Internal Hemroids

Internal  Hemroids
Often described as "varicose veins of the Excretory Orifice and rectum", hemroids are enlarged, bulging blood vessels in and about the Excretory Orifice and lower rectum. There are two types of hemroids: external and internal, which refer to their location. 

External (outside) hemroids develop near the Excretory Orifice and are covered by very sensitive skin. If a blood clot develops in one of them, a painful swelling may occur. The external hemroids feels like a hard, sensitive lump. It bleeds only if it ruptures. 

Internal (inside) hemroids develop within the Excretory Orifice beneath the lining. Painless bleeding and protrusion during bowel movements are the most common symptom. However, an internal hemroids can cause severe pain if it is completely "prolapsed" - protrudes from the Excretory Orifice opening and cannot be pushed back inside.

What Causes Hemroids?
An exact cause is unknown; however, the upright posture of humans alone forces a great deal of pressure on the rectal veins, which sometimes causes them to bulge. Other contributing factors include:

• Aging

• Chronic constipation or diarrhea

• Pregnancy

• Heredity

• Faulty bowel function due to overuse of laxatives or enemas; straining during bowel movements

• Spending long periods of time (e.g., reading) on the toilet

Whatever the cause, the tissues supporting the veins stretch. As a result, the veins dilate; their walls become thin and bleed. If the stretching and pressure continue, the weakened veins protrude.

Rubber Band Ligation of Internal Hemroids 
A. Bulging, bleeding, internal hemroids
B. Rubber band applied at the base of the hemroids
C. About 7 days later, the banded hemroids has fallen off leaving a small scar at its base (arrow).