Hemorrhoids:
Internal, External, Prolapsed, and Thrombosed
The good news is that, for most of us, hemorrhoids will never develop into a problem requiring surgery. But that doesn't mean they aren't a painful nuisance. To prevent hemorrhoids from becoming a major intruder into our lives, we need to learn the things we do to make them welcome in the first place. Never was it more true that knowledge is power than when dealing with hemorrhoids. By understanding how they form in our body, we can take the right steps to prevent hemorrhoids and make them a distant memeory.
We begin with the basics. (WARNING: The picture below is of a real hemorrhoid.)
What Are Hemorrhoids?
The Symptoms of Hemorrhoids
What About the Bleeding?
Who Gets Hemorrhoids?
What Are Hemorrhoids?
Hemorrhoids, sometimes referred to as piles, are swollen and inflamed varicose veins found inside the rectum and outside the anus (which is the opening at the end of the rectum that lets you empty your bowels). These veins have become stretched and weakened, often after repeated straining while sitting on the toilet.After repeated straining and stretching, the veins lose their elasticity. So blood, rather than flowing smoothly through these veins, collects there, gorges, and balloons. Interestingly, the term hemorrhoids is from a Greek word that means "flowing blood." It's from the same family as the term hemorrhage.
When hemorrhoids are cured, this trapped blood is freed to flow once again and is reabsorbed into the bloodstream.
Left untreated, in severe cases, the veins continue to gorge with trapped blood and the hemorrhoids can grow to the size of golf balls.
Hemorrhoids can be internal or external:
- Internal hemorrhoids lie inside the rectum and are covered by a mucous membrane. You can't see or feel these hemorrhoids (although doctors often can during an examination). Internal hemorrhoids usually don't cause discomfort, but they may still bleed. Generally, you can't see internal hemorrhoids unless they drop below the anal canal. Internal hemorrhoids that have "protruded" through the anus outside the body are called protruding hemorrhoids.
- External hemorrhoids These are the ones we can feel and often call "piles." External hemorrhoids lie outside the anal canal and are covered by skin. Because they have many more nerve endings than internal hemorrhoids, they can bleed heavily and be very painful. The pain in external hemorrhoids often results from blood clots. A hemorrhoid that has developed blood clots is known as a thrombosed external hemorrhoid, because it is in a state of thrombosis.
This is a diagram of both types of hemorrhoids:
This is a picture of a thrombosed external hemorrhoid:
Top of the page
The Symptoms Of Hemorrhoids
Symptoms include itching, burning, and, sometimes, bleeding accompanied by a lot of pain. In most cases, hemorrhoidal symptoms will go away within a few days if you relieve constipation and stop straining on the toilet.Top of the page
What About The Bleeding?
The bleeding is often the result of a hard bowel movement that bursts one of these sensitive, protruding veins. The blood on your toilet paper after wiping yourself may be the first time you realize you have a problem. It's important to know when bleeding hemorrhoids are a signal that it's time to see the doctor.Doctors classify hemorrhoids based on their severity. To judge this, they look at whether they can be seen outside the anus and whether they bleed. Even the least severe, or Grade I, hemorrhoids can bleed.
The system used by most doctors recognizes four grades of hemorrhoids. Each type is larger and more severe than the previous one:
Grade I. Hemorrhoids bleed, but they have not dropped outside the anus, where they can be seen (called "prolapsed").
Grade II. Hemorrhoids may prolapse with straining during attempted bowel movements, but they return to their normal position, inside the anus, on their own once the straining stops.
Grade III. Hemorrhoids prolapse with straining or by themselves, but you can push them back inside your anus (out of sight) with your fingers.
Grade IV. Hemorrhoids protrude with straining or by themselves, but they cannot be pushed back in manually. They drop outside the anus and stay out. Often, these are thrombosed hemorrhoids (engorged because of a blood clot) and are very painful.
Top of the page
Who Gets Hemorrhoids Most Often?
Studies tell us that 4 out of 5 of us will at some point develop hemorrhoids, so it's important to know what to do to prevent or cure them. Who gets hemorrhoids?- Young and middle-aged people get external hemorrhoids
- Ages 45-65 get hemorrhoids more frequently than the general population
- Higher earners
- Pregnant women
- Whites more than nonwhites
- Rural dwellers more than city folks
- Men and women equally
- Those with a family history
What Are Hemorrhoids?
The Symptoms of Hemorrhoids
What About the Bleeding?
Who Gets Hemorrhoids?
Top of the page
