Haemorroids

Haemorrhoids are clusters of vascular tissue, smooth muscle and connective tissue arranged in three columns along the anal canal. In healthy individuals, they act as cushions that help maintain continence.

Sandler RS, Peery AF. Rethinking What We Know About Hemorrhoids. Clinical Gastroenterology and Hepatology. 2019;17:8–15. doi:10.1016/j.cgh.2018.03.020

Although haemorrhoids — or ‘piles’ as they are otherwise commonly known — are normal structures, the term has become synonymous with them in an abnormally swollen and symptomatic state

NICE Clinical Knowledge Summary. Haemorrhoids. National Institute
for Health and Care Excellence. 2016.
https://cks.nice.org.uk/topics/haemorrhoids
(accessed Jan 2022).

It occurs when one strains in the toilet. This commonly occurs during constipation or during prolonged diarrhoea.
When one strains it puts pressure on the abdomen causing blood vessels (varicose veins) in the back passage to swell and inflame which in turn causes pain and bleeding.
Some can cause a blood clot in the blood vessel (thrombosed haemorrhoid)

Thrombosed haemorrhoids (acute haemorrhoidal disease, or perianal thrombosis)

Haemorrhoids that have no blood flow due to blood clots.
They’re most often external but can be internal, as well.
They are not considered to be dangerous, yet they can be quite painful.
They may present as a single lump or a circle of lumps.
In most cases, the blood clot is eventually reabsorbed by the body and the symptoms resolve themselves (the pain peaks at 48-72 hours after first signs and begins to decline by the fourth day as the thrombus is reabsorbed).

verywell health

Causes

Pregnancy
Long term cough
Heavy lifting
Constipation (straining when going to the toilet)
Diarrhoea
Low fibre diet
Overweight
Certain toilet behaviours, such as straining or spending more time on a seated toilet than on a squat toilet.

Source: OnHealth

Source: consultant360.com 'Thrombosed hemorrhoids'

Source: SlideShare 'Type 4'

Class/Types:

Class/Type 1:
This commonly develops inside the back passage (not seen or felt on outside)
Class/Type 2:
Haemorrhoid tends to be larger and pushes outside anus.
Class/Type 3:
The anus is on the outside and one can feel small lumps, it can be pushed back with a finger.
Class/Type 4:
The hemorrhoids are permanently outside anus. It cant be pushed back. Symptoms can be itchiness causing discomfort and a mucus discharge.

Symptoms

Does one have:

Type 1 and Type 2:

Type 1: This commonly develops inside the back passage (not seen or felt on outside).
Type 2: Haemorrhoid tends to be larger and pushes outside anus.

Anal pain at worst for the first 24 to 48 hours (especially when walking and/or bending down)?

Itching around anus even when or not going to toilet?

Increase discomfort/pain during or immediately after going to toilet?

A mucus discharge?

One strain when passing faeces?

Area feels hot, red and swollen (swelling or lump around the anus)?

Bright red blood when wiping bottom with a tissue?

(If possible to see) is it of a dark red/purple grapes appearance and/or of bright blood appearing on stool?

An aching or dragging (loosing) sensation in anal area?

Sit or stand a lot?

Any leaking of faeces?

Eat anything that irritates the area i.e. chilli and spices?

Overweight?

Type 3:

The anus is on the outside and one can feel small lumps, it can be pushed back with a finger.

Type 4:

The hemorrhoids are permanently outside anus.
It cant be pushed back.
Symptoms can be itchiness causing discomfort and a mucus discharge.

Does one believe they have:

Type 3

Regarding this condition, one will need to proceed further in the programme

Type 4

Regarding this condition, one will need to proceed further in the programme

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