These are within the anal canal and internal to the anal orifice. these are bright red or purple in colour, these are usually painless as anal canal membrane from where they originate is not sensitive to pain.
Situated outside the anal orifice and covered by skin, two varieties may coexist and the condition is called internoexternal haemorrhoids.
Haemorrhoids may be secondary to a few conditions eg.:-
Gd -1 when haemorrhoids do not come out from anal canal, bleeding is only symptom
Gd - 2 haemorrhoids come out only during defecation and is reduced spontaneously after defecation.
Gd - 3 haemorrhoids come out only during defecation and do not return by themselves, but need to be replaced manually and then they stay reduced.
Gd -4 The haemorrhoids that are permanently prolapsed. At this stage great discomfort is complained of with a feeling of heaviness in the rectum
INJECTION THERAPY:-ONLY WORKS IN 1st DEGREE HAEMORRHOIDS. Some so called doctors advertise
“BAWASEER EK TEEKE ME JAD SE KHATM”BEWARE OF SUCH ADVERTISEMENT as there is no role injection in any disease other than gd 1 haemorrhoids moreover it may be RISKY if it is not injected properly or given in other diseases like FISSURE or FISTULA.
RUBBER BAND LIGATION:-Previously it was treatment of choice in small haemorrhoids of gd 1 or 2, but now outdated because of its HIGH FAILURE RATE.
KSHAR SUTRA:- is treatment of choice in gd 2 to 4 haemorrhoids.when tied to the base of haemorrhoids they shed off in 5 to 7 days. there is no requirement of invassive procedures like operation and THERE IS NO CHANCE OF RELAPSE after getting treated by kshar sutra.
THROMBOSED PILE / PERIANAL HAEMATOMA:-
A small clot can be seen sometimes below skin. This is a consequent upon straining at stool, coughing, or lifting heavy weight. Condition appears suddenly and is very painful. It may be seen as tense and tender swelling.
Sometimes it resolve by itself or may fibrose or burst giving rise to bleeding. It can be incised the haemorrhoid under local anaesthesia.