external hemorrhoid


Also found in: Dictionary, Thesaurus, Encyclopedia.

hemorrhoid

 [hem´ŏ-roid]
an enlarged (varicose) vein in the mucous membrane inside or just outside the rectum; called also pile.

Internal hemorrhoids usually are first noticed when minor bleeding occurs with defecation. Pain occurs rarely, unless there is an associated disorder such as an anal fissure, thrombosis, or strangulation of the affected vein. External hemorrhoids produce varying degrees of pain, feelings of pressure, itching, irritation, and a palpable mass. Bleeding occurs only if the external hemorrhoid is injured or ulcerated and begins to break down.

Hemorrhoids are caused by increased pressure on the veins of the anus. Prolonged sitting, constipation, and hard, dry stools that are difficult to pass can lead to straining and sitting at stool for long periods of time, all of which add pressure on the anal veins. Failure to follow through on the urge to defecate can also lead to hemorrhoids. In women, probably the single most common cause is pregnancy.

External hemorrhoids can be treated by local applications of cold and an astringent cream, by sitz baths, and by avoidance of constipation. Internal hemorrhoids may require sclerosing or cryosurgery to obliterate the affected tissue. More advanced, chronic hemorrhoids usually must be removed surgically by ligation and excision (hemorrhoidectomy) or by barron ligation.
Types of hemorrhoids.
external hemorrhoid one distal to the pectinate line.
internal hemorrhoid one originating above the pectinate line and covered by mucous membrane.
prolapsed hemorrhoid an internal hemorrhoid that has descended below the pectinate line and protruded outside the anal sphincter.
strangulated hemorrhoid an internal hemorrhoid that has prolapsed sufficiently and for a long enough time for its blood supply to become occluded by the constricting action of the anal sphincter.

external hemorrhoid

Hemorrhoid located at or distal to the pectinate line (dentate margin), covered by anodermal epithelium or skin and extremely sensitive to most stimuli.
See: hemorrhoid for illus.
See also: hemorrhoid
References in periodicals archive ?
Hemorrhoidal disease (HD) is common in adults.11 In contrast, it is rarely seen in childhood patients although the incidence of HD in children and adolescents has been shown to increase.1,2,12 Literature indicates that there is no gender preponderance for external hemorrhoids in adult population13,14; however, most of the children reported with HD are boys.2,6,7,9 Similarly, in our study, we also noted that external HD was more common in boys, which could be attributed to the finding reported by adult studies that the anal canal in males is longer than females.4 Additionally, we consider that this difference could play a role in the manifestation of symptomatic hemorrhoids.
Although bleeding is a common symptom in internal HD, it results from the ulceration of the thrombosed hemorrhoids in external HD.4 External hemorrhoids are often revealed by external inspection.3 Moreover, while external hemorrhoids can be exposed by pulling aside the gluteal muscles, internal hemorrhoids can be seen via anoscopy.
In thrombosed external hemorrhoids, the conservative treatment is continued if it leads to thrombus resorption and pain relief.13 In adult patients, topical agents including steroids, anesthetic agents, and antiseptic agents have been used for the resolution of symptoms.18 Moreover, topical calcium channel blockers have also been used in the treatment of thrombosed external and internal hemorrhoids.
In a prospective study of 165 pregnant women, 15(9%) had anal lesions during the 3 months before delivery: 2 women had anal fissures and 13 had thrombosed external hemorrhoids. During the first 2 months after delivery, 58 women had anal disease (35%): 25 had anal fissures and 33 had thrombosed external hemorrhoids.
During the first 2 months after delivery, 58 women had anal disease (35%): 25 women had anal fissures, and 33 had thrombosed external hemorrhoids. Of the 33 external hemorrhoids, 30 were observed during the first day after delivery.
Cryosurgery freezes external hemorrhoids with liquid nitrogen.
Rectal examination revealed no masses or external hemorrhoids; stool was brown and Hemoccult negative.
External hemorrhoids originate below the dentate line and become acutely painful with thrombosis.
For thrombosed external hemorrhoids, surgery works best
External hemorrhoids may be asymptomatic, associated with discomfort, or a cause of acute pain in the event of a thrombosis.
No studies thus far have evaluated the role of phlebotonics in thrombosis of external hemorrhoids.
The North Carolina Medicaid program reimburses $50.54 for the destruction of external hemorrhoids (46935), $112.78 for the destruction of internal hemorrhoids (46934), and $151.62 for the destruction of both external and internal hemorrhoids (46936).