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There are two kinds of external hemorrhoids: Type I external hemorrhoids stick out from the area around the outside of the anus. Type 2 external hemorrhoids are actually internal hemorrhoids that stick out outside the anus. This informative article concerns external hemorrhoids, and will talk about both types.
The very first type of external hemorrhoid occurs outside the anal verge. The anal verge is the surface of the anus that's outside the sphincter when the anal muscle/valve is closed. The term hemorrhoid is defined in an anatomical sense because the tissue that forms the joint where the anus is connected to the rectum. This tissue is dense with arteries, veins, vessels and capillaries. When a person 'has hemorrhoids' the reference is to hemorrhoid tissue that is stricken with varicose veins of some kind. Varicosity could show as twisted and/or enlarged and/or swollen veins within the hemorrhoid tissue.
True external hemorrhoids (as opposed to interior hemorrhoids that are protruding outside through the anus) are uncommon and are sometimes not a hemorrhoid at all, but actually a misdiagnosed case of perianal hematoma. The perianal blood vessels are in fact underneath the skin surrounding the anus. When these vessels are damaged they may bleed internally, creating bruising and inflammation. Painful as perianal hematoma can be, it is treated in another manner when compared to hemorrhoids.
External hemorrhoids come about when the veins that drain the region of the inferior rectal arteries become varicose. Internal hemorrhoids occur when the veins that drain the region of the upper rectal arteries become varicose. External hemorrhoids are prone to thrombosis, which means they cause blood clots in blood vessels. When a vein within the drainage area of the lower rectal arteries (they connect to the pudental artery) ruptures or if an inter-vessel blood clot develops, the hemorrhoid is classified as a thrombosed hemorrhoid.
Hemorrhoid treatments are available for a wide variety of symptoms, from treatments that sooth minor itching to surgical procedures under full anesthetic. For most people, hemorrhoids get no worse than a slight, occasional annoyance. Signs or symptoms are mild and temporary. The condition heals spontaneously or symptoms are quickly alleviated using local treatments which may include using a bidet or extendable shower head or a warm sitz bath to sooth the inflamed tissue, followed by a cold compress plus a topical analgesic.
External hemorrhoids with little lumps get better with warm baths. The warm water relaxes the vessels in the rectum. Use of medicated creams must be carefully monitored if they have steroid preparations. Steroid preparations can weaken the skin, which could probably be a factor to future outbreaks. With that warning given, however: used early in an outbreak, steroidal cremes are probably the most assured ways of reversing the course of a flare-up.
Keep in mind that excessive washing or rubbing of the anus is not a cure and will aggravate the condition. So far as actually touching the spot goes, it needs to be limited to soaking, rinsing and the application of topical ointments or cremes.
A strangulated hemorrhoid is an internal hemorrhoid that has prolapsed (protruded out of the anus during defecation and will not spontaneously withdraw). The anus goes into spasm because it cannot at all close and ends up cutting off the oxygen supply to the hemorrhoid. These must be checked out by a doctor.
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