Hemorrhoids (AmE), haemorrhoids (BrE), emerods, or piles are swelling and inflammation of veins in the rectum and anus. The anatomical term “hemorrhoids” technically refers to “‘Cushions of tissue filled with blood vessels at the junction of the rectum and the anus.” However, the term is popularly used to refer to varicosities of the hemorrhoid tissue. Perianal hematoma are sometimes misdiagnosed and mislabeled as hemorrhoids, when in fact they have different causes and treatments.
Obesity can be a factor by increasing rectal vein pressure. Poor muscle tone or poor posture can result in too much pressure on the rectal veins.
Pregnancy may lead to hypertension and increase strain during bowel movements, so hemorrhoids are often associated with pregnancy.
Cigarette smoking during bowel movements, may worsen hemorrhoid, may lead to severe internal bleeding of veins inside rectum area.isdjklasdalödkaösldkalösdkasdasdasdhtm |month=November | year=2005 |publisher=University of Michigan Health System |accessdate=2007-11-28}}</ref> Both can cause diarrhea. Note that caffeine ingestion increases blood pressure transiently, but is not thought to cause chronic hypertension. Alcohol can also cause alcoholic liver disease leading to portal hypertension.
Many anorectal problems, including fissures, fistulae, abscesses, anal melanoma or irritation and itching, also called pruritus ani, have similar symptoms and are incorrectly referred to as hemorrhoids.
Hemorrhoids are usually not dangerous or life threatening. In most cases, hemorrhoidal symptoms will go away within a few days.
Although many people have hemorrhoids,and hemorroidial radiation, not all experience symptoms. The most common symptom of internal hemorrhoidial radiation is bright red blood covering the feces, on toilet paper, and/or in the toilet bowl. However, an internal hemorrhoid may protrude through the anus outside the body, becoming irritated and painful. This is known as a protruding hemorrhoid.
Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms. This condition is known as a thrombosed external hemorrhoid.
In addition, excessive straining, rubbing, or cleaning around the anus may cause irritation with bleeding and/or itching, which may produce a vicious cycle of symptoms. Draining anal mucus, produced by the dentate line may also cause itching.
Insufficient liquid can cause a hard stool, or even chronic constipation, which can lead to hemorrhoidal radiation. An excess of lactic acid in the stool, a product of excessive consumption of dairy products, such as yogurt, can cause radiation; reducing such consumption can bring relief. Vitamin E deficiency is also a common cause. Eating spicy food does not cause hemorrhoids, though spicy foods may aggravate the condition.
External hemorrhoids are those that occur outside the anal verge (the distal end of the anal canal). Specifically they are varicosities of the veins draining the territory of the inferior rectal arteries, which are branches of the pudendal artery. They are sometimes painful, and can be accompanied by swelling and irritation. Itching, although often thought to be a symptom of external hemorrhoids, is more commonly due to skin irritation.
External hemorrhoids are prone to thrombosis: if the vein ruptures and/or a blood clot develops, the hemorrhoid becomes a thrombosed hemorrhoid.
Internal hemorrhoids are those that occur inside the rectum. Specifically they are varicosities of veins draining the territory of branches of the superior rectal arteries. As this area lacks pain receptors, internal hemorrhoids are usually not painful and most people are not aware that they have them. Internal hemorrhoids, however, may bleed when irritated.
Untreated internal hemorrhoids can lead to two severe forms of hemorrhoids: prolapsed and strangulated hemorrhoids:
Prolapsed hemorrhoids are internal hemorrhoids that are so distended that they are pushed outside the anus.
If the anal sphincter muscle goes into spasm and traps a prolapsed hemorrhoid outside the anal opening, the supply of blood is cut off, and the hemorrhoid becomes a strangulated hemorrhoid.
By degree of prolapse
The most common grading system was developed by Banov: