Hemorrhoid is defined as an enlarged vein in the mucous membrane insideor outside the rectum. Hemorrhoids are usually caused by straining to evacuate hard, drystools. Symptoms include mild to moderate pain, itching, bleeding, and discomfortaggravated by defecation and prolonged sitting or standing. A hemorrhoid covered withrectal mucosa, whether inside the rectum or protruding outside the rectum is an internalhemorrhoid. Internal hemorrhoids frequently are found in patients with severe liverdisease as a result of increased portal hypertension. A hemorrhoid covered with skin is anexternal hemorrhoid.

Acute internal hemorrhoids are only visible if prolapse (i.e., hemorrhoids protrude fromthe anus) occurs. Painless bleeding may be the only symptom, and usually occurs at theend of defecation.

Acute external hemorrhoids appear as bluish, firm varices covered with skin, protrudin garound the anus. Bleeding is present only if the varices rupture.

Anorectal disorders: These are the most common causes of minor rectal bleeding.

• Hemorrhoids: Hemorrhoids are swollen rectal veins in the anal and rectal area. They can cause burning, painful discomfort, and bleeding.
• External hemorrhoids are small swellings that are easy to see and quite painful. Anal itching is common.
• Internal hemorrhoids are usually painless. A rectal mass sensation may be noted with bowel movements.
• Symptoms are brought on by hard stools and straining with bowel movements. Treatment focuses on relieving these symptoms with the use of stool bulking agents and softeners.
• In cases of thrombosed hemorrhoids, a clot forms within the swollen vein. This causes moderate-to-severe pain and requires minor surgery to remove them.

Internal and external hemorrhoids

The position of the hemorrhoid determines the main classification described as either internal or external. Remember that the anus, or anal canal, is the opening, and the rectum is the final portion of the colon, or large intestine, that leads to this opening. Hemorrhoids can occur both above the anal canal (internal) or below the anal canal in the skin around the anus (external). However, they exhibit different symptoms depending on the location.

Although usually painless, there may be some pain associated with internal hemorrhoids if they become thrombosed (develop a blood clot inside) or prolapsed for long periods of time. (A prolapse is the falling down or slipping of a body part from its usual position.) After a bowel movement, rectal bleeding may be noticed. Bright red blood may appear on toilet paper or in the toilet. The stool itself may also appear discolored.

Original image (drugs.com)

External hemorrhoids can be painful if thrombosed, but do not necessarily cause serious problems. The pain usually persists for only a few days. Swelling will usually subside in a few weeks. Hygiene is important when dealing with external hemorrhoids. Fecal matter must be kept from irritating the skin around the anus, which can cause more discomfort and itching.

Whether internal or external, thrombosed hemorrhoids occur when a blood clot forms inside the hemorrhoidal tissue. This is a very painful condition, but it usually resolves itself in a few days.