Hemorrhoid facts Internal and external Hemorrhoid Diagnosis and Treatment

Hemorrhoid facts Internal and external Hemorrhoid 

Internal

Internal hemorrhoids are those that originate above the dentate line.^[7] They are covered by columnar epithelium which lacks pain receptors.^[4] They were classified in 1985 into four grades based on the degree of prolapse.^[4][3]

• Grade I: No prolapse. Just prominent blood vessels. 
• Grade II: Prolapse upon bearing down but spontaneously reduce.
• Grade III: Prolapse upon bearing down and requires manual reduction.
• Grade IV: Prolapsed and cannot be manually reduced.

External

A thrombosed external hemorrhoid

External hemorrhoids are those that occur below the dentate or pectinate line.^[7] They are covered proximately by anoderm and distally by skin, both of which are sensitive to pain and temperature.^[4]

Formation of hemorrhoids

If the hemorrhoid originates at the top (rectal side) of the anal canal, it is referred to as an internal hemorrhoid. If it originates at the lower end of the anal canal near the anus, it is referred to as an external hemorrhoid. Technically, the differentiation between internal and external hemorrhoids is made on the basis of whether the hemorrhoid originates above or below the dentate line (internal and external, respectively).

As discussed previously, hemorrhoidal cushions in the upper anal canal are made up of blood vessels and their supporting tissues. There usually are three major hemorrhoidal cushions oriented right posterior, right anterior, and left lateral. During the formation of enlarged internal hemorrhoids, 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 cause problems. Unlike with internal hemorrhoids, it is not clear how external hemorrhoids form.

Prevention

A number of preventative measures are recommended including avoiding straining while attempting to defecate, avoiding constipation and diarrhea either by eating a high fiber diet and drinking plenty of fluid or taking fiber supplements, and getting sufficient exercise. Spending less time attempting to defecate, avoiding reading while on the toilet,  as well as losing weight for overweight persons and avoiding heavy lifting are also recommended

Prevalence of hemorrhoids

Although hemorrhoids occur in everyone, they become large and cause problems in only 4% of the general population. Hemorrhoids that cause problems are found equally in men and women, and their prevalence peaks between 45 and 65 years of age.

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Hemorrhoid facts

• Internal hemorrhoids are clumps of tissue within the anal canal that contain blood vessels, muscle, and elastic fibers. External hemorrhoids are enlarged blood vessels surrounding the anus.
• Internal hemorrhoids cause problems when they enlarge. The cause of the enlargement is not known.
• Complications of internal hemorrhoids include bleeding, anal itchiness, prolapse, incarceration, and gangrene. Pain is not common.
• The primary complication of external hemorrhoids is pain due to blood clotting in the hemorrhoidal blood vessels.
• When dealing with hemorrhoids, it is important to exclude other diseases of the anus and rectum that may cause similar symptoms such as polyps, cancer, and diseases of the skin.
• Treatment of hemorrhoids includes over-the-counter topical medications, sclerotherapy, rubber band ligation, heat coagulation,cryotherapy, anal dilation, Doppler ligation, sphincterotomy, and surgical hemorrhoidectomy. stapled hemorrhoidectomy.
• But the best and Permanent treatment for piles hemorrhoid is Kshar-Sutra Ligation without any recurrence 100% result in all type of piles. 

Hemorrhoid Treatments

Home Remedies and OTC Medication Treatments for Hemorrhoids

Over-the-counter products

Many over-the-counter products are sold for the treatment of hemorrhoids. Products used for the treatment of hemorrhoids are available as ointments, creams, gels, suppositories, foams, and pads.

• Local anesthetics: Local anesthetics temporarily relieve pain, burning, and itching by numbing the nerve endings.
• Vasoconstrictors:Vasoconstrictors are chemicals that resemble epinephrine, a naturally occurring chemical.
• Protectants: Protectants prevent irritation of the perianal area by forming a physical barrier on the skin that prevents contact of the irritated skin with aggravating liquid or stool from the rectum.
• Astringents: Astringents cause coagulation (clumping) of proteins in the cells of the perianal skin or the lining of the anal canal.
• Antiseptics: Antiseptics inhibit the growth of bacteria and other organisms.
• Keratolytics: Keratolytics are chemicals that cause the outer layers of skin or other tissues to disintegrate.
• Analgesics: Analgesic products, like anesthetic products, relieve pain, itching, and burning by depressing receptors on pain nerves.
• Corticosteroids:Corticosteroids reduce inflammation and can relieve itching, but their chronic use can cause permanent damage to the skin.
• Kshar-Sutra Ligation -But the best and Permanent treatment for piles hemorrhoid is Kshar-Sutra Ligation without any recurrence 100% result in all type of piles.