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Hemorrhoids

Hemorrhoids are dilated veins located beneath the lining of the anal canal. Internal hemorrhoids are located in the upper anal canal. External hemorrhoids are located in the lower anal canal.

Internal hemorrhoids become symptomatic when constipation causes disruption of the supporting tissues and resultant prolapse of the dilated anal veins. The most common symptom of internal hemorrhoids is painless rectal bleeding, which is usually bright red and ranges from a few drops to a spattering stream at the end of defecation. If internal hemorrhoids remain prolapsed, a dull aching may occur. Blood and mucus stains may appear on underwear, and itching in the perianal region is common in hemroids.

Management of internal hemorrhoids

Grade 1 and uncomplicated grade 2 hemorrhoids are treated with avoidance of nonsteroidal anti-inflammatory drugs.

Symptomatic grade 2 and grade 3 hemorrhoids. Treatment consists of hemorrhoid banding with an anoscope.

Grade 4 hemorrhoids require surgical hemorrhoidectomy.

External Hemorrhoids

External hemorrhoids occur most often in young and middle-aged adults, becoming symptomatic only when they become thrombosed.

External hemorrhoids are characterized by rapid onset of constant burning or throbbing pain, accompanying a new rectal lump.

Treatment