Clinical Features of Hemorrhoids

 

Clinical signs and symptoms:

(1) bleeding, often as red blood

(2) anal mass

(3) anal pain or irritation

(4) discharge

(5) difficulty with anal hygiene, including soiling

(6) pruritis ani

(7) difficult and/or painful defecation

Type	Location	Epithelium	Vascular Source
external	distal to dentate line	squamous	inferior hemorrhoidal plexus
internal	proximal to dentate line	glandular mucosa	superior hemorrhoidal plexus
mixed	proximal and distal to dentate line	glandular and squamous	both superior and inferior hemorroidal plexi

 

Complications:

(1) thrombosis

(2) ulceration

(3) prolapse

(4) anal fissure

 

Differential diagnosis (may occur concomitant with hemorrhoids):

(1) skin tags

(2) hypertrophied anal papilla

(3) condyloma accuminatum (anal warts)

(4) cancer

(5) rectal prolapse

(6) anal fissure from other cause

(7) perianal abscess