Hemorrhoids are large blood vessels located in the rectum, anal canal and peri-anal tissues. These dilated blood vessels usually cause pain and bleeding. In general there are two types of hemorrhoids.
The first is external hemorrhoids. External hemorrhoids cause pain and bleeding. When a external hemorrhoid has a blood clot lodged within it, a thrombosed external hemorrhoid is present. Patients should seek medical evaluation with within 72 hours of this occurrence. It is during this period of time that removal of the blood clot, with simple surgical techniques, may improve their symptoms dramatically. After 72 hours, the blood clot becomes more established and is less likely to improve the situation if removed.
Internal hemorrhoids are the second type of hemorrhoids and are located within the rectum. These do not cause pain since the inside of the rectum and the GI tract do not have nerve endings. Thus, internal hemorrhoids cause variable amounts of bleeding but not pain. On occasion, external hemorrhoids may protrude (prolapse) into the anal canal and to the outside of the GI tract. If this occurs, surgical evaluation is strongly recommended. In general, dietary changes and simple outpatient techniques such as banding can manage internal hemorrhoids.
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