they were before. Although many people have hemorrhoids, not all experience symptoms. The most common symptom of internal hemorrhoids is bright red blood covering the stool, on toilet paper, or in the toilet bowl. However, an internal hemorrhoid may protrude through the anus outside the body, becoming irritated and painful. This is known as a protruding hemorrhoid. Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms. This condition is known as a thrombosed external hemorrhoid. In addition, excessive straining, rubbing, or cleaning around the anus may cause irritation with bleeding and/or itching, which may produce a vicious cycle of symptoms. Draining mucus may also cause itching.

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How Common Are Hemorrhoids?

Hemorrhoids are very common in both men and women. About half of the population have hemorrhoids by age 50. Hemorrhoids are also common among pregnant women. The pressure of the fetus in the abdomen, as well as hormonal changes, cause the hemorrhoidal vessels to enlarge. These vessels are also placed under severe pressure during childbirth. For most women, however, hemorrhoids caused by pregnancy are a temporary problem.

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How Are Hemorrhoids Prevented?

The best way to prevent hemorrhoids is to keep stools soft so they pass easily, thus decreasing pressure, and to empty bowels without undue straining as soon as possible after the urge occurs. Exercise, including walking, and eating a high fiber diet, help reduce constipation and straining by producing stools that are softer and easier to pass.

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See diagnosis and treatment for hemorrhoids.