Hemorrhoids

Hemorrhoidal disease

“…The term “hemorrhoids” is often used to describe anal pathology when, in fact, hemorrhoids are normal vascular structures of the anorectal anatomy 1. Hemorrhoids are vascular cushions that contain submucosal connective tissue, blood vessels, smooth muscle, and nerves that control the opening and closure of the internal and external anal sphincters.…”

“…Hemorrhoids are vascular cushions that contain submucosal connective tissue, blood vessels, smooth muscle, and nerves that control the opening and closure of the internal and external anal sphincters. They also help determine the difference between gas or stool in the rectum to maintain fecal continence 1,2. Arterial supply to hemorrhoids occurs through the superior, middle, and inferior rectal arteries also known as the hemorrhoidal arteries.…”

“…Approximately 40% of patients with HD are asymptomatic 1. Rectal bleeding, pain, and hemorrhoidal prolapse are the most common signs and symptoms of HD, especially when there is an increase in intra-abdominal pressure during defecation 1-3…”

“…HD may produce pruritus and severe pain described as burning, stinging, aching, soreness, tenderness, and sensitivity 1,5. Previously swollen external hemorrhoids may shrink and leave very small, dangly skin tags that pose no harm 1. Patients may also have a combination of internal and external HD 1.…”

“…Bloody stool with mucus may indicate malignancy or inflammatory bowel disease 2,6. Anal cancer, anal fistula, anal fissure, anal condyloma (warts), polyps, and proctitis should also be considered 1,6. Patients with portal hypertension secondary to cirrhosis of the liver may have dilated rectal veins, known as rectal varices, that may be confused with internal HD 1,2,7…”