The cushions of tissue that are filled with blood vessels at the region where the rectum and anus meet are anatomically referred to as ‘hemorrhoids‘. Hemorrhoids are also called ‘piles’ which is defined as things laid one upon the other.

To name problems associated with the anus, sometimes is just easy for people to use the terms ‘hemorrhoids’ or ‘piles’. These are actually part of the normal anatomy in the area.

The anal canal is lined with fibrovascular cushions or pads of submucosal tissue. There are normally three of these tissues that are suspended in the anal canal by a framework of connective tissue that is connected to the internal sphincter.

There is a network of interconnecting veins in everyone of these cushions which permits the cushions to become enlarged. This process helps with anal continence, and prevention of leaking stool, liquid or gas.

There is a need to maintain the normal functions of these blood vessels. The cause of the hemorrhoids is thought to be the disturbance of the normal anatomy of the connective tissue and changes in the blood vessels.

The blood vessels in the anal area are affected and can make the hemorrhoids very painful. This happens when some of the veins balloon. They can be very tender especially with prolonged sitting position as they can protrude beyond the anus as grape-like clusters or they can also remain inside the anal area.

Hemorrhoids are a common problem. They usually affect people between the age of 20 - 50 years.

It is also reported that the incidence of hemorrhoids increases with age. 50% of people over 50 years will experience some degree of hemorrhoids during their lives.

There is some data indicating how much of the population has it. It is also indicated that there is difficulty in obtaining the accurate number of people suffering from hemorrhoids because many people with the condition never seek treatment.

You may wonder why some people affected by this condition do not seek assistance from their doctors. One of the possible reasons is because this may be perceived by the person as an intimate and extremely personal and private matter.

When the patient finally comes to seek help, it is important for the doctor to be sensitive and respectful when approaching the patient for information gathering. The information obtained is important in order to make the diagnosis which in turn will help with the decision about treatment.

During the examination, the patient must be given the opportunity to have a chaperone. The patient’s dignity and modesty must be protected at all times.

Rectal bleeding is a ‘red flag’ sign and one of the signs that make it an urgent case. The bleeding is usually associated with hemorrhoids and fissures, but an examination is needed to be done by the doctor and you may require further investigations.

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