Hemorrhoids do not bleed or hurt but have balls

Hemorrhoids, specifically, have many types, the three largest categories are: internal hemorrhoids, external hemorrhoids, and mixed hemorrhoids. There is a fleshy ball on the anus, which does not cause pain or bleeding. This is a pure external hemorrhoid. Based on these three characteristics, in order to get a more accurate classification, we need to look at the nature of the meatus and finally confirm the diagnosis. In the following content, we will talk in detail about the dangers and medical classification of external hemorrhoids.

Classification

Connective tissue external hemorrhoids

Connective tissue external hemorrhoids are named because of their shape. They are also called skin hemorrhoids.

External hemorrhoids caused by hanging objects and cuticles. This type of external hemorrhoids is characterized by thickening and hypertrophy of the skin folds at the edge of the anus, with connective tissue hyperplasia, no varicose veins inside the hemorrhoids, very few blood vessels, a wide base and long tip, yellowish-brown or brown-black in color, protruding and easy to see, and varying in size and shape. Sometimes there is only one, in the middle behind or in front of the anus, and sometimes there are several around the anus.

Etiology and pathology: Often caused by constipation. When dry stool passes through the anus, it over-stretches the anal skin and tears the anal folds, causing infection, inflammation, edema, and fibrosis. After the inflammation subsides, the folds cannot return to normal. Repeated injuries will cause the folds to proliferate and hypertrophy, becoming external hemorrhoids. Various inflammations of the anus and rectum, such as proctitis, anal stenosis, internal hemorrhoids, anal sinusitis, anal fistula, anal fissure, etc., are also the causes of connective tissue external hemorrhoids. In addition, anal surgeries, such as hemorrhoidectomy and anal sinusectomy, can affect the return of anal lymph and blood due to improper skin cutting, suturing, and ligation, often causing connective tissue external hemorrhoids.

If there is no inflammation in connective tissue external hemorrhoids, the patient may only feel a foreign body sensation in the local area or the anus is difficult to clean after defecation. There is often a small amount of secretions and feces accumulated, which irritates the anus and may cause eczema and itching. If it becomes inflamed, you will feel pain and have difficulty sitting, standing or walking. At first, it is just the folds that are swollen, with feces and secretions accumulated in the middle, the skin is dark red, and the epidermis is peeling; due to repeated inflammatory stimulation, the skin outside the anus has protrusions, which are soft and yellow in color, often on the midline behind the anus, and sometimes in front of or on both sides of the anus.

Varicose external hemorrhoids

Varicose external hemorrhoids are varicose external hemorrhoidal venous plexus below the dentate line, forming round, oval or prismatic soft lumps at the edge of the anus. If there is edema, the shape will become larger. In traditional Chinese medicine, it falls into the category of qi hemorrhoids. As stated in the Complete Book of Experience on Sores and Ulcers: Illustrated Explanation of Hemorrhoids and Fistulas: “Hemorrhoids caused by gas will go out when exposed to gas.” This disease is generally painless and does not cause bleeding. The only complaint is a feeling of heaviness or foreign body in the anus. It often occurs with third-stage internal hemorrhoids and mixed hemorrhoids.

Etiology and pathology: All kinds of causes that cause hemorrhoids can cause varicose external hemorrhoids. The main factors are: due to improper diet, sitting or standing for a long time, long-term constipation or diarrhea stimulation, long-term continuous increase in abdominal pressure, and infection and damage, the external hemorrhoidal venous plexus dilates, becomes congested, and is tortuous.

Inflammatory external hemorrhoids

Etiology and pathology: It is often caused by infection after anal damage, or anal fissure causing inflammation and edema of anal folds. Hemorrhoid patients feel burning pain, wetness and itching in the anus, and the symptoms worsen after defecation or excessive activity. During examination, the anal folds were found to be congested, swollen, and with a small amount of secretions.

Thrombosed external hemorrhoids

Etiology and pathology: Thrombosed external hemorrhoids are the most common type of external hemorrhoids. It is often caused by excessive force during defecation, strenuous activity or forceful coughing, which causes the veins at the edge of the anus to rupture, and blood to seep into the connective tissue and form blood clots, forming round or oval lumps of varying sizes under the skin of the anus, located inside the anal canal or outside the anal edge. The lump is soft at first and becomes hard after a few days. If there is no inflammation, the lump can be completely absorbed and disappear within 3-4 weeks without leaving any trace; if there is repeated inflammation, the connective tissue in the lump will proliferate and it may become connective tissue external hemorrhoids; if infection occurs, an abscess may form.

After defecation or straining, a round or oval lump suddenly appears under the skin at the edge of the anus. The patient feels abnormal pain, which worsens during activity or defecation. Due to sphincter spasm, there is a foreign body sensation in the lower rectum and anus, which hinders walking and makes sitting or lying down restless. The surface of the lump is slightly darker in color, sometimes purple-red, slightly hard, and obviously painful to touch. Sometimes after 2-3 days, the blood clot is absorbed, the pain is relieved, and it can heal itself. Sometimes the infection becomes purulent and the epidermis breaks, resulting in anal fistula.

Distinguishing between external and internal hemorrhoids

External hemorrhoids are located below the tooth line, with pain and lumps as the main symptoms, and skin tags of varying sizes and shapes growing around the anus. According to different pathological characteristics, it can be divided into four types: varicose vein, connective tissue, thrombotic and inflammatory. Among them, inflammatory external hemorrhoids are the most common, with the main manifestations being protruding skin folds at the anus, redness, swelling, heat, pain, edema, obvious congestion, tenderness, increased pain during defecation, and a small amount of secretions. Some may be accompanied by general discomfort and fever.

Internal hemorrhoids occur above the dentate line of the anal canal. They are generally painless, and the main symptoms are bleeding during bowel movements and prolapsed hemorrhoids. In severe cases, blood may spurt out, and prolapsed hemorrhoids may not return to their original position on their own. There may also be difficulty in defecation, inability to wipe clean after defecation, and a feeling of heaviness and distension. According to the severity of internal hemorrhoids and clinical manifestations, they can be divided into three stages: Stage I internal hemorrhoids are bleeding during defecation, but there is no prolapse, and the mucosa above the tooth line is nodular; Stage II internal hemorrhoids are bleeding, dripping or spurting during defecation, and hemorrhoids prolapse, but can be reduced on their own after defecation; Stage III internal hemorrhoids prolapse during defecation or when abdominal pressure increases due to coughing, fatigue, or weight bearing, and need to be reduced manually.

harm

1. Although it is said that external hemorrhoids are not easy to bleed, it does not mean that there is no possibility of bleeding. External hemorrhoids will bleed after being scratched or inflamed. Long-term blood in the stool can lead to anemia.

2. Blood in the stool or swelling around the anus are symptoms of external hemorrhoids, but if you think that blood in the stool or any swelling around the anus is caused by hemorrhoids, you will be careless and delay the treatment of the real disease, intestinal tumors, and lose the best time for treatment.

3. External hemorrhoids: Hemorrhoids are outside the anus, and the secretions increase, inducing anal pruritus or anal eczema. Female patients may also suffer from gynecological diseases.

4. Because external hemorrhoids are spherical objects growing outside the anus, they block the anus. When gas is produced, the gas is often held inside because the air pressure is not strong enough. Farts are waste gases discharged by the body, mostly carbon dioxide, hydrogen and methane. If waste gases exist in the body for a long time, the density will be too high, which will cause bloating in the lower abdomen, or cause the blood vessels to be compressed, affecting the normal contraction of the heart, and easily causing insufficient blood supply, such as dizziness, brain swelling, weakness, etc.