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
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