There are 2 types of external hemorrhoids: Type I external hemorrhoids protrude from the region around the exterior of the anus. Type 2 external hemorrhoids are really interior hemorrhoids that protrude outside the anus. This informative article is about external hemorrhoids, and would discuss both types.
The first type of external hemorrhoid takes place outside the anal verge. The anal verge is the area of the anus that's outside the sphincter when the anal muscle/valve is closed. The word hemorrhoid is defined in an anatomical sense as the tissue that forms the joint where the anus is connected to the rectum. This particular tissue is absolutely dense with arteries, veins, vessels and capillaries. If someone 'has hemorrhoids' the reference is actually to hemorrhoid tissue that's stricken with varicose veins of some sort. Varicosity can show as twisted and/or enlarged and/or swollen veins in the hemorrhoid tissue.
True external hemorrhoids (unlike interior hemorrhoids that are protruding outside through the anus) are rare and are often not really a hemorrhoid in any way, but actually a misdiagnosed case of perianal hematoma. The perianal blood vessels are under the skin around the anus. In case these vessels are damaged they will bleed internally, creating bruising and swelling. Painful as perianal hematoma may be, it's treated in another manner than hemorrhoids.
External hemorrhoids occur when the veins that drain the region of the lower rectal arteries become varicose. Internal hemorrhoids come about when the veins that drain the area of the superior rectal arteries become varicose. External hemorrhoids are vulnerable to thrombosis, which means they bring about blood clots in blood vessels. When a vein within the drainage area of the inferior rectal arteries (they link to the pudental artery) ruptures or if an inter-vessel blood clot grows, the hemorrhoid is categorized as a thrombosed hemorrhoid.
Hemorrhoid treatments exist for a wide range of signs or symptoms, from treatments that sooth slight itching to surgical procedures under full anesthetic. For many, hemorrhoids get no worse than a minor, occasional annoyance. Signs or symptoms are mild and short-term. The condition heals spontaneously or signs or symptoms are easily alleviated using local treatments that might include using a bidet or extendable shower head or perhaps a warm sitz bath to sooth the swollen tissue, followed by a cold compress as well as a topical analgesic.
External hemorrhoids with small lumps improve with warm baths. The warm water relaxes the vessels in the rectum. Use of medicated lotions should be closely monitored if they contain steroid preparations. Steroid preparations may weaken the skin, which might probably contribute to future outbreaks. With that caution given, however: used early in an outbreak, steroidal cremes are probably the most solid methods of reversing the course of a flare-up.
Remember that excessive washing or rubbing of the anus is no cure and would worsen the condition. As far as actually touching the area goes, it needs to be restricted to soaking, rinsing and the application of topical ointments and cremes.
A strangulated hemorrhoid is an interior hemorrhoid that has prolapsed (protruded outside the anus during defecation and won't spontaneously withdraw). The anus goes into spasm as it cannot in any way close and winds up cutting off the oxygen supply to the hemorrhoid. These should be checked out by a doctor.
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