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__NOTOC__
__NOTOC__
{{Hemorrhoids}}
{{Hemorrhoids}}
{{CMG}}
{{CMG}}; {{AE}}{{AY}}
 
==Overview==
==Overview==
Hemorrhoids may be caused by factors that increase the pressure in the rectal [[veins]] such as [[Chronic cough, severe cold|chronic cough]], [[chronic constipation]], and straining.
==Causes==
==Causes==
The causes of hemorrhoids include genetic predisposition (weak rectal vein walls and/or valves), straining during [[bowel]] movements, and too much pressure on the rectal veins due to poor muscle tone or poor posture. Similarly, sitting for prolonged periods of time can cause hemorrhoids. [[Hypertension]], particularly in the [[portal vein]], can also cause hemorrhoids because of the connections between the portal vein and the [[vena cava]] which occur in the rectal wall - known as [[portocaval anastomoses]].<ref>{{cite web |title=Causes of Hemorrhoids |url=http://www.mayoclinic.com/health/hemorrhoids/DS00096/DSECTION=3 |date=Nov 28, 2006  |publisher=Mayo Clinic |accessdate=2007-12-07}}</ref>
===Common Causes===
 
Hemorrhoids may be caused by factors that increase the pressure in the rectal [[veins]] including the following:<ref name="pmid28567655">{{cite journal |vauthors=Guttenplan M |title=The Evaluation and Office Management of Hemorrhoids for the Gastroenterologist |journal=Curr Gastroenterol Rep |volume=19 |issue=7 |pages=30 |year=2017 |pmid=28567655 |doi=10.1007/s11894-017-0574-9 |url=}}</ref>
Additional factors that can influence the course of hemorrhoids (mostly by increasing rectal vein pressure), especially for those with a genetic predisposition, are [[obesity]] and a [[sedentary lifestyle]].
*Advanced age
 
*[[Chronic constipation]]
Increased straining during bowel movements, (e.g. [[constipation]], [[diarrhea]]) may lead to hemorrhoids. <ref name="titleHemorrhoids during pregnancy: Treatment options - MayoClinic.com">{{cite web |author=Harms R |title=Hemorrhoids during pregnancy: Treatment options |url=http://www.mayoclinic.com/health/hemorrhoids-during-pregnancy/AN01720 |date=Nov 3, 2007 |publisher=MayoClinic |accessdate=2007-11-28}}</ref>
*Chronic [[cough]]
*[[Cirrhosis]]
*Heavy lifting
*Low dietary fiber
*[[Sedentary lifestyle]]
*Straining
*[[Ascites]]


[[Pregnancy]] causes hypertension and increases strain during bowel movements, and thus hemorrhoids are often associated with pregnancy.
===Causes by Organ System===
{| style="width:80%; height:100px" border="1"
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" | '''Cardiovascular'''
| style="width:75%" bgcolor="Beige" ; border="1" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Chemical/Poisoning'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Dental'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Dermatologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| bgcolor="Beige" | [[Naltrexone]], [[oxcarbazepine]], [[pramipexole]]
|-
|- bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Environmental'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| bgcolor="Beige" |Straining, [[portal hypertension]], increased intra-abdominal pressure, [[diarrhea]], [[cirrhosis]], [[chronic constipation]], [[ascites]]


Excessive consumption of [[alcohol]] or [[caffeine]] can both cause hemorrhoids.<ref name="titleHemorrhoids">{{cite web |author=Burney RE |title=Hemorrhoids |url=http://www.med.umich.edu/1libr/aha/aha_hem_crs.htm |date=November 2005 |publisher=University of Michigan Health System |accessdate=2007-11-28}}</ref> Both can cause [[diarrhea]]. Alcohol can also cause [[alcoholic liver disease]] leading to [[portal hypertension]]. Caffeine on the other hand can cause general [[hypertension]].
|-
===Food===
|- bgcolor="LightSteelBlue"
Dehydration can cause a hard stool or chronic constipation which can lead to hemorrhoidal irritation.
| '''Genetic'''
An excess of [[lactic acid]] in the stool, a product of excessive consumption of dairy products such as cheese, can cause irritation and a reduction of consumption can bring relief.  [[Vitamin E]] deficiency is also a common cause.
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Neurologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
| bgcolor="Beige" |Low dietary fiber
|-
|- bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| bgcolor="Beige" |[[Pregnancy]]
|-
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| bgcolor="Beige" |Pelvic[[ tumors]]
|-
|- bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Psychiatric'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| bgcolor="Beige" |Chronic [[cough]]
|-
|- bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Sexual'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Trauma'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Urologic'''
| bgcolor="Beige" |Straining with prostatism


Food considered "probiotic", such as yogurt with active culture, may help keep the gut functioning normally and thus help prevent flare-ups, as will the consumption of fruit.
|-
|- bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| bgcolor="Beige" |[[Sedentary lifestyle]], prolonged sitting, [[obesity]], heavy lifting, advanced [[age]]
|-
|}


[[Image:Hemorrhoids2.jpg|thumb|left|Direct view of hemorrhoid seen on [[sigmoidoscopy]]]]
===Causes in Alphabetical Order===
 
*Advanced [[age]]
=== Use of squat toilets ===
*[[Anal intercourse]]
Based on their very low incidence in the developing world, where people squat for bodily functions, hemorrhoids have been attributed to the use of the unnatural "sitting" toilet.<ref>{{cite journal |author=Sikirov BA |title=Primary constipation: an underlying mechanism |journal=Med. Hypotheses |volume=28 |issue=2 |pages=71–3 |year=1989 |pmid=2927355 |doi=}}</ref><ref>{{cite journal |author=Sikirov D |title=Comparison of straining during defecation in three positions: results and implications for human health |journal=Dig. Dis. Sci. |volume=48 |issue=7 |pages=1201–5 |year=2003 |pmid=12870773 |doi=}}</ref> In 1987, an Israeli physician, Dr. Berko Sikirov, published a study testing this hypothesis by having hemorrhoid sufferers convert to [[squat toilets]].<ref name="pmid3623887">{{cite journal |author=Sikirov BA |title=Management of hemorrhoids: a new approach |journal=Isr. J. Med. Sci. |volume=23 |issue=4 |pages=284–6 |year=1987 |pmid=3623887 |doi=}}</ref> Eighteen of the 20 patients were completely relieved of their symptoms (pain and bleeding) with no recurrence, even 30 months after completion of the study.  [http://naturesplatform.com/images/Sikirov_table.gif This chart] summarizes the results.
*[[Ascites]]
 
*Chronic [[constipation]]
No follow-up studies have ever been published. The [http://www.fascrs.org/displaycommon.cfm?an=1&subarticlenbr=12 American Society of Colon & Rectal Surgeons] is silent regarding the therapeutic value of squatting.
*Chronic [[cough]]
*[[Cirrhosis]]
*[[Diarrhea]]
*Heavy lifting
*Increase intra-abdominal pressure
*Low dietary fiber
*[[Obesity]]
*Pelvic [[tumors]]
*[[Portal hypertension]]
*[[Pregnancy]]
*Prolonged sitting
*[[Sedentary lifestyle]]
*Straining with prostatism
*Straining


==References==
==References==
{{reflist|2}}
{{Reflist|2}}
 
{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[Category:Gastroenterology]]
[[Category:Surgery]]
[[Category:Needs overview]]

Latest revision as of 22:03, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]

Overview

Hemorrhoids may be caused by factors that increase the pressure in the rectal veins such as chronic cough, chronic constipation, and straining.

Causes

Common Causes

Hemorrhoids may be caused by factors that increase the pressure in the rectal veins including the following:[1]

Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Naltrexone, oxcarbazepine, pramipexole
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic Straining, portal hypertension, increased intra-abdominal pressure, diarrhea, cirrhosis, chronic constipation, ascites
Genetic No underlying causes
Hematologic No underlying causes
Iatrogenic No underlying causes
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic Low dietary fiber
Obstetric/Gynecologic Pregnancy
Oncologic Pelvictumors
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Chronic cough
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy No underlying causes
Sexual No underlying causes
Trauma No underlying causes
Urologic Straining with prostatism
Miscellaneous Sedentary lifestyle, prolonged sitting, obesity, heavy lifting, advanced age

Causes in Alphabetical Order

References

  1. ↑ Guttenplan M (2017). "The Evaluation and Office Management of Hemorrhoids for the Gastroenterologist". Curr Gastroenterol Rep. 19 (7): 30. doi:10.1007/s11894-017-0574-9. PMID 28567655.

Template:WH Template:WS

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