HEMORRHOIDS
HEMORRHOIDS
HEMORRHOIDS
Hemorrhoids, also known as piles, are protrusions of varicose veins and connective tissue around the anal canal extending to inside the rectum. Symptoms are itching, pain, bleeding, and swelling. The number one cause is genetics (an absence of valves within the hemorrhoidal veins), followed by irregular bowel habits (constipation or diar
Hemorrhoids, also known as piles, are protrusions of varicose veins and connective tissue around the anal canal extending to inside the rectum. Symptoms are itching, pain, bleeding, and swelling. The number one cause is genetics (an absence of valves within the hemorrhoidal veins), followed by irregular bowel habits (constipation or diarrhea) and any activity that increases intra-abdominal pressure (prolonged straining, lifting, etc.). Hemorrhoids can be external (covered by anal skin), internal (covered by rectal mucosa), or thrombosed, meaning that a blood clot, or thrombus, has formed within the hemorrhoid.
PROLAPSE
HEMORRHOIDS
HEMORRHOIDS
Internal hemorrhoids are staged or graded by their degree of prolapse and are classified, depending on severity, into four stages or degrees. First-degree hemorrhoids bleed but do not prolapse outside of the anal canal; second-degree hemorrhoids prolapse outside of the anal canal, usually upon defecation, but retract spontaneously. Third-
Internal hemorrhoids are staged or graded by their degree of prolapse and are classified, depending on severity, into four stages or degrees. First-degree hemorrhoids bleed but do not prolapse outside of the anal canal; second-degree hemorrhoids prolapse outside of the anal canal, usually upon defecation, but retract spontaneously. Third-degree hemorrhoids require manual placement back inside the anal canal after prolapsing, and fourth-degree hemorrhoids consist of prolapsed tissue that cannot be manually replaced and is usually strangulated or thrombosed.
FISSURE
HEMORRHOIDS
FISSURE
Fissures are cracks or tears in the anal skin that typically cause pain and bleeding with bowel movements. It is usually, but not always, caused by the passage of a hard, dry bowel movement through a tight anal sphincter (e.g., anal spasm or stenosis). They can occur alone or in the presence of hemorrhoids. Both are caused by constipatio
Fissures are cracks or tears in the anal skin that typically cause pain and bleeding with bowel movements. It is usually, but not always, caused by the passage of a hard, dry bowel movement through a tight anal sphincter (e.g., anal spasm or stenosis). They can occur alone or in the presence of hemorrhoids. Both are caused by constipation and/or excessive straining during bowel movements. Treatment is usually necessary to prevent infection, abscess, or pruritus ani (also known as an “itchy anus”).
Laser therapy of acute anal fissure (1) under local anesthesia is a simple, non-invasive and painless surgical procedure with a low rate of complications. Management of anal fissures (2) include topical creams, botulinum toxin, controlled-intermittent anal dilatation (3), or a lateral internal sphincterotomy surgery (2) with or without an anal-cutaneous flap (4).