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What are hemorrhoids/hemroids ?
Discover important facts about hemorrhoids (hemroids) and hemorrhoids (hemroids) classification


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Hemorrhoids are normal structures of the human anatomy and need treatment only when they are inflamed.

He mroids should not be treated when there are no physical signs for their activation.

Hemorrhoids are swollen but normally present blood vessels in and around the anus and lower rectum that stretchunder pressure, similar to varicose veins in the legs.


Video interview of Dr. Sidney Smith, who is  Gastroenterelogy Specialist, about what are hemorrhoids:



Another medical video about "what are hemorrhoids":



Video picture of hemorrhoids: hemorrhoids rubber band ligation:




Piles are found in three locations of the anal canal, one at the left center, and one each in the right upper and lower "corners". 

Hemorrhoids are important for helping us keep ourselves continent, i.e. keep us from having a bowel movement at an inappropriate time. They do this by becoming engorged when abdominal pressure is increased (such as whenstraining to lift something) so that the anal canal is completely ‘blocked’. Hemorrhoidal disease is a result of chronically increased intra-abdominal pressure and swelling. 

This increased pressure can be caused by constipation and subsequent straining to get stool out, pregnancy, cirrhosis of the liver, some forms of cancer, or for no good reason at all.

Hemorrhoids are not tumors or growths. Hemorrhoids are unique to humane beings. No other creature develops this problem.

Hemorrhoids classification


Hemorrhoids can be classified as external, internal and interno-external (when both types are associated). The external piles are situated in the lower one-third of the anal canal and are covered by skin.

Video of Dr. Noorali Bharwani about external and internal hemorrhoids:


External hemorrhoids beneath the anal skin enlarge over time due to dilatation or repeated thrombosis. The overlying skin may stretch to develop a skin tag, which prevents adequate hygiene. Occasionally, a clot within an external haemorrhoid will cause severe pain and may bleed if the clot erodes through the overlying skin.

External haemorrhoids usually cause pain and itching even after a small thrombosis as they are beneath richly innervated skin. This type of hemorrhoid most often affects younger people. External haemorrhoids produce severe pain only if they are actually thrombosed. The thrombosed hemorrhoids form a clot in your blood that prevents the blood from flowing normaly.

Internal hemorrhoids are seen in the upper two-thirds of the anal canal and are covered by the mucous membrane. Mucose membrane is the moist layer of tissue linining the digestive tract and anal canal which makes mucus –a thick, slippery fluid. 

Internal hemorrhoids, which are covered by mucosa, typically bleed or prolapse, but do not cause pain. In this case you may complain of rectal fullness, mucous discharge and bright red blood dripping into the toilet or on the toilet paper. Occasionally, internal hemorrhoids will incarcerate within the outer ring of the anal canal and develop thrombosis and necrosis. Internal haemorrhoids usually cause painless, bright red bleeding associated with defaecation.

Many patients with internal hemorrhoids also have an anal fissure,  which can co-exist with the hemorrhoids and in time causes spasm of the internal sphincter resulting in further tearing and ulceration and a lot of pain.

Internal hemorrhoids are also classified by degree as: first, second,third degree and fourth degree.

  • First-degree  , where bleeding is the predominant symptom and piles do not prolapse out of the ano-rectal region. 
  • Second degree-rectal prolapse is spontaneously reducible. 
  • Those that prolapse on defaecation but need to be replaced back manually and then stay reduced are called third-degree 
  • Hemorrhoids in grade IV cannot be replaced back once they are prolapsed. 

Hemorrhoids can be cured by employing  an effective hemorrhoids treatment.

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