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HemorrhoidS Classification and external resources
Schematic demonstrating the anatomy of hemorrhoids.
ICD-10	I84.
ICD-9	455
MedlinePlus	000292
eMedicine	med/2821

Hemorrhoids (AmE), haemorrhoids (BrE), emerods, or piles are varicosities or swelling and inflammation of veins in the rectum and anus. Image File history File links Download high-resolution version (1100x813, 516 KB) Diagram to show a variety of Hemorrhoids to assist in the Hemorrhoid article. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // I00-I99 - Diseases of the circulatory system (I00-I02) Acute rheumatic fever (I00) Rheumatic fever without mention of heart involvement (I01) Rheumatic fever with heart involvement (I02) Rheumatic chorea (I05-I09) Chronic rheumatic heart diseases (I05) Rheumatic mitral valve diseases (I050) Mitral stenosis (I051) Rheumatic mitral insufficiency (I06) Rheumatic aortic... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... AME is an abbreviation that can refer to: The African Methodist Episcopal Church Aircraft Maintenance Engineer (in Canada) Alternate Mission Equipment Aviation Medical Examiner (in the United States) AmE usually stands for American English This page concerning a three-letter acronym or abbreviation is a disambiguation page — a navigational aid... Breton (Brezhoneg) is a Celtic language spoken by some of the inhabitants of Brittany in France. ... Varices in general refers to distended veins. ... For other uses, see swelling. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... In biology, a vein is a blood vessel which carries blood toward the heart. ... The rectum (from the Latin rectum intestinum, meaning straight intestine) is the final straight portion of the large intestine in some mammals, and the gut in others, terminating in the anus. ... This article is about the bodily orifice. ...

Hemorrhoids are actually the anatomical term for "'Cushions of tissue filled with blood vessels at the junction of the rectum and the anus."^[1] However, the term has come into common usage to indicate the condition described herein. Perianal hematoma are sometimes misdiagnosed and mislabled as hemorrhoids, when in fact they have different causes and treatments^[2]. The rectum (from the Latin rectum intestinum, meaning straight intestine) is the final straight portion of the large intestine in some mammals, and the gut in others, terminating in the anus. ... This article is about the bodily orifice. ...

Prevalence

This article or section deals primarily with the United States and does not represent a worldwide view of the subject. Please improve this article or discuss the issue on the talk page.

Hemorrhoids are common. In the USA, the prevalence is about 4.4%.^[3][4] It is estimated that approximately one half of all Americans have had this condition by the age of 50, and that 50% to 85% of the world's population will be affected by hemorrhoids at some time in their life.^{[citation needed]} However, only a small number seek medical treatment. Annually, only about 500,000 in the U.S. are medically treated for massive hemorrhage, with 10 to 20% of them requiring surgeries. Image File history File links Gnome-globe. ... In epidemiology, the prevalence of a disease in a statistical population is defined as the total number of cases of the disease in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population. ...

According to a British medical journal of 1972 hemorrhoids "are common in economically developed communities, rare in developing countries, and almost unknown in tribal communities, where the influence of Western countries is slight."^[5]

Causes

Increased straining during bowel movements, by constipation or diarrhea, may lead to hemorrhoids. ^[6] It is thus a common condition due to constipation caused by water retention in women experiencing premenstrual syndrome or menstruation. Constipation, costiveness, or irregularity, is a condition of the digestive system where a person (or animal) experiences hard feces that are difficult to egest. ... In medicine, diarrhea, also spelled diarrhoea (see spelling differences), refers to frequent loose or liquid bowel movements. ... PMS links to this article. ... Not to be confused with Mensuration. ...

Hypertension, particularly portal hypertension, can also cause hemorrhoids because of the connections between the portal vein and the vena cava which occur in the rectal wall -- known as portocaval anastomoses.^[7] For other forms of hypertension, see Hypertension (disambiguation). ... In medicine, portal hypertension is hypertension (high blood pressure) in the portal vein and its branches. ... The superior and inferior venae cavae are the veins that return the blood from the body into the heart. ...

Obesity can be a factor by increasing rectal vein pressure. Sitting for prolonged periods of time can cause hemorrhoids. Poor muscle tone or poor posture can result in too much pressure on the rectal veins.

Pregnancy causes hypertension and increases strain during bowel movements, so hemorrhoids are often associated with pregnancy. This article is about human pregnancy in biological females. ...

Excessive consumption of alcohol or caffeine can cause hemorrhoids.^[8] Both can cause diarrhea. Note that caffeine ingestion increases blood pressure transiently, but is not thought to cause chronic hypertension. Alcohol can also cause alcoholic liver disease leading to portal hypertension. This article does not cite any references or sources. ... For other uses, see Caffeine (disambiguation). ... In medicine, portal hypertension is hypertension (high blood pressure) in the portal vein and its branches. ...

Symptoms

Many anorectal problems, including fissures, fistulae, abscesses, or irritation and itching, also called pruritus ani, have similar symptoms and are incorrectly referred to as hemorrhoids.

Hemorrhoids usually are not dangerous or life threatening. In most cases, hemorrhoidal symptoms will go away within a few days.

Although many people have hemorrhoids, not all experience symptoms. The most common symptom of internal hemorrhoids is bright red blood covering the stool, on toilet paper, or in the toilet bowl. However, an internal hemorrhoid may protrude through the anus outside the body, becoming irritated and painful. This is known as a protruding hemorrhoid.

Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms. This condition is known as a thrombosed external hemorrhoid.

In addition, excessive straining, rubbing, or cleaning around the anus may cause irritation with bleeding and/or itching, which may produce a vicious cycle of symptoms. Draining mucus may also cause itching.

Food

This section does not cite any references or sources. (September 2006) Please help improve this section by adding citations to reliable sources. Unverifiable material may be challenged and removed.

Insufficient liquid can cause a hard stool, or even chronic constipation, which can lead to hemorrhoidal irritation. An excess of lactic acid in the stool, a product of excessive consumption of dairy products such as cheese, can cause irritation; reducing such consumption can bring relief. Vitamin E deficiency is also a common cause. Image File history File links Question_book-3. ... For the production of milk by mammals, see Lactation. ... Cheese is a solid food made from the milk of cows, goats, sheep, and other mammals. ... Tocopherol, or Vitamin E, is a fat-soluble vitamin in eight forms that is an important antioxidant. ...

Eating fruit helps avoid conditions that lead to hemorrhoids.

Food considered "probiotic", such as yogurt with active culture, may help keep the gut functioning normally and thus prevent flare-ups. Probiotics are dietary supplements containing potentially beneficial bacteria or yeasts. ...

Types of hemorrhoids

Direct view of hemorrhoid seen on sigmoidoscopy

• (I84.3-I84.5) External hemorrhoids are those that occur outside of the anal verge (the distal end of the anal canal). They are sometimes painful, and can be accompanied by swelling and irritation. Itching, although often thought to be a symptom from external hemorrhoids, is more commonly due to skin irritation.
  • (I84.3) External hemorrhoids are prone to thrombosis: if the vein ruptures and a blood clot develops, the hemorrhoid becomes a thrombosed hemorrhoid.^[9]
• (I84.0-I84.2) Internal hemorrhoids are those that occur inside the rectum. As this area lacks pain receptors, internal hemorrhoids are usually not painful and most people are not aware that they have them. Internal hemorrhoids, however, may bleed when irritated.
• (I84.1) Untreated internal hemorrhoids can lead to two severe forms of hemorrhoids: prolapsed and strangulated hemorrhoids:
  • Prolapsed hemorrhoids are internal hemorrhoids that are so distended that they are pushed outside the anus.
  • If the anal sphincter muscle goes into spasm and traps a prolapsed hemorrhoid outside the anal opening, the supply of blood is cut off, and the hemorrhoid becomes a strangulated hemorrhoid.

Image File history File links Hemorrhoids2. ... Image File history File links Hemorrhoids2. ... Sigmoidoscope inserted through the anus and rectum and into the sigmoid colon. ... The pectinate line (anocutaneous line, dentate line, anal verge, anorectal junction) is a line which marks the end of the anal canal and the beginning of the rectum. ... In zootomy, several terms are used to describe the location of organs and other structures in the body of bilateral animals. ... The anal canal is the terminal part of the large intestine. ... Thrombosis is the formation of a clot or thrombus inside a blood vessel, obstructing the flow of blood through the circulatory system. ... A thrombus is the final product of blood coagulation, through the aggregation of platelets and the activation of the humoral coagulation system. ... The rectum (from the Latin rectum intestinum, meaning straight intestine) is the final straight portion of the large intestine in some mammals, and the gut in others, terminating in the anus. ... In a sensory system, a sensory receptor is a structure that recognizes a stimulus in the internal or external environment of an organism. ... Look up Sphincter in Wiktionary, the free dictionary. ... A spasm is a sudden, involuntary contraction of a muscle, a group of muscles, or a hollow organ, or a similarly sudden contraction of an orifice. ...

By degree of prolapse

The most common grading system was developed by Banov:^[3][10]

• Grading of Internal Hemorrhoids
  • Grade I: The hemorrhoids do not prolapse.
  • Grade II: The hemorrhoids prolapse upon defecation but spontaneously reduce.
  • Grade III: The hemorrhoids prolapse upon defecation, but must be manually reduced.
  • Grade IV: The hemorrhoids are prolapsed and cannot be manually reduced.

Prevention

This section does not cite any references or sources. (September 2006) Please help improve this section by adding citations to reliable sources. Unverifiable material may be challenged and removed.

Prevention of hemorrhoids includes drinking more fluids, eating more dietary fiber (such as fruits, vegetables and cereals high in fiber), exercising, practicing better posture, and reducing bowel movement strain and time. Hemorrhoid sufferers should avoid using laxatives and should strictly limit time straining during bowel movement. Wearing tight clothing and underwear will also contribute to irritation and poor muscle tone in the region and promote hemorrhoid development. Some sufferers report a more comfortable experience without underwear or wearing only very lightweight underwear. Image File history File links Question_book-3. ... Dietary fibers are the indigestible portion of plant foods that move food through the digestive system, absorbing water and making defecation easier. ... Defecation or feceation (known colloquially as pooping or shitting) is the act of eliminating solid or semisolid waste material from the digestive tract. ... A laxative is a preparation used for the purpose of encouraging defecation, or the elimination of feces. ...

Women who notice they have painful stools around the time of menstruation would be well-advised to begin taking extra dietary fiber and fluids a couple days prior to that time. Not to be confused with Mensuration. ... Dietary fibers are the indigestible portion of plant foods that move food through the digestive system, absorbing water and making defecation easier. ...

Fluids emitted by the intestinal tract may contain irritants that may increase the fissures associated with hemorrhoids. Washing the anus with cool water and soap may reduce the swelling and increase blood supply for quicker healing and may remove irritating fluid.

Kegel exercises for the pelvic floor may also prove helpful. A Kegel exercise, named after Dr. Arnold Kegel, is an exercise designed to strengthen the pubococcygeus muscles. ...

Many people do not get a sufficient supply of dietary fiber (20 to 25 grams daily) and small changes in a person's daily diet can help tremendously in both prevention and treatment of hemorrhoids.

Use of squat toilets

Based on their very low incidence in the developing world, where people squat for bodily functions, hemorrhoids have been attributed to the use of the unnatural "sitting" toilet.^[11][12] In 1987, an Israeli physician, Dr. Berko Sikirov, published a study testing this hypothesis by having hemorrhoid sufferers convert to squat toilets.^[13] Eighteen of the 20 patients were completely relieved of their symptoms (pain and bleeding) with no recurrence, even 30 months after completion of the study. This chart summarizes the results. French Squatter toilet A squat toilet is a toilet where the user squats. ...

No follow-up studies have ever been published. The American Society of Colon & Rectal Surgeons is silent regarding the therapeutic value of squatting.

Examination

Endoscopic image of internal hemorrhoids seen on retroflexion of the flexible sigmoidoscope at the ano-rectal junction

After visual examination of the anus and surrounding area for external or prolapsed hemorrhoids, a doctor would conduct a digital examination. In addition to probing for hemorrhoidal bulges, a doctor would also look for indications of rectal tumor or polyp, enlarged prostate and abscesses. Image File history File linksMetadata Hemorrhoids. ... Image File history File linksMetadata Hemorrhoids. ... Sigmoidoscope inserted through the anus and rectum and into the sigmoid colon. ... A rectal examination or rectal exam is an internal examination of the rectum by a physician or other healthcare professional. ... For malignant tumors specifically, see cancer. ... Polyp of sigmoid colon as revealed by colonoscopy. ... The prostate is a compound tubuloalveolar exocrine gland of the male mammalian reproductive system. ... For the death metal band, see Abscess (band). ...

Visual confirmation of hemorrhoids can be done by doing an anoscopy, using a medical device called an anoscope. This device is basically a hollow tube with a light attached at one end that allows the doctor to see the internal hemorrhoids, as well as polyps in the rectum. An anoscopy is an examination using a small, rigid speculum (anoscope) inserted a few inches into to the anus in order to evaluate problems of the anal canal. ...

If warranted, more detailed examinations, such as sigmoidoscopy and colonoscopy can be performed. In sigmoidoscopy, the last 60cm of the colon and rectum are examined whereas in colonoscopy the entire bowel is examined. Sigmoidoscope inserted through the anus and rectum and into the sigmoid colon. ... Colonoscopy is the minimally invasive endoscopic examination of the large colon and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. ... It has been suggested that this article or section be merged with Large intestine. ...

A pathologist will look for dilated vascular spaces which exhibit thrombosis and recanalization.

Treatments

Treatments for hemorrhoids vary in their cost, risk, and effectiveness. Different cultures and individuals approach treatment differently. Some of the treatments used are listed here in increasing order of intrusiveness and cost.

For many people, hemorrhoids are mild and temporary conditions that heal spontaneously or by the same measures recommended for prevention. There is no medicine that will cure hemorrhoids, but local treatments such as warm sitz baths, using a bidet, extendable showerhead, cold compress, or topical analgesic (such as Nupercainal), can provide temporary relief. Especially in the case of external hemorrhoids with a visible lump of small size, the condition can be improved with warm bath causing the vessels around rectal region to be relaxed. Consistent use of medicated creams during the early stages of a hemorrhoid flare-up will also provide relief and may stave off further development and irritation. However, creams containing steroid preparations weaken the skin and may contribute to further flare-ups. Keep the area clean and dry, with some lubrication provided by hemorrhoidal creams or a lubricant. Ointment or suppositories such as Proctosedyl ^[14][15] and Faktu ^[16] can also relieve the symptoms. Hydrotherapy, formerly called hydropathy, is probably the oldest form of medical treatment. ... A toilet (left) and a bidet (right). ... Suppository casting mould A suppository is a drug delivery system that is inserted either into the rectum (rectal suppository), vagina (vaginal suppository) or urethra (urethral suppository) where it dissolves. ...

Natural treatments

Some people claim to have successfully applied natural procedures for treatment or reversal of chronic conditions. These procedures largely echo the prevention measures. However, self-care measures, including herbal or "natural" remedies, should not be undertaken without medical consent to avoid possible drug interactions. They include:

• Reducing regional pressure in such ways as improving posture and muscle tone, or in severe cases, undergoing a profound psychophysical reeducation, by a method such as the Alexander Technique.
• Taking herbs and dietary supplements that strengthen vein walls, such as Butcher's Broom, Horse-chestnut, bromelain, and Japanese Pagoda Tree extracts. Drinking 99% pure aloe juice can also relieve itching and swelling.^{[citation needed]}
• Topical application of natural astringents and soothing agents, such as Witch hazel (astringent), Cranesbill, Aloe vera, and honey.
• Drinking chamomile tea several times a day.
• Eating fiber-rich bulking agents such as plantain and Psyllium seed husks to help create a softer stool that is easier to pass, to lessen the irritation of existing hemorrhoids.
• Using the squatting position for bowel movements.^[17]
• For sufferers of hemorrhoids caused by poor vein circulation (coupled with varicose veins in lower extremities and/or varicocele), sleeping overnight with raised legs helps reduce or completely eliminate especially external hemorrhoids. A 12-inch by 24-inch foam wedge is available in most medical supplies stores for less than $50. It should be covered with a zippered, removable, 50% cotton muslin cover.^{[citation needed]}

The combination of internal and external remedies is particularly recommended, e.g. Witch-hazel suppositories combined with frequent cups of strong chamomile tea.^[18] ‹ The template below is being considered for deletion. ... Butchers broom (Ruscus aculeatus, Ruscaceae, formerly in Liliaceae) is a low evergreen Eurasian shrub of the lily family, with flat shoots that give the appearance of stiff, spine-tipped leaves. ... Species Aesculus arguta: Texas Buckeye Aesculus californica: California Buckeye Aesculus chinensis: Chinese Horse-chestnut Aesculus flava (): Yellow Buckeye Aesculus glabra: Ohio Buckeye Aesculus hippocastanum: Common Horse-chestnut Aesculus indica: Indian Horse-chestnut Aesculus neglecta: Dwarf Buckeye Aesculus parviflora: Bottlebrush Buckeye Aesculus pavia: Red Buckeye Aesculus sylvatica: Painted Buckeye Aesculus turbinata... Pineapple, one member of the Bromeliaceae family Bromelain can refer to one of two protease enzymes extracted from the plant family Bromeliaceae, or it can refer to a combination of those enzymes along with other compounds produced in an extract. ... Species Styphnolobium affine - Coralbean Styphnolobium japonicum - Pagoda Tree Styphnolobium monteviridis Styphnolobium is a small genus of three or four species of small trees and shrubs in the subfamily Faboideae of the pea family Fabaceae, formerly included within a broader interpretation of the genus Sophora. ... A bottle of tannic acid, an astringent Astringent medicines cause shrinkage of mucous membranes or exposed tissues and are often used internally to check discharge of blood serum or mucous secretions. ... Witch hazel is an astringent produced from the leaves and bark of the North American shrub, Witch-hazel. ... Species See list The cranesbills make up the genus Geranium of 422 species of annual, biennial, and perennial plants found throughout the temperate regions of the world and the mountains of the tropics, but mostly in the eastern part of the Mediterranean. ... Species See Species For other uses, see Aloe (disambiguation). ... Binomial name Matricaria recutita L. German Chamomile (Matricaria recutita), also spelt Camomile, is an annual plant of the sunflower family Asteraceae. ... This article is about the fruit. ... Psyllium seed husks, also known as ispaghula or simply as psyllium, are portions of the seeds of the plant Plantago psyllium or Plantago ovata. ...

Dietary supplements can help treat and prevent many complications of hemorrhoids, and natural botanicals such as Butchers Broom, Horse-chestnut, and bioflavonoids can be an effective addition to hemorrhoid treatment.^[19]

Butcher's Broom extract, or Ruscus aculeatus, contains ruscogenins that have anti-inflammatory and vasoconstrictor effects that help tighten and strengthen veins. Butcher’s Broom has traditionally been used to treat venous problems including hemorrhoids and varicose veins.^[20][21][22] Butchers broom (Ruscus aculeatus, Ruscaceae, formerly in Liliaceae) is a low evergreen Eurasian shrub of the lily family, with flat shoots that give the appearance of stiff, spine-tipped leaves. ...

Horse-chestnut extract, or Aesculus hippocastanum, contains a saponin known as aescin, that has anti-inflammatory, anti-edema, and venotonic actions. Aescin improves tone in vein walls, thereby strengthening the support structure of the vein. Double blind studies have shown that supplementation with Horse-chestnut helps relieve the pain and swelling associated with chronic venous insufficiency.^[23][24] Saponins are the glycosides of 27 carbon atom steroids, or 30 carbon atom triterpenes. ...

Bilberry extract, or Vaccinium myrtillus, is an anthocyanoside bioflavonoid. Supplementation with this potent flavonoid protects and maintains venous strength and function.^[20][25]

Surgical /non medicinal treatments

Some people require the following medical treatments for chronic or severe hemorrhoids:

• Rubber band ligation
  Sometimes called Baron ligation. Elastic bands are applied onto an internal hemorrhoid to cut off its blood supply.^[26] Within several days, the withered hemorrhoid is sloughed off during normal bowel movement.
• Hemorrhoidolysis/Galvanic Electrotherapy
  Desiccation of the hemorrhoid by electrical current.
• Sclerotherapy (injection therapy)
  Sclerosant or hardening agent is injected into hemorrhoids. This causes the vein walls to collapse and the hemorrhoids to shrivel up.
• Cryosurgery
  A frozen tip of a cryoprobe is used to destroy hemorrhoidal tissues.^[27] Rarely used anymore because of side effects.
• Laser, infrared or BICAP coagulation
  laser, Infrared beam, or electricity is used to cauterize the affected tissues. Lasers are now much less popular. Infrared coagulation has been studied in comparison with RBL and found to be as effective in hemorrhoids up to grade III. These are the most readily available non-surgical procedures in the US.
• Hemorrhoidectomy
  A true surgical procedure to excise and remove hemorrhoids. Has possible correlation with incontinence issues later in life; in addition, many patients complain that pain during recovery is severe. For this reason is often now recommended only for severe (grade IV) hemorrhoids.
• Stapled Hemorrhoidectomy
  Also called the procedure for prolapse and hemorrhoids, it is designed to resect soft tissue proximal to the dentate line, which disrupts the blood flow to the hemorrhoids. It is generally less painful than complete removal of hemorrhoids and also allows for faster recovery times. It's meant for hemorrhoids that fall out or bleed and is not helpful for painful outside conditions.
• Enema
  This Practice is used to clean the rectum. While it is a simple procedure, it can be complicated by hemorrhoids, so in such cases, it should be done by a doctor. In an enema, water is injected into the rectum and then flushed out, cleaning the area.
• Doppler Guided Hemorrhoidal Artery Ligation
  The only evidence-based surgery for all grades of hemorrhoids. It does not involve cutting tissues or even a stay at the hospital; patients are usually back to work on the same day. It is the best treatment for bleeding piles, as the bleeding stops immediately. ^[28]
• HAL-RAR
  To date, Doppler Guided Hemorrhoidal Artery Ligation was indicated in management of Grade II & Grade III Hemorrhoids but with the availabilty of HAL Recto Anal Repair Management of prolapsing hemorrhoids without excision is also possible.
• Transanal hemorrhoidal dearterialization (THD)
  Similar to HAL, but more standardizable and therefore safer, less painful and has a shorter recovery time.

Rubber band ligation is an outpatient treatment for second-degree internal hemorrhoids. ... HEMORRHOIDAL DISEASE is one of the most frequent, disabling, and painful conditions of mankind. ... It has been suggested that this article or section be merged with Foam sclerotherapy. ... For other uses, see Laser (disambiguation). ... Electricity (from New Latin ēlectricus, amberlike) is a general term for a variety of phenomena resulting from the presence and flow of electric charge. ... Severe cases of hemorrhoidal prolapse – 3rd and 4th Degree – will normally require surgery. ... This 2qt (about 1. ...

Diseases with similar symptoms

Symptoms associated with rectal cancer, anal fissure, anal abscess, anal fistula, Perianal hematoma, and other diseases may be similar to those produced by hemorrhoids and may be reduced by the topical analgesic methods described above. For this reason, it is a good idea to consult with a physician when these symptoms are encountered, particularly for the first time, and periodically should the problem continue. In the US, colonoscopy is recommended as a general diagnostic for those over age 50 (40 with family history of bowel cancers); a clear (normal) scope is good for 10 years. Diagram of the stomach, colon, and rectum Colorectal cancer, also called colon cancer or bowel cancer, includes cancerous growths in the colon, rectum and appendix. ... An anal fissure is an unnatural crack or tear in the anus skin. ... An anal abscess is a abscess adjacent to the anus, characterized by extremely painful bowel movements. ... An anal fistula is an abnormal infection that grows a second head between the epithelialised surface of the anal canal and (usually) the perianal skin. ...

References

eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 332nd day of the year (333rd in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 341st day of the year (342nd in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) was a common year starting on Monday of the Gregorian calendar in the 21st century. ... is the 332nd day of the year (333rd in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ...

See also

• Anal fissure
• Anal fistula
• Perianal hematoma
• Proctoscopy

An anal fissure is an unnatural crack or tear in the anus skin. ... An anal fistula is an abnormal infection that grows a second head between the epithelialised surface of the anal canal and (usually) the perianal skin. ... A medical procedure where an instrument, consisting of a tube or speculum equipped with a light, used to examine the rectum. ...

External links

• Hemorrhoid at the Open Directory Project