Haemorrhoids—postulated pathogenesis and proposed prevention

Burkitt, Denis; Graham-Stewart, C.W.

doi:10.1136/pgmj.51.599.631

Cited by 65 publications

(20 citation statements)

References 6 publications

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“…The etiology of hemorrhoids is uncertain. Ever since work by Burkitt and Graham-Stewart [12][13][14] in the 1970s, hemorrhoids have been considered to be caused by a low-fiber diet and constipation. The current belief is that constipation leads to chronic straining and hard stools, resulting in degeneration of the supportive tissue in the anal canal and distal displacement of anal cushions.…”

Section: Etiologymentioning

confidence: 99%

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Rethinking What We Know About Hemorrhoids

Sandler

Peery

2019

Clinical Gastroenterology and Hepatology

133

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Although hemorrhoids are responsible for considerable economic cost and personal suffering, they have received surprisingly little research attention. In the United States, hemorrhoids are the third most common outpatient gastrointestinal diagnosis with nearly 4 million office and emergency department visits annually. The etiology of hemorrhoids is speculative. A low-fiber diet and constipation have historically been thought to increase the risk for hemorrhoids, but not proven. Symptoms commonly attributed to hemorrhoids include bleeding, pain, pruritus, fecal seepage, prolapse, and mucus discharge. Research has found that these symptoms were equally reported by patients with and without hemorrhoids. Medical therapies for hemorrhoids have not been formally studied except for fiber where the results have been inconsistent. A number of office-based interventions such as rubber band ligation and infrared coagulation are widely used and economically favorable for practitioners. Surgical procedures are effective at eliminating hemorrhoids but may be painful. Given the burden of disease and numerous gaps in our understanding, the time has come for targeted research to understand the cause, symptoms, and best treatment for patients with symptomatic hemorrhoids.

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Section: Etiologymentioning

confidence: 99%

“…22 Hemorrhoids are thought to be more common in developed countries. 13 In addition to differences in fiber consumption and constipation, the posture during defecation is another factor that distinguishes developed from developing countries. In societies that have adopted Western toilets, people sit during defection as opposed to squatting.…”

Section: Etiologymentioning

confidence: 99%

Rethinking What We Know About Hemorrhoids

Sandler

Peery

2019

Clinical Gastroenterology and Hepatology

133

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“…Symptomatic haemorrhoidal disease constitutes a common problem in general practice, as well as in general and colorectal surgical clinics, affecting between 4 and 30% of the population, a third of whom may seek medical advice [1–3]. Many treatments are available but no single treatment has been shown to be consistently superior [4–9].…”

Section: Introductionmentioning

confidence: 99%

A prospective randomized trial of consultant‐led injection sclerotherapy compared with nurse practitioner‐led noninvasive interventions in the management of patients with first and second degree haemorrhoids

Porrett

Lunniss

2001

Colorectal Disease

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A bulking agent and Nurse led education, advice and bowel habit retraining is as effective in reducing the incidence of bleeding from 1st and 2nd degree haemorrhoids as injection sclerotherapy. Patients who consult a NP with symptomatic 1st and 2nd degree haemorrhoids feel more empowered in the long term. Non-invasive bowel retraining methods should be offered as an alternative to more traditional, invasive treatments for patients with symptomatic early hemorrhoidal disease.

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“…Basic of all these factors is the engorgement and subsequent prolapse of the enlarged anal cushion. 3,4 There are various classifications of haemorrhoids according to anatomical position and severity of disease and symptoms. In great majority of cases there are three main piles which occupy well-defined position.…”

Section: Introductionmentioning

confidence: 99%

Plication: an innovative method of treating piles

et al. 2019

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Background: The cause of haemorrhoids remains unknown. Factors contributing to haemorrhoids are constipation, prolonged squatting, pregnancy, aging, heredity, portal hypertension, abdominal tumour etc.Methods: This prospective study was carried out in department of surgery, M.K.C.G MCH, Berhampur, Odisha, India from 01st August 1995 to 31st July 2017. Patients from both sex and different age groups having haemorrhoids were included. Patients with piles secondary to anorectal tumours, prolapsed and thrombosed piles, anorectal pathology like fissure were excluded from study. Preoperative, intraoperative interventions and postoperative care were carried out according to laid procedure described below.Results: Total 1014 patients of piles were selected for plication and conventional haemorrhoidectomy and most of them were between 31-50 years of age while 362 cases underwent plication, rest 346 cases were treated with haemorrhoidectomy. All patients in this study had bleeding per rectum as the main symptom. Out of 507 patients which has been examined for plication, 272 (53.65%) had 2nd degree, 235 (46.35%) had 3rd degree piles. Results of plication of piles are satisfactory and only 4% patients had pain for which long term analgesics were given.Conclusions: Treatment of haemorrhoids is well debated topic and various methods are being used by surgeons all over world. Plication of piles appears to have significant advantages over conventional methods in terms of patient comfort, duration of stay in hospital and incidence of complications. Literature on this subject is briefly reviewed.

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Haemorrhoids—postulated pathogenesis and proposed prevention

Cited by 65 publications

References 6 publications

Rethinking What We Know About Hemorrhoids

Rethinking What We Know About Hemorrhoids

A prospective randomized trial of consultant‐led injection sclerotherapy compared with nurse practitioner‐led noninvasive interventions in the management of patients with first and second degree haemorrhoids

Plication: an innovative method of treating piles

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