Hemorrhoids: What are they?

The anatomical term for hemorrhoids is “cushions of tissue filled with blood vessels at the junction of the rectum and the anus.”

Constant pressure on the walls of the rectum weakens the muscles that support the blood vessels that line the anus. When they become enlarged and lose their support, the problem develops into a sac-like protrusion inside the rectal canal (called internal hemorrhoids) or under the skin around the anus (called external hemorrhoids).

Internal hemorrhoids and external hemorrhoids
There are two types of hemorrhoids - internal hemorrhoids and external hemorrhoids.

Internal hemorrhoids occur when our internal veins become swollen. Unless the condition is severe, internal hemorrhoids cannot be seen or felt.

External hemorrhoids occur when our external veins and blood vessels around the anus swell-up. External hemorrhoids can be seen around the outside of the anus and unlike internal hemorrhoids - they are sensitive and cause discomfort.

If the internal hemorrhoid pushes out of the anal opening, this condition is called a prolapsed hemorrhoid. Sometimes, blood can pool in an external hemorrhoid, forming a clot or thrombus, this condition is called a thrombosed hemorrhoid.

Internal hemorrhoids degrees of prolepses
In order to assist with internal hemorrhoids treatment, a grading system has been defined depending on the extent of the hemorrhoids descent into the anal canal and out of the anus. The first and second degree internal hemorrhoids can only be seen with a professional proctoscope examination.

  • Internal hemorrhoids grade I: hemorrhoids are enlarged; however, they never prolapse and rarely produce symptomatology.
  • Internal hemorrhoids grade II: hemorrhoids prolapse with defecation but they return to their original position spontaneously.
  • Internal hemorrhoids grade III: hemorrhoids prolapse upon defecation and even with physical effort, requiring manual replacement back to their point of origin.
  • Internal hemorrhoids grade IV: hemorrhoids are permanently prolapsed regardless of any attempts to replace them at their original position.

    • Now that we know what hemorrhoids are and how to diagnose internal and external hemorrhoids, I hope I helped you feel not as alone as you thought you were. On my next article I will answer the question: What are the symptoms of hemorrhoids?