Internal Hemorrhoid

The term hemorrhoids, also known as piles, and hemorrhoidal disease refer to the state of symptoms attributed to the vascular cushions present in the anal canal. Hemorrhoids are naturally occurring vascular tissues within the submucosa in the anal canal and comprise loose connective tissue, smooth muscle (Treitz’s muscle), and blood vessels with many arteriovenous connections (why hemorrhoidal bleeding is typically bright red). Hemorrhoids are thought to aid in stool continence by providing bulk to the anal canal. Hemorrhoids typically occur at three locations: left lateral, right anterior, right posterior positions. Hemorrhoids receive vascular supply by the superior, middle and inferior hemorrhoidal arteries. Venous drainage is through the inferior and middle hemorrhoidal veins which ultimately drain into the iliac veins. Hemorrhoids classify into four grades: grade I hemorrhoids bulge into the anal canal and do not prolapse; grade II hemorrhoids prolapse during defecation and reduce spontaneously; grade III hemorrhoids prolapse and require manual reduction; grade IV hemorrhoids prolapse and are irreducible.