Haemorrhoids often described as "varicose veins of the anus and rectum,” they are enlarged, bulging blood vessels in and around the anus and lower rectum. The rectum is the bottom section of your colon (large intestine). The tissues supporting the vessels stretch. As a result, the vessels expand, the walls thin and bleeding occurs. When the stretching and pressure continue, the weakened vessels protrude. The two types of hemorrhoids, external and internal, refer to their location.
External (outside) hemorrhoids form near the anus and are covered by sensitive skin. They are usually painless unless a blood clot (thrombosis) forms.
Thrombosed external hemorrhoids are blood clots that form in an outer hemorrhoid in the anal skin. If the clots are large, they can cause significant pain. A painful anal mass may appear suddenly and get worse during the first 48 hours. The pain generally lessens over the next few days. You may notice bleeding if the skin on top opens.
Internal (inside) hemorrhoids form within the anus beneath the mucous linings. Painless bleeding and protrusion during bowel movements are the most common symptoms. However, an internal hemorrhoid can cause severe pain if it is completely prolapsed. This means it has slide out of the anal opening and cannot be pushed back inside.
If pain from a thrombosed hemorrhoid is severe, the blood clot needs to be removed with a small incision.
Traditional haemorrhoidectomy is called as Milligan Morgan Open haemorrhoidectomy in which the complete pile mass is excised. This is the most complete surgical method for removing extra tissue that causes bleeding and protrusion. It is done under spinal anesthesia using either sutures or staples. Postoperatively, there is some pain at the operated site and healing of the operated wound takes 6-8 weeks.
Hemorrhoids do not increase the risk of colorectal cancer nor cause it. However, Anorectal cancer can presents with bleeding from anus just like bleeding haemorrhoids. So early consultation and examination of the anal region by colorectal surgeon to differentiate haemorrhoids from cancer is the key to get the best results & increased survival rates.