Hemorrhoid Classification: What Do They All Mean?

By: Donald Urquhart

Hemorrhoidal cushions are blood-rich cushions of tissue within the anal canal that are present in every healthy human being.

They lie within the anal canal and perform several functions on a continual basis without which the body would soon start to suffer. Hemorrhoidal cushions flex and bend with the body's movements, allowing the anal canal to be flexible enough to endure such activities as walking, running, leaping, and bending. In addition, hemorrhoidal cushions function as "pressure pads", giving our brains a signal when we need to have a bowel movement. Lastly, they protect the delicate tissues, ligaments, and muscles surrounding the anal canal from the damage that daily bowel movements would otherwise inflict. The blood vessels of the hemorrhoidal cushions are particularly good at expanding and contracting, thus filling the honeycombed tissue with blood or draining it away, depending on the body's immediate need.

Internal hemorrhoids are what happens when one of the veins within a hemorrhoidal cushion swells beyond its capacity to retract. When the rest of the hemorrhoidal cushion retracts, the vein stays swollen, stuck out from the surface of its cushion. The vein, of course, takes connected tissue with it, and an internal hemorrhoid is born. Internal hemorrhoids are a fairly common condition occuring within the anal canal, and many people unknowingly have small internal hemorrhoids that don't cause problems.

Internal hemorrhoids are classified according to a system of grades.

Grade One internal hemorrhoids do not protrude from the anal canal, though they may cause other symptoms such as bleeding or itching.

Grade Two hemorrhoids are at the first stage of hemorrhoidal prolapse, which is to say that they protrude from the anal canal during a bowel movement but retract back into the body upon completion of said bowel movement.

Grade Three hemorrhoids protrude from the anal sphincter during a bowel movement and do not retract upon completion, but will stay inside if pushed back in manually. Grade Three hemorrhoids have a tendency to bleed more often and are generally easier to inflame.

Grade Four hemorrhoids protrude from the body all the time. If pushed back in, they will slip out on their own shortly with no effort required. Hemorrhoids this severe need to be seen by a doctor, as they bleed much more easily, are prime targets for infection, and may develop an internal blood clot, also known as thrombosis.

External hemorrhoids are a bit different.

They do not emerge from hemorrhoidal cushions, which are only found on the inside of the anal canal. Instead, they originate from veins that run from the hemorrhoidal cushions down to the external area surrounding the anal sphincter before heading back up to the heart.

This set of U-shaped veins is frequently subject to the same pressures as the veins directly connected to the hemorrhoidal cushions, but because they are not specifically designed to expand and contract as much, external hemorrhoids are slightly less common.

Thrombosis can occur in either internal or external hemorrhoids.

Whenever a blood clot develops and is trapped within a hemorrhoid it turns into a thrombosed hemorrhoid. Thrombosed hemorrhoids generally hurt a great deal due to the general inflammation that invariably sets in. These need to be seen by a doctor, as thrombosed hemorrhoids can lead to many complications.

These are all terms that your doctor may use in referring to the specific condition of your hemorrhoids.

If you or someone you know is prone to hemorrhoids, it may help to become familiar with this terminology as it make communication with your medical provider much easier and eventually lead to a hemorrhoid-free life.

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