Sunday, June 7, 2009



What is the hemorrhoid?
Hemorrhoids or piles are ano-rectal varicose dilatation involving the hemorrhoids plexus of veins, there are lax pelvic veins and venous stasis Inadequate peri-vascular support and the absence of valves permit reversed venous flow in the hemorrhoids plexus.
The writer experiences for medication and diet treatment of piles, had good result or relief since 1982, it seems prime restitution.
The description is on the treatment option.

The situation:
A part of women have hemorrhoids, which often develop during pregnancy or delivery, sedentary habits, erect posture, and venous congestion and dilatation accentuate these varicoses. Hemorrhoids can occur at any age and affect both sexes female and male.
Hereditary factors may predispose to piles.
What types or varieties of piles? There are external and internal piles.
External piles are those of the inferior hemorrhoids plexus, are covered by anal skin and arise below the ano-rectal line.
Internal piles implicate the superior hemorrhoids plexus of veins, are covered by mucous membrane and have their origin above the ano-rectal line.

What is the problem?
What are the causes, symptoms and signs of hemorrhoids?
Can we treat hemorrhoids?
What are the option of treatments?
What are the potential complication of treatments?
How much the cost treatment of piles by option?

The answers for problem solving are the following description:

Problem solving:
The cause of piles

The causes include reduced vascular drainage of the pelvic organs such as pregnancy, constipation; repeated trauma to rectum and anus due to sodomy , sexual perversion, large and hard stool which can followed by mucousal fissures, infection and ruptured blood vessels and increased venous pressure in portal hypertension. Bacterial infection may develop in the venous circulation, producing peri-phlebitis and endo-phlebitis.
Bacterial infection may cause proctitis or rectitis [inflammation of the rectum] due to staphylococcus, streptococcus, pseudomonas aeroginosa, gonorrhea, lymphopathya venereum, amebiasis dysentery, anaerobic bacteria
Thrombosis or rupture of vessels often results in slough and ulceration.

Symptoms and signs
There are 4 principle symptoms:
Pruritus ani: the itching is usually localized anal circle; distressing symptoms of a underlying local or general disorder , it occurs because the sensitive, often moist perineal [pudendal] skin is exposed to irritating fecal material retained in anal recesses. The perianal skin may be erythematous [reddish], moist or bleeding.
Pain: mild or severe pain is the result of constriction, edema, or strangulation of piles; severe pain usually in external piles due to the sensitive of the skin; the internal piles mucosa is less sensitive than the skin.
Bleeding: which may be mild or severe occur with mucous laceration, venous distention, obstruction, or ulceration of prolapsed internal piles as a result of straining or difficult defecation.
Prolapse: protrusion of piles may occur suddenly after sub-mucous rupture of veins, thrombosis or strangulation of internal piles.
The stage of pile consists of:
First stage: small protrude of internal mucous of piles or small mass of external piles like polyp, while or after defecation.
Second: protrude of piles larger mass of internal mucous but can reduced spontaneously after defecation; Slight or profuse bright red bleeding, usually at stool with protrusion following defecation, at first reduced spontaneously but later requiring manual replacement; soreness, sense of incomplete evacuation and lumbar discomfort.
Third: protrude of larger mass and can not spontaneously reduced but the piles can be pushed back to above ano-rectal line.
Fourth stage: larger mass protruded and can not be push manually into abdomen above ano-rectal line, it need emergency treatment to prevent strangulation and putrefaction.

Examination and diagnose:
Inspection, palpation and proctoscopy for non protruded piles reveal a globular expansible mass covered by mucous membrane. Protruded piles are visible as protuberant purple nodules covered by mucosa.

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