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
Yesterday
Higher intake levels of coffee appear to be associated with reduced risk of developing chronic kidney disease, according to data from the Atherosclerosis Risk in Communities Study.
Jairia Dela Cruz, 6 days ago
Taking 10 resting blood pressure (BP) readings daily for 2 days provides a reliable, stable representation of patients’ resting systolic (S)BP and diastolic (D)BP, according to a study. This approach shows that the current home BP monitoring protocol of twice-daily readings for 4–7 days may be trimmed down to just 48 hours.
Pearl Toh, 12 Apr 2018
A smartwatch photoplethysmography coupled with a mobile application using a machine learning algorithm can passively and accurately detect atrial fibrillation (AF) in patients undergoing cardioversion, albeit with less accuracy in ambulatory individuals with self-reported AF, a proof-of-concept study shows.
Pearl Toh, 6 days ago
Impaired endothelial-dependent microvascular reactivity appears to be predictive of albuminuria progression in Asian patients with type 2 diabetes (T2D) who have normal urine albumin levels at baseline, but not in those with microalbuminuria, a prospective longitudinal cohort study suggests.