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The exact definition of hemorrhoids is debatable. They have been defined as masses of tissue within the anal canal and outside the body on the anus. Hemorrhoids have also been defined as swollen and inflamed veins. The anal canal is also known as the rectum. Hemorrhoids are also known as piles. Hemorrhoids are common affecting fifty percent of the population by the age of fifty. Some of the causes of hemorrhoids are increased pressure due to pregnancy and straining while having a bowel movement.

Hemorrhoids Digestive system


Hemorrhoid symptoms depend on whether they are internal or external hemorrhoids.

Internal hemorrhoids cannot be seen or felt. Straining or irritation during a bowel movement may cause slight bleeding. There usually is no pain or discomfort from internal hemorrhoids because there are no pain-sensitive nerve endings in the rectum. Sometimes an internal hemorrhoid is pushed out and becomes painful and irritating. This is called a prolapsed hemorrhoid.

External hemorrhoids are painful. Sometimes blood can accumulate in an external hemorrhoid and form a clot. This is call a hemorrhoidal thrombosis and the symptoms are severe pain, swelling and inflammation. External hemorrhoids can become itchy and bleed when irritated.


External hemorrhoids can be diagnosed by a simple physical exam. Internal hemorrhoids can be diagnosed by a digital rectal exam, but this is not the most reliable method as internal hemorrhoids are usually too soft to be detected. Internal hemorrhoids are usually diagnosed by internally examining the rectum with a anoscope, proctoscope or a sigmoidoscope. It is important to determine if bleeding is caused by internal hemorrhoids as this symptom can be an early sign of colon-rectal cancer.


Hemorrhoids develop from an increase in pressure on the veins in the lower rectum or anal canal. The pressure on the veins can be caused by obesity, pregnancy, childbirth sitting for too long especially on the toilet, standing for too long, constipation with straining or extreme diarrhea. Heredity may play a role in the development of hemorrhoids.


Most patients with hemorrhoids can treat them with over the counter medications and creams.

If the discomfort (itching, swelling and pain) is mild, creams, ointments, and witch hazel soaked pads will provide relief for hemorrhoids. A daily warm bath will also reduce swelling and itchiness. Sometimes, hemorrhoids require surgery or other procedures to remove them.

If a hemorrhoid thrombosis is present (a blood clot in the hemorrhoid), the clot needs to be removed. This provides prompt relief and can be done in the doctor’s office via a small incision. There are a few surgical procedures to remove hemorrhoids. These procedures are rubber band ligation, sclerotherapy, traditional surgery or stapling.

Rubber band ligation is an outpatient procedure in which the physician wraps one or two rubber bands around the base of the hemorrhoid, which is internal. This is a simple method of cutting off the circulation. The hemorrhoid dies off and falls off. Sclerotherapy is a procedure in which a chemical is injected into the hemorrhoid around the blood vessel. This procedure will shrink the hemorrhoid. Traditional surgery to remove hemorrhoids is called a hemorrhoidectomy. The surgery can be performed as an outpatient or inpatient, with general or local anesthesia, depending on the complexity of the case.

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