hemoroid

Hemorrhoids are swollen veins in the lower rectum and anus. They form part of the normal vascular cushions that help control bowel continence, but when they enlarge or protrude they are referred to as hemorrhoidal disease. Hemorrhoids can be classified as internal, located inside the rectum, or external, under the skin around the anus.

Internal hemorrhoids lie above the dentate line and may prolapse through the anus. External hemorrhoids occur below the dentate line and are more likely to be painful, especially if a blood clot forms. Symptoms vary and can include bright red blood on toilet paper or in stool, itching or irritation around the anus, a lump that may protrude or be felt at the anal verge, and pain if there is thrombosis or prolapse.

Risk factors and causes include increased pressure on the rectal veins from straining during bowel movements, constipation or prolonged diarrhea, sitting for long periods, pregnancy, obesity, aging, and a low-fiber diet. A history of recurring constipation, heavy lifting, or a family tendency can also contribute.

Diagnosis is typically based on medical history and physical examination, including visual inspection and a digital rectal exam. In some cases, anoscopy, proctoscopy, or other endoscopic tests are used to evaluate internal hemorrhoids and exclude other conditions such as fissures, infections, or colorectal disease.

Treatment focuses on symptom relief and underlying causes. Many cases improve with conservative measures: a high-fiber diet with adequate fluids, regular exercise, avoiding prolonged straining, and sitz baths. Over-the-counter topical treatments and mild analgesics may help. For persistent or symptomatic hemorrhoids, procedures such as rubber band ligation, sclerotherapy, infrared coagulation, or surgical hemorrhoidectomy or stapled hemorrhoidopexy may be recommended. Prevention centers on maintaining soft stools and healthy bowel habits. Seek medical care for heavy bleeding, severe pain, a lump that persists after reduction, fever, or any concern for a more serious condition.