Curriculum · Gastroenterology
Haemorrhoids
What it is
Hemorrhoids are an anorectal cause of rectal bleeding, and they are named by their side of the dentate line. Internal hemorrhoids lie above the dentate line and external hemorrhoids below it, and that one fact is why the two differ so much. Anorectal causes, hemorrhoids and anal fissure, are the most common cause of rectal bleeding overall, particularly in young patients. That is the contrast to hold: acute painless lower GI bleeding in older adult patients is usually caused by colonic diverticula or angiodysplasia instead.
Causes and risk
What is listed is increased intra-abdominal pressure: chronic constipation, staying in one place for a long time as with an accountant, chronic cough, and weightlifting.
How it presents
Internal hemorrhoids bleed, with or without prolapse, and they are painless because they lie above the dentate line. External hemorrhoids do not bleed. They are painful, and they present with thrombosis.