What are Hemorrhoids?
A lot of people have hemorrhoids but only 4% of population suffers from it world wide.
It is the veins in the anal canal when it becomes dilated and engorged with blood. There are 3 main vessels and each one has 2 rudimentary veins. The main veins lie at 3 - 6 -12 O'clock when the patient lies on his back (lithotomy position)
There are internal and external hemorrhoids. The difference between them is one above and the other below something called the dentate line inside the anus.
What are the causes of Hemorrhoids?
The cause of hemorrhoids is not known yet. But there are many theories about its cause
1. Some says it is the price that humans pay for standing upright as this increases the pressure inside the hemorrhoidal veins.
2.Weakness in the muscle supporting the rectal canal due to straining as in case of chronic constipation, some have the habit of straining in the toilet to finish the job faster, eating spicy foods, low fibers in the diet.
3. During pregnancy due to pressure of the gravid uterus on the pelvic veins especially during labor.
4. After repeated anal fissure (tear in the anal verge occurs in straining to pass hard stools) stricture and fibrosis of the anal sphincter will occur leading to increase force needed to pass stools through the tight sphincter.
5. In liver cirrhosis as there is rise in the pressure in the veins which the hemorrhoidal drains into it. This is called secondary piles
Symptoms and signs of Hemorrhoids:
In most cases hemorrhoids are asymptomatic, in few cases the patient may suffer from RED blood in stools (dark blood is something else), pain during defecation, lumps appears from the anal verge during defecation.
Pain usually occur when there is complications such as inflammation, or thrombosis in the external hemorrhoids or if it is accompanied with anal fissure or in 4th degree pile it my get outside and becomes constricted be the anal sphincter where it becomes swollen, edematous and oozing.
Diagnosis of Hemorrhoids:
This is done by qualified surgeon through history and clinical examination. He may use proctoscope.
Treatment of Hemorrhoids:
There are wide variety of choices such as
. Surgery
. Band ligation
. Sclerotherapy (inject it with sclerosing material)
. Cryosurgery
. Infrared coagulation
. Laser surgery
. Medical treatment (cream, anesthetic ointment, decongestant, laxative, analgesics, hot sitz baths, herbal treatment)
M.BATRAN
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