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Friday, July 24, 2009

What Are Hemorrhoids?

Posted by patrick

By Richard Hill

Hemorrhoid or hemorrhoids, refers to a condition where there is a presence of masses of dilated blood vessel underneath the lining of the skin in the anal canal or rectum. Studies have documented that the inflamed mass is actually composed of spongy vascular tissue with several direct arteriovenous connections. Hippocrates coined the term hemorrhoids from the Greek words hema meaning blood and rhoos meaning flowing.

Men and women alike can have hemorrhoids; these are extremely common occurrences and in fact more than 50% of the population has them by the time they reach 50 years of age. Hemorrhoids have traditionally been thought of as varicose veins of the anus or rectum, or as "varicosities" of hemorrhoidal tissue.

Hemorrhoids have been around since the beginning of mankind, and although their origin isn't specifically known, they began, possibly, when we were first upright. During the Middle Ages, hemorrhoids were called St. Fiacre's curse; St. Fiacre is the gardeners' patron saint, and he contracted a horrible case of prolapsed hemorrhoids after he had spent the day laboring in his garden.

Hemorrhoids are usually classified as two different types, external and internal. If hemorrhoids are external, they are below the anal sphincter, and if they are internal, they are above the anal sphincter. Typically, hemorrhoids are chronic for people, although they may also be acute.

The first form, internal hemorrhoids, can be found within the right posterior, right anterior and left lateral positions inside the anal canal. The position of hemorrhoids within the anal canal however remains remarkably consistent. Internal hemorrhoids are generally not painful and most people are not conscious that they are inflicted since the area lacks pain receptors. When irritated however, may bleed. If not detected and treated at once, it may lead to severe forms such as strangulated and prolapsed hemorrhoid.

The second form, external hemorrhoids, occurs outside the anal verge. Occasionally, it is painful, and can be experienced with swelling and irritation. Although itching occurs, it is not a symptom of hemorrhoid but is usually due to skin irritation. If the dilated vein ruptures and/or develops a blood clot, it will be termed as thrombosed hemorrhoid (most often occurs on external hemorrhoids).

Hemorrhoids are classified by history rather than by physical examination. Grade I hemorrhoids bleed but are not prolapsed; Grade II hemorrhoids prolapse and undergo spontaneous reduction. Grade IIIs prolapse and undergo manual reduction, and Grade IVs prolapse irreducibly. These classifications have been around for many years and correspond quite well to treatment algorithms. Quite often, Grades I and II can be treated without surgery, while Grades III and IV will probably require surgery.

Often times, women may experience hemorrhoids during their first pregnancy, in the last trimester. The causes for this are not clearly known, but it may be as a result of venous return impediment by the gravid uterus, chronic straining, and/or hormonal changes. Again, the real cause isn't known, but usually, once women have given birth, these hemorrhoidal symptoms go away. In some cases, a form of surgery called a hemorrhoidectomy may be necessary, and can be performed safely, with little risk of death to the mother and with little danger to the fetus.

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