hemorrhoids
Hemorrhoids
(PILES)
Medical Author: |Jay W. Marks, MD|Medical Editor: |Thomas P. Sokol, MD, FACS, FASCRS|
- |What are hemorrhoids?|
- |What causes hemorrhoids?|
- |What are the symptoms of hemorrhoids?|
- |How are hemorrhoids diagnosed?|
- |How are hemorrhoids treated?|
- |General measures|
- |Over-the-counter medications for hemorrhoids|
- |Nonoperative procedures for internal hemorrhoids |
- |Surgical procedures|
- |Hemorrhoids At A Glance|
- |Patient Discussions: Hemorrhoids - Effective Treatments|
Featured hemorrhoids patient discussions on effective treatments experienced"I have a huge hemorrhoid as big as two fingers that a doctor treated with silver nitrate to stop the bleeding because it was easily soaking a pad. Now he has referred me to a surgeon. This came on suddenly -- last weekend -- with no warning. Preparation H seems to do no good. " "For my hemorrhoids zinc oxide ointment of 20% helped more than the hemorrhoid cream but I would clean the area with witch hazel and alternate between the cream and the zinc oxide. Mine were really bad and I was worried, but it took about 7-10 days and I was much better. Thanks to this web site. " "My job involves standing for hours, and not much walking between patients. If this is your type of problem, too, try walking, jogging, or pelvic- related exercises like yoga, sit-ups, pelvic lifts, and pushups. " |Read All Comments on Hemorrhoids| »Top Searched Hemorrhoids Terms:|treatment|, |anusol|, pictures|, |bleeding|, |symptoms|, external, |cause|, internal, thrombosed, |surgery|, |home remedies|, |pregnant| Patient Discussions are not a substitute for professional medical advice, or treatment.See the disclaimer at the |bottom of the comments page|. |
What are hemorrhoids?
A precise definition of hemorrhoids does not exist, but they can be described as masses or clumps ("cushions") of tissue within the anal canal that contain blood vessels and the surrounding, supporting tissue made up of muscle and elastic fibers. The anal canal is the last four centimeters through which |stool| passes as it goes from the |rectum| to the outside world. The |anus| is the opening of the anal canal to the outside world.
Although most people think hemorrhoids are abnormal, they are present in everyone. It is only when the hemorrhoidal cushions enlarge that hemorrhoids can cause problems and be considered abnormal or a disease.
Prevalence of hemorrhoids
Although hemorrhoids occur in everyone, they become large and cause problems in only 4% of the general population. Hemorrhoids that cause problems are found equally in men and women, and their prevalence peaks between 45 and 65 years of age.
Anatomy of hemorrhoids
The arteries supplying blood to the anal canal descend into the canal from the rectum above and form a rich network of arteries that communicate with each other around the anal canal. Because of this rich network of arteries, hemorrhoidal blood vessels have a ready supply of arterial blood. This explains why bleeding from hemorrhoids is bright red (arterial blood) rather than dark red (venous blood), and why bleeding from hemorrhoids occasionally can be severe. The blood vessels that supply the hemorrhoidal vessels pass through the supporting tissue of the hemorrhoidal cushions.
The anal veins drain blood away from the anal canal and the hemorrhoids. These veins drain in two directions. The first direction is upwards into the rectum, and the second is downwards beneath the skin surrounding the anus. The dentate line is a line within the anal canal that denotes the transition from anal skin (anoderm) to the lining of the rectum.
Formation of hemorrhoids
If the hemorrhoid originates at the top (rectal side) of the anal canal, it is referred to as an internal hemorrhoid. If it originates at the lower end of the anal canal near the anus, it is referred to as an external hemorrhoid. Technically, the differentiation between internal and external hemorrhoids is made on the basis of whether the hemorrhoid originates above or below the dentate line (internal and external, respectively).
As discussed previously, hemorrhoidal cushions in the upper anal canal are made up of blood vessels and their supporting tissues. There usually are three major hemorrhoidal cushions oriented right |posterior|, right |anterior|, and left | lateral|. During the formation of enlarged internal hemorrhoids, the vessels of the anal cushions swell and the supporting tissues increase in size. The bulging mass of tissue and blood vessels protrudes into the anal canal where it can cause problems. Unlike with internal hemorrhoids, it is not clear how external hemorrhoids form.
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