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"Hemorrhoid" as a medical term is defined as the tissue at the joining of the anus and the rectum. In general parlance, "having hemorrhoids," means varicose (i.e., enlarged, knotted, or swollen) veins in the hemorrhoid tissue at the joint of the rectum and the anus. Another condition, perianal hematoma, bruising consequence of internally bleeding veins within perianal tissue, is often mistaken for hemorrhoids. Hemorrhoid treatment plan is different from perianal hematoma treatment. The perianal veins lie just under the dermis surrounding the external surface of the sphincter. Internal hemorrhoids are the focal point of this article.

Hemorrhoids are grouped as either internal or external. All hemorrhoids start as an internal hemorrhoid. Finally, hemorrhoids protrude out the anus even if the muscle is closed.

The tissue in the inside of the rectum has no pain receptors. As a result of this, internal hemorrhoids aren't typically diagnosed until there's a problem with them. Problems occur when irritation leads to existing internal hemorrhoids to swell. The veins in this region drain the superior rectal veins, and problems with the varicose veins in the area can lead to a cycle of swelling. There are other diseases with symptoms that, at some stages, duplicate features of hemorrhoids. If normal treatment fails to relieve an outbreak of hemorrhoid inflammation, the subsequent possible causes should be checked: boil, knotted vein, anal irritation, anal melanoma, fissure or fistula.

Mild symptoms typically disappear without treatment in 3 or 4 days. Most people with hemorrhoids don't understand it until some irritation has caused an internal hemorrhoid to bleed, which the patient notices in the bowl or on their underwear. Typically, internal hemorrhoids minor and are not a threat to overall health. The situation can be said to be severe when defecation forces an internal hemorrhoid to protrude from the anus.

With proper treatment internal hemorrhoids can remain internal. Untreated, or aggravated by secondary factors like pregnancy, internal hemorrhoids can become prolapsed. This means an internal hemorrhoid that was protruding during passing stool has ceased to naturally withdraw to the inside of the sphincter. It is now a prolapsed pile.

The irritation of the hemorrhoid on the sphincter muscle often causes the muscle to spasm. When this happens, a prolapsed hemorrhoid can be strangled by the spasmodic muscle compromising the oxygen supply.

Under the commonly used 4 Grade system for classifying hemorrhoids, the most severe type of hemorrhoid, the strangled hemorrhoid where blood loss in necrotizing tissue, is a Grade 4. At the other end of the scale is a Grade 1 internal hemorrhoid. This hemorrhoid does not prolapse during defecation and is internal at all times. In between are the prolapsed hemorrhoid - one that protrudes during defecation but minimizes naturally - and the Grade 3 hemorrhoid, which has to be reduced by manual squeezing before it is able to withdraw.

The possible causes of internal hemorrhoids are many; hereditary predisposition, pregnancy, poor diet, chronic constipation, chronic diarrhea, alcohol abuse, excess smoking leading to capillary reduction, hypertension (especially portal hypertension), obesity, poor muscle tone, poor posture and caffeine have all been cited as contributing factors.

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