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What Are Hemorrhoids?

Perry Gamsby

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Hemorrhoids are one of the most common complaints of mankind and have been around for as long as we have. (See History of Hemorrhoids for more information. ) In the United States alone, recent figures indicate over ten million people have hemorrhoids, that's more than 4% of the population at any one time suffering this condition. At least a third of those people seek medical treatment which results in over 1.5 million prescriptions per year.

US figures indicate a higher average per capita of sufferers than other continents, perhaps because of diet and lower consumption of fibre on average than Europeans or Asians. Hemorrhoids are also very common during pregnancy, possibly because of the weight of the baby on the lower organs causing straining during bowel movements.

Half of the population over 50 years of age will most likely suffer this condition at some time. While the number of sufferers has increased apace with population growth, surgical treatment of hemorrhoids has decreased significantly suggesting better non surgical management regimes being pursued and found to be more effective.
What Are Hemorrhoids?

Hemorrhoids are present even in healthy people. They are, in layman's terms, veins in the anus that enlarge and bleed. For a professional explanation, may I quote the superb description offered by Dr Scott Thornton MD, Consulting Surgeon, Department of Surgery, Bridgeport Hospital and a member of the prestigious American Society of Colon and Rectal Surgeons,

"Hemorrhoids are not varicosities; they are clusters of vascular tissue (e. g. , arterioles, venules, arteriolar-venular connections), smooth muscle (e. g. , Treitz muscle), and connective tissue lined by the normal epithelium of the anal canal. Hemorrhoids are present in utero and persist through normal adult life. Evidence indicates that hemorrhoidal bleeding is arterial and not venous. This evidence is supported by the bright red color and arterial pH of the blood.

Hemorrhoids are categorized into internal and external hemorrhoids. These categories are anatomically separated by the dentate (pectinate) line. External hemorrhoids are hemorrhoids covered by squamous epithelium, whereas internal hemorrhoids are lined with columnar epithelium. Similarly, external hemorrhoids are innervated by cutaneous nerves that supply the perianal area. These nerves include the pudendal nerve and sacral plexus. Internal hemorrhoids are not supplied by somatic sensory nerves and therefore cannot cause pain. At the level of the dentate line, internal hemorrhoids are anchored to the underlying muscle by the mucosal suspensory ligament.
Hemorrhoids have 3 main cushions. These cushions are situated in the left lateral, right posterior and right anterior areas of the anal canal. Minor tufts can be found between the cushions. "

For most of us this tells us that there are two types of hemorrhoids, internal and external, although internal ones may protrude outside the anus. These will not hurt as they don't have nerves. The external hemorrhoids do have nerves and they do hurt!

In upcoming articles on this touchy subject we will examine hemorrhoids even more closely and have a look at surgical and non-surgical remedies.

Perry Gamsby is a freelance writer who has a wealth of published material including eBooks and eZines to his credit. He has written a novel ‘The Cool Side of the Pillow’ as well as six eBooks specifically for those people interested in the Philippines and Filipinas. Whether it is how to meet a Filipina, how to marry or migrate her or how to live there, work there or simply survive there, Perry has written about it. Perry is also a well respected personal protection professional and self defense expert with 16 DVD titles and 3 manuals to his credit. For more from this author, visit


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