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For More InfoHemorrhoids

Hemorrhoids affect almost 500,000 people throughout the United States every year. It affects both men and women alike and at some point over half of all people in Charlottesville and Central Virginia will be affected by hemorrhoids. The majority of people can usually be treated through diet modification and altering their defecation habits.


Hemorrhoids are caused by overdistension of the normal veins that line the inside of the anus. They are similar to the varicose veins that occur in the legs. The etiology of hemorrhoids is most commonly genetic, being passed from generation to generation. They are exacerbated by factors that increase pressure in the anus: pregnancy, obesity, constipation and heavy lifting.

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Internal hemorrhoids occur above the dentate line within the anus. They are characterized as painless as there is no innervation of the anus in this region. They can, however, cause bleeding. Additionally, hemorrhoids in this region can become quite large due to chronic pressure. They may even cause bulging (or prolapse) of the overlying anal tissue to the outside of the anus.

External hemorrhoids occur below the dentate line and are frequently itchy and painful. They can become irritated enough to crack and bleed. Alternatively, they can become swollen with blood and feel like a tender lump on the edge of the anus.

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Treatment options for hemorrhoids vary depending on the severity of symptoms and the degree of prolapse. External hemorrhoids, if thrombosed, often need to be incised to relieve the painful symptoms. For hemorrhoids that are not prolapsing, diet and topical medications are often sufficient. For hemorrhoids that are prolapsing, treatment will often require surgery to permanently remove the redundant tissue. This is necessary in about 10% of people who seek treatment for hemorrhoids. Fortunately, new research in hemorrhoid surgery has lead to the development of less painful surgical options.

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