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Hemorrhoids are a condition whereby you have dilated blood vessels underneath the lining of the skin in your anus or in your rectum. Usually, this inflamed tissue is spongy vascular tissue that has several direct arteriovenous links. Hippocrates himself actually coined the term hemorrhoid, from the Greek words "hema," which means "blood," and "rhoos," which means "flowing."

Men and women both can have this problem, and it's extremely common. In fact, more than 50% of the population will have it by the time they're 50 years of age. Most often, hemorrhoids have been called rectal varicose veins or "varicosities" of hemorrhoid tissue.

Hemorrhoids have been around since the beginning of mankind, and although their origin isn't specifically known, they began, possibly, when we were first upright. During the Middle Ages, hemorrhoids were called St. Fiacre's curse; St. Fiacre is the gardeners' patron saint, and he contracted a horrible case of prolapsed hemorrhoids after he had spent the day laboring in his garden.

Hemorrhoids are usually classified as two different types, external and internal. If hemorrhoids are external, they are below the anal sphincter, and if they are internal, they are above the anal sphincter. Typically, hemorrhoids are chronic for people, although they may also be acute.

Internal hemorrhoids are found within the left lateral, right anterior, and right posterior positions inside the anal canal. Usually, hemorrhoidal positions are consistent within the anus. In general, internal hemorrhoids are not painful and most people don't even know they have them, since the area doesn't have pain receptors. If they become irritated, they may bleed, however. They should be detected and treated at once, or you can get strangulated or prolapsed hemorrhoids.

External hemorrhoids, in contrast to their internal cousins, occur on the outside of the anus. These hemorrhoids can be painful, with some swelling and irritation. There can also be itching, although this isn't necessarily a symptom of hemorrhoids, but can be caused by skin irritation. If the dilated vein develops a blood clot and/or ruptures, it is then called a thrombosed hemorrhoid; thrombosed hemorrhoids usually occur on external hemorrhoids.

Hemorrhoids are classified by history and not as a result of physical exam. They are graded I through IV, mostly. Grade I may bleed but are not prolapsed, Grade II hemorrhoids are prolapsed and have spontaneous reduction, Grade III are prolapsed but can undergo manual reduction, and Grade IV has irreducible prolapse. These classifications have been around for many years and associate well with the treatment prescribed for each group. Usually, Grade I or II hemorrhoids can be treated effectively without surgery, while Grades III and IV usually will need surgery for intervention.

For most women on their first pregnancy, they experience hemorrhoids during the last trimester. Suggested potential causes are impediment of venous return by the gravid uterus, hormonal changes and chronic straining. Although the real etiology is unknown, once the woman has given birth, the majority of hemorrhoidal symptoms subside. In unusual cases, a surgery called hemorrhoidectomy may possibly be necessary and can be performed with minimum morbidity and little threat to the fetus.