Hemorrhoids Information

Introduction

What are hemorrhoids?

Hemorrhoids are masses (cushions) of tissue in the anal canal that contain blood vessels and surrounding supporting tissue made up of muscle and connective fibers. (The anal canal is the last 1.5 inches through which the stool passes as it goes from the rectum to the exterior of the anus.)

While we normally only speak of hemorrhoids as a disease, they are in fact quite normal. Everyone has hemorrhoids from the time they are born until they die. It is only when the hemorrhoidal tissues enlarge and cause problems that we begin to speak of them as a disease.

Healthy hemorrhoids are the network of tissues that make bowel movements possible. These vascular masses extend into the rectal canal and prevent stool from escaping between bowel movements. Tissue surrounding the anus fills with blood to help initiate bowel movements. Downward pressure during defecation presses them back against the walls of the rectum, allowing the stool to escape. Excessive pressure causes the veins in this tissue to swell. The swollen veins will eventually stretch the surrounding tissue and the fibers that anchor the hemorrhoidal cushions to the rectum will fail.

Enlarged hemorrhoids are a condition in which the veins around the anus and lower rectum are swollen and inflamed. Hemorrhoids are not usually dangerous or life threatening. Swollen hemorrhoids are a common medical condition and over half of both men and women have had hemorrhoids by age 50.

They are either internal or external. Internal hemorrhoids originate at the top of the rectum and are a swelling of the veins inside the rectum. They form when the vessels of the anal cushions swell and the supporting tissues increase in size. The bulging mass of tissue and blood vessels protrudes into the anal canal where it can have problems.

The most common symptom of internal hemorrhoids is bright red blood covering the stool. You can notice this by looking on the toilet paper or in the toilet bowl. In addition to bleeding, internal hemorrhoids can cause itching and irritation. They are painful if they cause a spasm of the sphincter area around the hemorrhoids. If the hemorrhoid is strangulated (pinched), it can produce acute pain.

External hemorrhoids originate at the lower end of the anal canal near the anus. They are a swelling of the veins around the exterior of the anus and they protrude outside the anus. Symptoms include painful swelling or a hard lump around the anus. The hard lump is a result of blood clotting.

Causes of hemorrhoids

Hemorrhoids are groups of vascular tissue, muscle and connective tissue in the anal canal. Most experts agree that excessive straining with defecation causes engorgement of the hemorrhoids and probably interferes with blood flow in the veins. Pregnancy and high tension of the anal sphincter muscle produce a similar result.

Any increased pressure in the rectal veins leads to enlarged hemorrhoids. This pressure may result from pregnancy, heavy lifting, or excessive straining during bowel movements.

Aging is a factor when it causes a weakening of the support structures. The supporting tissue that anchors the hemorrhoids to the underlying muscle of the anal canal can deteriorate over time. When this occurs, the hemorrhoidal tissue loses its connections and slides down into the anal canal.

Some experts believe heredity may also be a factor. A person may inherit the tendency to get hemorrhoids.

External hemorrhoids are formed when there is a clot of coagulated blood attached to the hemorrhoidal vein. The formation of this clot is usually associated with a specific event such as straining with constipation, physical exertion or diarrhea.