Haemorrhoids : epidemiology, risk factors, clinical features and management

Abstract

Haemorrhoids are one of the most common anal disorders encountered in primary care. Haemorrhoids are defined as the symptomatic enlargement and distal displacement of the normal anal cushions.1 These cushions are usually found in three main locations: left lateral, right anterior, and right posterior (3, 7 and 11 o'clock positions) .2 These vascular cushions participate in the drainage of the anal canal. It has also been suggested that these cushions intensify the action of the anal sphincter mechanism, thereby contributing to continence. There are two types of haemorrhoids: internal and external. Internal haemorrhoids arise above the dentate line, are viscerally innervated and therefore painless. External haemorrhoids can be painful because they originate below the dentate line and have a somatic innervation.3 Internal haemorrhoids are further subdivided according to the degree of prolapsed.