Key Information Regarding External Hemorrhoids
There are a couple of kinds of external hemorrhoids: Type I external hemorrhoids protrude from the area around the exterior of the anus. Type 2 external hemorrhoids are actually interior hemorrhoids that stick out outside the anus. This article is about external hemorrhoids, and would talk about both types.
The first type of external hemorrhoid occurs outside the anal verge. The anal verge is the region of the anus that is outside the sphincter when the anal muscle/valve is closed. The word hemorrhoid is defined in an anatomical sense since the tissue that forms the joint where the anus is attached to the rectum. This particular tissue is absolutely dense with arteries, veins, vessels and capillaries. When someone 'has hemorrhoids' the reference is to hemorrhoid tissue that's afflicted with varicose veins of some sort. Varicosity may manifest as twisted and/or enlarged and/or swollen veins in the hemorrhoid tissue.
True external hemorrhoids (unlike interior hemorrhoids that are protruding outside through the anus) are uncommon and are often not a hemorrhoid in any way, but a misdiagnosed case of perianal hematoma. The perianal blood vessels are underneath the dermis around the anus. In case these vessels are damaged they may bleed internally, creating bruising and swelling. Painful as perianal hematoma can be, it's treated in a different manner than hemorrhoids.
External hemorrhoids come about when the veins that drain the area of the lower rectal arteries become varicose. Internal hemorrhoids arise when the veins that drain the region of the superior rectal arteries become varicose. External hemorrhoids are prone to thrombosis, which means they produce blood clots in blood vessels. When a vein in the drainage area of the inferior rectal arteries (they connect to the pudental artery) ruptures or an inter-vessel blood clot grows, the hemorrhoid is categorized as a thrombosed hemorrhoid.
Hemorrhoid treatments are available for a wide range of symptoms, from treatments that sooth slight itching to surgery under full anesthetic. For many, hemorrhoids get no worse than a negligible, occasional annoyance. Symptoms are mild and short-term. The condition heals spontaneously or signs and symptoms are quickly alleviated using local treatments that might include using a bidet or extendable shower head or a warm sitz bath to sooth the swollen tissue, followed by a cold compress plus a topical analgesic.
External hemorrhoids with small lumps get better with warm baths. The warm water relaxes the vessels around the rectum. Use of medicated lotions have to be carefully monitored if they contain steroid preparations. Steroid preparations can weaken the skin, which may possibly contribute to future outbreaks. With that warning given, however: used early in an outbreak, steroidal cremes are one of the most solid methods of reversing the course of a flare-up.
Keep in mind that excessive washing or rubbing of the anus is no cure and will worsen the situation. As far as actually touching the region goes, it should be restricted to soaking, rinsing and the application of topical ointments and cremes.
A strangulated hemorrhoid is an internal hemorrhoid that has prolapsed (protruded outside the anus during defecation and will not spontaneously withdraw). The anus goes into spasm since it cannot at all close and winds up cutting off the oxygen supply to the hemorrhoid. These must be looked at by a doctor.
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