Hemorrhoid Anatomy

In general hemorrhoids occur at the lining of the lower rectum and anus. Hemorrhoids occur at two levels relative to the anus. They are either internal, external or a combination of both. The level of the hemorrhoid influences the type of treatment. External Hemorrhoid Anatomy:

• Occur below the level of nerve endings therefore treatment can be painful.
• Usually accompany internal hemorrhoids.
• Can make skin tags.
• Typically readily found by patients near the anal opening.

Internal Hemorrhoid Anatomy

• Above the level of nerve endings and therefore usually don’t hurt.
• Cause an anal mass only if they prolapse or descend out of the anus.
• Four (4) degrees are defined based on the degree of prolapse.
• Treatment is based on the degree of the hemorrhoid.

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Theories of Pathogenesis

Several theories of pathology (why hemorrhoids occur) exist. None have proven to be universally correct. All result in easily traumatized hemorrhoid tissue leading to bleeding, pain, swelling, prolapse or other symptoms.

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