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Various Types Of External Hemorrhoids
There are two types of external hemorrhoids: Type I external hemorrhoids stick out from the area around the exterior of the anus. Type 2 external hemorrhoids are actually internal hemorrhoids that protrude outside the anus. This article concerns external hemorrhoids, and will discuss both types.
The very first type of external hemorrhoid occurs outside the anal verge. The anal verge is the region of the anus that's outside the sphincter when the anal muscle/valve is closed. The term hemorrhoid is defined in an anatomical sense as the tissue that forms the joint where the anus is attached to the rectum. This tissue is dense with arteries, veins, vessels and capillaries. If a person 'has hemorrhoids' the reference is to hemorrhoid tissue that's stricken with varicose veins of some kind. Varicosity can manifest as twisted and/or enlarged and/or swollen veins within the hemorrhoid tissue.
True external hemorrhoids (as opposed to interior hemorrhoids that are protruding outside through the anus) are rare and are sometimes not a hemorrhoid in any way, but actually a misdiagnosed case of perianal hematoma. The perianal blood vessels are in fact under the dermis surrounding the anus. When these vessels are damaged they will bleed internally, creating bruising and inflammation. Painful as perianal hematoma can be, it's treated in another manner when compared to hemorrhoids.
External hemorrhoids occur when the veins that drain the area of the inferior rectal arteries become varicose. Internal hemorrhoids occur when the veins that drain the area of the upper rectal arteries become varicose. External hemorrhoids are prone to thrombosis, which means they produce blood clots in blood vessels. When a vein within the drainage area of the lower rectal arteries (they link to the pudental artery) ruptures or an inter-vessel blood clot develops, the hemorrhoid is classified as a thrombosed hemorrhoid.
Hemorrhoid treatments exist for a wide variety of symptoms, from treatments that sooth slight itching to surgical procedures under full anesthetic. For most people, hemorrhoids get no worse than a minor, occasional annoyance. Symptoms are mild and temporary. The condition heals spontaneously or symptoms are easily alleviated using local treatments which may 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 little lumps improve with warm baths. The warm water relaxes the vessels around the rectum. Use of medicated creams must be closely monitored if they have steroid preparations. Steroid preparations can weaken the skin, which may probably be a factor to future outbreaks. With that caution given, however: used early in an outbreak, steroidal cremes are one of the most assured ways of reversing the course of a flare-up.
Remember that excessive washing or rubbing of the anus is not a cure and will worsen the condition. So far as actually touching the area goes, it should be limited to soaking, rinsing and the application of topical ointments or cremes.
A strangulated hemorrhoid is an interior hemorrhoid that has prolapsed (protruded out of the anus during defecation and will not spontaneously withdraw). The anus goes into spasm since it cannot at all close and ends up cutting off the oxygen supply to the hemorrhoid. These should be looked at by a doctor.
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