What Are Hemorrhoids?

Do I Have Hemorrhoids?

Internal hemorrhoids can cause many different types of problems, which are discussed below. It is important to remember, though, that there are a number of other conditions that can mimic the symptoms of hemorrhoids. Some examples of these other conditions include anal fissures, fistulas, abscesses, warts, and cancer. Do not ignore anal symptoms no matter how minor or benign they may seem.

Get yourself checked out.

How Do Hemorrhoids Develop?

The final sections of the digestive tract are called the rectum and the anal canal. This is where stool is stored just prior to elimination. Embedded within the wall of the canal are three inflatable areas called anal cushions. These cushions have a very important function. Whenever you put pressure on your abdomen, such as during lifting, straining, or coughing, the anal cushions instantly inflate with blood to form a strong seal that prevents you from leaking stool. With time, repeated inflations at high pressures can cause the anal cushions to stretch out. When this occurs, they are easily irritated and can cause lots of problems. The anal cushions have now become internal hemorrhoids.

Symptoms

Symptoms from internal hemorrhoids can be divided into 2 categories:

  • “Inflammatory” symptoms are due to direct irritation of the tissue.
  • “Mechanical” symptoms are due to the stretching and downward sliding of the tissue.

Inflammatory Symptoms

Pain – when internal hemorrhoids are subjected to chronic irritation, the tissue becomes raw and can cause discomfort.

Bleeding – the raw internal hemorrhoid tissue bleeds easily with continued irritation.

Itching – inflamed internal hemorrhoids sometimes secrete a mucous material that, when deposited on the external skin, can cause itching and burning externally.

Mechanical Symptoms

Pressure – the enlarged internal hemorrhoids can press on the internal sphincter muscle, causing a sensation that feels like you need to move your bowels.

Prolapse – when internal hemorrhoids have stretched considerably, the internal tissue can protrude out of the anus during bowel movements. Sometimes this tissue needs to be pushed back in.

Difficulty with hygiene – the enlarged internal hemorrhoids can keep the internal sphincter muscle propped open after bowel movements. This can cause the so-called “never-ending wipe” that affects so many patients.

Leakage – if the internal sphincter muscle remains propped open, staining of the undergarments with fecal material can occur.

External Hemorrhoids

The presence of external hemorrhoids is usually an indication of too much pressure on the internal hemorrhoid system. When there is too much pressure internally, that pressure is transmitted through a network of veins to the external skin just around the outside of the anus, causing the external skin to stretch and bulge out forming external hemorrhoids. This is similar in concept to squeezing a balloon on one side so that it bulges out on the other side.

The important thing to know about external hemorrhoids is that they generally do not cause any symptoms whatsoever! The pain, bleeding, itching, and difficulty with hygiene are generally due to the internal hemorrhoids, as explained above. An exception to this is when a blood clot forms inside an external hemorrhoid, called a thrombosed external hemorrhoid. This condition is often felt as a firm lump that appears suddenly around the anus which usually causes significant pain and can sometimes bleed.

The good news is that a thrombosed external hemorrhoid will typically resolve on its own, usually feeling much better after about 10 days. Taking frequent baths in plain, very warm water can provide relief for this condition.