Hemorrhoids Explained: Causes, Symptoms, Stages & Treatment
Hemorrhoids are a common problem that many people experience at some point in their lives. They happen when the blood vessels in the rectum or anus become swollen, causing discomfort, itching, or even bleeding. While they can be painful, the good news is that hemorrhoids are treatable. In this article, we’ll explain what causes hemorrhoids, their symptoms, and the best ways to get relief and prevent them from coming back.
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| Hemorrhoids Explained: Causes, Symptoms, Stages & Treatment |
What Are Hemorrhoids?
Hemorrhoids are normal anatomical structures present in everyone, located near the anal canal. They consist of vascular cushions that help maintain continence and control stool passage.
Anatomy of Hemorrhoids
The hemorrhoidal plexus is a collection of clusters formed by the blood vessels of the hemorrhoids. These clusters consist of a dense network of blood vessels equipped with valves that regulate blood flow, causing dilation or distension.
Hemorrhoids play a role in continence, particularly for liquid stools and gas, as they dilate due to blood flow, contributing to the closure of the anus.
Types of Hemorrhoids
Hemorrhoids can be classified as internal or external based on their location.
Internal Hemorrhoids
Internal hemorrhoids are located above the pectinate line, the anatomical boundary between the rectum and the anal canal.
This region lacks pain receptors, so internal hemorrhoids are typically painless unless they become enlarged or thrombosed.
External Hemorrhoids
External hemorrhoids are located below the pectinate line and are covered by anoderm, a highly sensitive skin layer.
Because this area contains numerous nerve endings, external hemorrhoids are more likely to cause pain, irritation, and discomfort.
Hemorrhoidal Disease
While hemorrhoids are a normal part of human anatomy, they can become symptomatic and develop into hemorrhoidal disease, one of the most common proctological conditions worldwide.
Common Symptoms of Hemorrhoids
According to the American Society of Colon and Rectal Surgeons (ASCRS) (Source):
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Bleeding – Bright red blood on toilet paper or in the stool.
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Prolapse – Internal hemorrhoids may protrude from the anus during bowel movements.
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Pain – More common with external hemorrhoids, especially if thrombosed.
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Anal Itching – Internal hemorrhoids may secrete mucus, causing irritation.
Hemorrhoid Stages
The classification of hemorrhoids into four stages helps determine the best treatment approach:
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Stage I: Hemorrhoids are visible through an anoscope but do not prolapse.
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Stage II: Prolapse occurs with straining but resolves spontaneously.
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Stage III: Prolapsed hemorrhoids require manual reduction.
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Stage IV: Permanent prolapse that cannot be manually reduced.
(Sources: Cleveland Clinic – Hemorrhoid Staging)
Causes and Risk Factors of Hemorrhoidal Disease
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (Source), common risk factors include:
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Chronic constipation or straining
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Low-fiber diet
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Prolonged sitting or sedentary lifestyle
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Obesity
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Pregnancy
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Aging and weakened connective tissue
Vascular Theory of Hemorrhoid Development
One widely accepted explanation for hemorrhoidal disease is the vascular theory, which suggests that hemorrhoids result from increased arterial inflow and decreased venous outflow, leading to congestion and swelling. In severe cases, prolonged congestion can cause hemorrhoidal prolapse.
(Source: Journal of Gastroenterology and Hepatology – Study on Hemorrhoid Pathophysiology)
Conclusion
Hemorrhoids can be uncomfortable, but they don’t have to take over your life.
Simple habits like eating more fiber, drinking warm water, and not sitting for too long can help prevent hemorrhoids.
If you already have hemorrhoids, there are many ways to treat them, from home remedies to medical treatments.
By taking the right steps, you can find relief and keep hemorrhoids from coming back.
Medical sources and references:
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Mayo Clinic – Hemorrhoids Overview
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American Society of Colon and Rectal Surgeons – Hemorrhoid Treatment Guidelines
