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.
Both men and women can have this kind of disease and it is extremely common and likely to be present in more than 50 percent of the population by 50 years of age. Traditionally, hemorrhoids have been referred as varicose veins of the rectum or varicosities of the hemorrhoid tissue.
Throughout history, hemorrhoids have been a problem for humans, and possibly date back to when we first learned how to walk upright. During the Middle Ages, hemorrhoids were called St. Fiacre’s curse. St. Fiacre was the patron saint of gardeners, and he contracted a terrible case of hemorrhoids that prolapsed after a day of working very hard in his garden.
There are usually two classifications of hemorrhoids namely internal and external hemorrhoids. The internal hemorrhoids are those that take place above the anal sphincter and those that take place below the anal sphincter are coined as external hemorrhoids. A single person can suffer from both forms at the same time. Though typically, hemorrhoids are considered chronic health problems, they may trigger acute episodes.
Internal hemorrhoids are within the right anterior, left lateral, and right posterior positions inside the anal canal. These positions within the anal canal are remarkably consistent. Usually, internal hemorrhoids are painful and most people don’t even know they have them, since that area doesn’t have pain receptors. If they get irritated, however, they might bleed. If they aren’t detected and treated right away, these may become strangulated or prolapsed, which is extremely serious.
External hemorrhoids occur outside of the anal verge. These can be painful, and often have irritation and swelling or with them. They may also itch, although this is not really a symptom of hemorrhoids but instead is because the skin has become irritated. If the dilated veins rupture or if a blood clot develops, this becomes a thrombosed hemorrhoid, a condition that occurs most often with external hemorrhage.
The classification of hemorrhoids is by history and not by means of physical examination. The grading is as follows: Grade I – bleeding without prolapsed; Grade II – prolapse with spontaneous reduction; Grade III – prolapse with manual reduction; Grade IV – irreducible prolapse. This classification has been adopted for many years and associates relatively well with treatment algorithms. Often, Grade I and II hemorrhoids are effectively treated by non-operative methods while Grade III and Grade IV hemorrhoids are likely to necessitate 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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