Hemorrhoids are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed; the unqualified term “hemorrhoid” is often used to refer to the disease.
The signs and symptoms of hemorrhoids depend on the type present. Internal hemorrhoids often result in painless, bright red rectal bleeding when defeating. External hemorrhoids often result in pain and swelling in the area of the anus. If bleeding occurs it is usually darker.
Symptoms frequently get better after a few days. Askin tag may remain after the healing of an external hemorrhoid.
While the exact cause of hemorrhoids remains unknown, a number of factors which increase pressure in the abdomen are believed to be involved. This may include constipation, diarrhea and sitting on the toilet for a long time. Hemorrhoids are also more common during pregnancy.
Diagnosis is made by looking at the area. Many people incorrectly refer to any symptom occurring around the anal area as “hemorrhoids” and serious causes of the symptoms should be ruled out. Colonoscopy is reasonable to confirm the diagnosis and rule out more serious causes.
Often, no specific treatment is needed. Initial measures consist of increasing fiber intake, drinking fluids to maintain hydration, NSAIDs to help with pain, and rest. Medicated creams may be applied to the area to help relieve any of the symptoms. A number of minor procedures may be performed if symptoms are severe or do not improve with conservative management.
External hemorrhoids, if not thrombosed, may cause few problems, but when thrombosed, hemorrhoids may become very painful. Internal hemorrhoids usually present with painless, bright red rectal bleeding during or following a bowel movement.
Other symptoms may include mucous discharge, a perianal mass if they prolapse through the anus, itchiness, and fecal incontinence. Internal hemorrhoids are usually only painful if they become thrombosed or necrotic.