Prolapsed internal hemorrhoids

A patient came into the Emergency Department this morning complaining of severe pain in his anus and lots of blood in his stool that he attributed to hemorrhoids. This patient knew what he was talking about considering he had been struggling with them for 10 years, but they had never been so bad as to compel him to visit the ED.

What exactly are hemorrhoids? It turns out that everyone has hemorrhoids; they are connective tissue that normally serve as a sort of cushion for fecal matter passing through the anal canal. It's only when they become inflamed (think constipation, pregnancy) that you notice they're there. Hemorrhoids are classified according to whether they're internal or external, with the internal ones typically being more bloody and the external ones typically being more painful.

My patient had a few external hemorrhoids, but it turned out that the ones causing most of his pain were prolapsed internal hemorrhoids - that is, internal hemorrhoids that were pushed to the exterior when he had a bowel movement. The immediate treatment is simple: resolve them, which is medical jargon for "push them back inside with a gloved finger." And that's exactly what I did.

Considering that this poor guy has been suffering from hemorrhoids for so long, and that he is no longer able to gain relief from them by standard treatments like Preparation H and ibuprofen, his next step may be to look at a surgical fix. This will be especially true once his prolapsed hemorrhoids can no longer be resolved.