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==Pathophysiology== | ==Pathophysiology== | ||
The pathophysiology of hemorrhoids includes 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> | * The pathophysiology of hemorrhoids includes 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. | |||
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]]. | * [[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> | ||
* 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]]. | |||
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> | * 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> | ||
* [[Pregnancy]] causes hypertension and increases strain during bowel movements, and thus hemorrhoids are often associated with pregnancy. | |||
[[Pregnancy]] causes hypertension and increases strain during bowel movements, and thus hemorrhoids are often associated with pregnancy. | * 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> | ||
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> | |||
{{#ev:youtube|QKndv13bXHA}} | {{#ev:youtube|QKndv13bXHA}} | ||
===Food=== | ===Food=== | ||
Dehydration can cause a hard stool or chronic constipation which can lead to hemorrhoidal irritation. | * Dehydration can cause a hard stool or chronic constipation which can lead to hemorrhoidal irritation. | ||
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. | * 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. | |||
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. | * 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. | ||
=== Use of unnatural "sitting" toilets === | === Use of unnatural "sitting" toilets === | ||
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. | * 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. | |||
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. | * 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. | ||
==Gross pathology== | ==Gross pathology== | ||
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|[[Image:Hemorrhoids - By Internet Archive Book Images - httpswww.flickr.comphotosinternetarchivebookimages14784684835Source book page httpsarchive.orgstreamdiseasesofrectum00gantdiseasesofrectum00gant-pagen490mode1up, No restrictions, ht.jpg|center|300px|thumb|By Internet Archive Book Images - httpswww.flickr.comphotosinternetarchivebookimages14784684835Source book page httpsarchive.orgstreamdiseasesofrectum00gantdiseasesofrectum00gant-pagen490mode1up, No restrictions, ht]] | |[[Image:Hemorrhoids - By Internet Archive Book Images - httpswww.flickr.comphotosinternetarchivebookimages14784684835Source book page httpsarchive.orgstreamdiseasesofrectum00gantdiseasesofrectum00gant-pagen490mode1up, No restrictions, ht.jpg|center|300px|thumb|By Internet Archive Book Images - httpswww.flickr.comphotosinternetarchivebookimages14784684835Source book page httpsarchive.orgstreamdiseasesofrectum00gantdiseasesofrectum00gant-pagen490mode1up, No restrictions, ht]] | ||
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==References== | ==References== | ||
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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
Pathophysiology
- The pathophysiology of hemorrhoids includes 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.[1]
- 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.
- Increased straining during bowel movements, (e.g. constipation, diarrhea) may lead to hemorrhoids. [2]
- Pregnancy causes hypertension and increases strain during bowel movements, and thus hemorrhoids are often associated with pregnancy.
- Excessive consumption of alcohol or caffeine can both cause hemorrhoids.[3]
{{#ev:youtube|QKndv13bXHA}}
Food
- Dehydration can cause a hard stool or chronic constipation which can lead to hemorrhoidal irritation.
- 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.
- 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.
Use of unnatural "sitting" toilets
- 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.[4][5]
- In 1987, an Israeli physician, Dr. Berko Sikirov, published a study testing this hypothesis by having hemorrhoid sufferers convert to squat toilets.[6] 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.
- No follow-up studies have ever been published. The American Society of Colon & Rectal Surgeons is silent regarding the therapeutic value of squatting.
Gross pathology
External hemorrhoids appear on inspection of the anal verge as skin tags or prolapsed veins either strangulated or free. Internal hemorrhoids appear as bluish bulging of the veins in the mucosa.
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References
- ↑ "Causes of Hemorrhoids". Mayo Clinic. Nov 28, 2006. Retrieved 2007-12-07.
- ↑ Harms R (Nov 3, 2007). "Hemorrhoids during pregnancy: Treatment options". MayoClinic. Retrieved 2007-11-28.
- ↑ Burney RE (November 2005). "Hemorrhoids". University of Michigan Health System. Retrieved 2007-11-28.
- ↑ Sikirov BA (1989). "Primary constipation: an underlying mechanism". Med. Hypotheses. 28 (2): 71–3. PMID 2927355.
- ↑ Sikirov D (2003). "Comparison of straining during defecation in three positions: results and implications for human health". Dig. Dis. Sci. 48 (7): 1201–5. PMID 12870773.
- ↑ Sikirov BA (1987). "Management of hemorrhoids: a new approach". Isr. J. Med. Sci. 23 (4): 284–6. PMID 3623887.