Haemorrhoids may present as a painful swelling within or at the anus. If this occurs acutely - the classical 'strangulated' pile - it may represent clotting in the venous plexus of the cushion. Usually, this resolves with ultimate clot lysis. Simple analgesia is required in the interim.
An alternative cause of pain is obstruction to the venous and lymphatic flow from the cushion when a haemorrhoid is trapped outside the anal margin for a long period of time.
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