Hemroids in Blood Vessel 

The term, "hemroids" refers to groups of blood vessels in the anorectal area which are present in everyone. However, less than XX % become symptomatic from difficulties with their hemroids. There are two types of hemroids: internal and external. This distinction is important, because of the possible symptoms and treatment alternatives. The division is marked anatomically by the dentate line, which embryologically delineates where skin-type structures meet with rectal lining structures. Importantly, there are many nerve endings for pain distal (beyond) to this line, where the external hemroids are, whereas proximal (in front) to this line, there are no pain fibers.

Both types of hemroids can bleed, thrombose (clot), and prolapse. Normally, external hemroids can be uncomfortable and sometimes disabling when they thrombose. Internal hemroidsal symptoms have been graded:

Grade 1: Bleeding
Grade 2: Prolapse, but reduce spontaneously
Grade 3: Prolapse, requiring manual reduction
Grade 4: Prolapse, unable to be reduced

Initial evaluation includes a history and physical examination. In the history, your physician will ask you questions regarding your symptoms, your diet, previous therapies and examinations. An anoscopy (3-4 inch scope inserted through your anus) may be performed to localize the problem or to determine if other problems coexist.