Haemorrhoids are normal anatomical structures with a vascular plexus structure that act as cushions at the anal outlet. They contain blood vessels, smooth muscles and connective tissue.
Internal and External Haemorrhoids
Internal haemorrhoids: Located above the dentate line; cause painless bleeding and prolapse. Classified into 4 grades.
External haemorrhoids: Below the dentate line, outside the anus; cause severe pain when thrombosed.
Symptoms
Bright red bleeding after defecation, anal itching, burning, moisture, tissue prolapse from the anus and pain (especially with thrombosis).
Causes
Chronic constipation, prolonged sitting on the toilet, low-fibre diet, pregnancy, obesity and a sedentary lifestyle.
Treatment
Dietary changes (increased fibre, plenty of water), sitz baths, topical creams; office procedures (rubber band ligation, sclerotherapy, infrared coagulation); haemorrhoidectomy in refractory cases.