hemorrhoids
HEMORRHOIDS
Hemorrhoids are swollen and inflamed vascular structures or veins around the anus or in the lower rectum.
External hemorrhoids are located closer to the anal verge and are covered with squamous epithelium. It produces symptoms only when thrombosed or when they give rise to large skin tags which make hygiene difficult. Common symptoms are anal pain of acute onset and a palpable lump in the perianal area.
Internal hemorrhoids originate above the dentate line and are covered with rectal or transitional mucosa. It does not cause cutaneous pain. Prolapse of internal hemorrhoids may cause bleeding, mucus discharge, fecal soiling and anal pruritus.

Definition

External vs Internal Hemorrhoids

  • If hemorrhoids are present, differentiate between external and internal hemorrhoids
  • Hemorrhoids are classified according to their location relative to the dentate line

External Hemorrhoids

  • Located closer to the anal verge and are covered with squamous epithelium
  • Produce symptoms only when thrombosed or when they give rise to large skin tags which make hygiene difficult
  • Common symptoms are anal pain of acute onset and a palpable lump in the perianal area

Internal Hemorrhoids

  • Originate above the dentate line and are covered with rectal or transitional mucosa
  • Do not cause cutaneous pain
  • Prolapse of internal hemorrhoids may cause bleeding, mucus discharge, fecal soiling and anal pruritus

Signs and Symptoms

  • Rectal bleeding
    • Most common presenting symptom
    • Bright red blood which may drip or squirt into the toilet bowl or scanty amounts may be seen on toilet tissue
  • Discomfort due to rectal protrusion or lump
  • Anal pain
  • Anal itching
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Gastroenterology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Pearl Toh, Yesterday
Every-two-month injections of the long-acting cabotegravir + rilpivirine were noninferior to once-monthly injections for virologic suppression at 48 weeks in people living with HIV*, according to the ATLAS-2M** study presented at CROI 2020 — thus providing a potential option with more convenient dosing.
Stephen Padilla, 19 Mar 2020
The assumption that children are less vulnerable to the coronavirus disease 2019 (COVID-19) compared to adults is not quite true and may even be dangerous, suggests a recent study.
6 days ago
Sustained use of lopinavir-combined regimen appears to confer benefits among patients with the novel coronavirus disease (COVID-19), with improvement possibly indicated by increasing eosinophils, suggests a recent study.
4 days ago
COVID-19 is a novel disease, with no existing immunity. The virus can be transmitted from person to person, quickly and exponentially. Here’s what we can do to slow down the spread, if not contain the outbreak.