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Hemorrhoids are painful, swollen veins in the lower portion of the rectum or anus. Hemorrhoids are very common, especially during pregnancy and after childbirth. They result from increased pressure in the veins of the anus. The pressure causes the veins to swell, making them painful, particularly when you are sitting. The most common cause is straining during bowel movements. Hemorrhoids may be caused by: Straining during bowel movements; Constipation; Sitting for long periods of time; Anal infections; Certain diseases, such as liver cirrhosis; Hemorrhoids may be inside or outside the body. Internal hemorrhoids occur just inside the anus, at the beginning of the rectum. External hemorrhoids occur at the anal opening and may hang outside the anus. Hemorrhoids are vascular-rich connective tissue cushions located within the anal canal. Internal hemorrhoids lie proximal to the dentate line in the anal canal, whereas external hemorrhoids are located distal to the dentate line. Hemorrhoidal disease presents as painless rectal bleeding or sudden onset of perianal pain with a tender palpable perianal mass. Diagnosis is confirmed with visualization of the protruding tissue or anoscopic visualization. Treatment includes increasing dietary fiber, rubber band ligation, infrared photocoagulation, sclerotherapy, or surgical hemorrhoidectomy. Complications include recurrence or worsening of symptoms, excessive bleeding, nonreducible prolapse, and, rarely, pelvic sepsis.
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