Hemorroids - External

Also Known As: Hemorroids - External, Hemorroids

Hemorrhoids (US English) or haemorrhoids, are vascular structures in the anal canal which help with stool control. They become pathological or piles when swollen or inflamed. In their physiological state they act as a cushion composed of arterio-venous channels and connective tissue that aid the passage of stool. The symptoms of pathological hemorrhoids depend on the type present. Internal hemorrhoids usually present with painless rectal bleeding while external hemorrhoids present with pain in the area of the anus.

Recommended treatment consists of increasing fiber intake, oral fluids to maintain hydration, NSAID analgesics, sitz baths, and rest. Surgery is reserved for those who fail to improve following these measures.

External hemorroids are on the outside of the anus and are visable on direct visualization.

External hemorrhoids are those that occur below the dentate or pectinate line. They may actually be concealed from view however. Specifically, they are varicosities of the veins draining the territory of the inferior rectal arteries, which are branches of the internal pudendal artery. They are sometimes painful, and often accompanied by swelling and irritation. Itching, although often thought to be a symptom of external hemorrhoids, is more commonly due to skin irritation. The skin irritation may be brought about by the inflammation of the external hemorrhoid which in turn leads to a barely noticeable watery discharge and skin irritation. External hemorrhoids are prone to thrombosis: if the vein ruptures and/or a blood clot develops, the hemorrhoid becomes a thrombosed hemorrhoid.[11]

The hallmark for external hemorrhoid thrombosis is significant pain in a previously non-painful hemorrhoid.


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