The classification of hemorrhoids is generally divided into internal hemorrhoids, external hemorrhoids and mixed hemorrhoids according to the occurrence of hemorrhoids. It is delimited by the dentate line (the dentate line is a zigzag line formed by the connection between the rectal mucosa and the anal skin).
1, internal hemorrhoids occur on the tooth line, the surface is covered with mucous membranes, usually can not be seen, stool can be removed from the anus, can not be removed from the anus, can be returned by itself, but often accompanied by blood in the stool.
2, external hemorrhoids are formed by external hemorrhoidal venous plexus, under the tooth line, the surface covers the skin, can be seen, can not be returned to the anus, not often bleeding, external hemorrhoids patients accompanied by internal hemorrhoids.
3, mixed hemorrhoids are near the dentate line, with internal hemorrhoids, external hemorrhoids two characteristics.
Clinically, it is generally divided into three stages according to the severity of the development of internal hemorrhoids.
Stage I internal hemorrhoids: the pathological manifestations are varicose veins in hemorrhoids, increased veins, dilated and thickened, protrusions under the rectal mucosa, soft and red, with capillaries and connective tissue of varicose veins. Symptoms can be seen, due to fecal stimulation, mucous membranes rough, sometimes erosion, defecation can be blood. This stage bleeding more, no pain, not out.
Stage II internal hemorrhoids: Pathological manifestations were varicose enlargement, mucous membranes thickened, purplish red. Symptoms can be seen, defecation is often driven by stool, hemorrhoidal mass separated from the muscle layer, moving down, defecation of hemorrhoidal nucleus out of the anus, after defecation can be due to sphincter contraction and natural return into the anus. The hemorrhage of this stage is less than that of the hemorrhoids in the first stage, if there is infection, there is anal pain, tenesmus.
Stage III internal hemorrhoids: Pathological manifestations: connective tissue hyperplasia, mucosa hardening, thickening, red purple. Symptoms can be seen, can not recover after exiting, must be restored by hand or after rest into the anus. Exertion, coughing, walking, squatting, and weight bearing can cause hemorrhoids to escape from the anus, with less bleeding, easy inflammation, and pain. If it can not be returned in time for a long time, it can lead to blocked blood flow, poor reflux, swelling and pain of hemorrhoid nucleus, thrombosis, and then surface ulceration, forming incarceration.
External hemorrhoids are clinically divided into four types: thrombus external hemorrhoids, varicose external hemorrhoids, inflammatory external hemorrhoids and connective tissue external hemorrhoids.
1, thrombotic external hemorrhoids: most of them are due to forced defecation, dry stool, cough and other violent activities, so that anal vein rupture, blood extravasation into the connective tissue, become hematoma, subcutaneous silting in the anus to form a small swelling, and sudden onset, severe pain, swelling discomfort, anal subcutaneous may feel hard and smooth blood clots, can be one, can be several. Uninfected people can heal themselves within 4 to 5 weeks, and the infection can form a perianal abscess.
2, varicose external hemorrhoids: the anal edge of the bulge into oval or long shape, touch soft, no pain, stool force, visible anal edge of dark purple mass, defecation or rest after the mass volume can be reduced.
3, inflammatory external hemorrhoids: is due to the inflammation of the anal fold edema, pain, swelling, redness, fever. Most are caused by damaged anal friction and bacterial infection.
4, connective tissue external hemorrhoids: by the anal margin of the skin fold becomes larger, connective tissue hyperplasia, the formation of skin, mostly after inflammatory external hemorrhoids, or due to hard stool caused anal damage, infection, edema inflammation dissipated, the fold can not recover, so repeated, or due to anal secretion increase can lead to such external hemorrhoids. This kind of hemorrhoids is usually without any symptoms, only after defecation is not easy to wipe, so that the anus has wet, itching and other stimulation.
Clinical manifestations:
1, blood in the stool, attack from time to time, feel something out of the anus, or swollen pain outside the anus, increased secretions, often polluted underwear, that is, roughly think of haemorrhoids when bleeding is a common symptom of internal hemorrhoids, bright red, painless, the amount of bleeding is generally not much, sometimes more, spraying, can cause serious anemia over time.
2, the hemorrhoids block out, the second and third stages of internal hemorrhoids can be propped out of the anus, from their own recovery to must be pushed back into the anus by hand, otherwise it is easy to incarcerate, necrosis.
3, pain simple internal hemorrhoids without pain. When the internal hemorrhoidal mucosa erosion, edema, secondary infection can have pain, such as the occurrence of incarcerated strangulation, necrosis infection, can have severe pain.
4, pruritus rectal mucosa due to hemorrhoidal prolapse, stimulating secretion increase, sphincter relaxation, secretion outflow, so that perianal skin itching, and even skin eczema.