Revised morphology and hemodynamics of the anorectal vascular plexus: impact on the course of hemorrhoidal disease

Aigner, Felix; Gruber, Hannes; Conrad, Friedrich; Eder, Jasmin; Wedel, Thilo; Zelger, Bettina; Engelhardt, V. A.; Lametschwandtner, Alois; Wienert, V.; Böhler, U.; Margreiter, Raimund; Fritsch, Helga

doi:10.1007/s00384-008-0572-3

Cited by 139 publications

(101 citation statements)

References 18 publications

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“…This may be due to their high physical activity and standing for a longer period of time. 15 As shown in Figure 3, the prevalence of hemorrhoids was also higher in students (15%) followed by business man (10%) and doctors (2.5%). This was due to their sedentary life styles, prolonged standing or stress.…”

Section: Discussionmentioning

confidence: 83%

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Study of risk factors and clinical features of hemorrhoids

Ali

Shoeb

2017

Int Surg J

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Background: Hemorrhoids are very common diseases of the anal region and creates physical and psychological disturbances and significantly affects the quality of life. This study was aimed to determine the risk factors and clinical symptoms associated with it.Methods: The study was conducted in Krishnarajendra Hospital, Mysore, for a period of one year from January 1984 to December 1984. A total of 40 patients with hemorrhoids were included in the study. The risk factors and clinical symptoms associated with incidence of hemorrhoids were noted in detailed and analysed.Results: Male preponderance was seen in the study (85%). Patients with age group between 20-39 years were found of high incidence of hemorrhoids (55%). Out of 40, 15 (37.5%) males and 2 (5%) females had habitual constipation and 7 (17.5%) males had occasional constipation. Farmers were found to the most commonly affected people with hemorrhoids (60%) followed by students (15%), households (15%) and business man (10%). The common clinical symptom observed was bleeding per rectum and mass per rectum in 85% of patients, pain during defecation in 77.5%, soiling of clothes observed in 22.5% and history of pruritus in 12.5% of males.Conclusions: The patients suffering with hemorrhoids were suggested to adopt healthy life style and modifications at their occupations accordingly.

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Section: Discussionmentioning

confidence: 83%

“…9 The most common manifestation of hemorrhoids is rectal bleeding associated with bowel movement. 15 About 85% of the patients in the study had bleeding per rectum and mass per rectum as the main clinical symptom. These results were consistent with the previous studies.…”

Section: Discussionmentioning

confidence: 95%

Study of risk factors and clinical features of hemorrhoids

Ali

Shoeb

2017

Int Surg J

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“…The color of the blood is usually bright red due to the presence of arteriovenous channels in the hemorrhoid tissue 33) . Dark red blood or blood mixed with stool may indicate that bleeding is from a rectal or colonic lesion.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding complications, one report stated that 35 patients necessitated low anterior resection for rectal perforation 96) , so care must be taken to utilize proper techniques such as the purse-string suture 93) . Compared to LE, PPH has advantages that include less postoperative pain, less bleeding, shorter hospital stays, and quicker return to normal activities 1,33) . Some reports state that there is no significant difference between the two techniques in terms of recurrence rates 94,98) , but other studies cite higher recurrence rates with PPH after long-term follow-up 57,95,97,99) .…”

Section: ) Pphmentioning

confidence: 99%

Japanese Practice Guidelines for Anal Disorders I. Hemorrhoids

Yamana

2017

J Anus Rectum Colon

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The pathogenesis of hemorrhoids is a weakening of the anal cushion and spasm of the internal sphincter. Bowel habits and lifestyles can be risk factors for hemorrhoids. The prevalence of hemorrhoids can encompass 4 to 55% of the population. Symptoms include bleeding, pain, prolapsing, swelling, itching, and mucus soiling. The diagnosis of hemorrhoids requires taking a thorough history and conducting an anorectal examination. Goligher's classification, which indicates the degree of prolapsing with internal hemorrhoids, is useful for choosing treatment. Drug therapy for hemorrhoids is typically utilized for bleeding, pain, and swelling. Ligation and excision (LE) is considered for Grade III and IV internal and external hemorrhoids. Rubber band ligation is used to treat up to Grade III internal hemorrhoids. Phenol almond oil is effective for internal hemorrhoids up to Grade III, while aluminum potassium sulfate and tannic acid have shown efficacy in treating prolapsing in internal hemorrhoids at Grades II, III, and IV. Procedure for prolapse and hemorrhoids (PPH) is surgically effective for Grade III internal hemorrhoids; however, the long-term prognosis is not favorable, with high recurrence rates. Separating ligation is effective surgical treatment for internal/external hemorrhoids Grade III and Grade IV. The basic approach to thrombosed external hemorrhoids and incarcerated hemorrhoids is conservative treatment; however, in some acute or severe cases, surgical resection is considered. Comparing the different instruments used for hemorrhoid surgery, all reduce operating time, blood loss, post-operative pain, and length of time until the return to normal activity. They do, of course, increase the cost of the procedure.

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“…The most commonly accepted hypothesis is sliding of the anal canal lining when the supporting tissues of the anal cushions become non-functional and the anal cushions bulge downwards. 1,2 The sites of the three major anal cushions are: right anterior, right posterior and left lateral. Histological evaluation of these anal cushions reveals a variety of changes.…”

Section: Pathophysiologymentioning

confidence: 99%

Hemorrhoids: which is the best therapeutic option?

et al. 2018

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Hemorrhoids are one of the commonest of rectal diseases seen all across the globe. Constipation and bleeding are the main symptoms associated with this condition. The condition maybe associated with an underlying carcinoma as well. Understanding the pathophysiology will enable the surgeon to determine the best therapeutic option for this condition. A brief review of clinical evaluation and treatment options is presented in this paper.

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Revised morphology and hemodynamics of the anorectal vascular plexus: impact on the course of hemorrhoidal disease

Abstract: Coordinated filling and drainage of the anorectal vascular plexus is regulated by intrinsic vascular sphincter mechanisms. Both morphological and functional failure of this vascular system may contribute to the development of hemorrhoidal disease.

Cited by 139 publications

References 18 publications

Study of risk factors and clinical features of hemorrhoids

Study of risk factors and clinical features of hemorrhoids

Japanese Practice Guidelines for Anal Disorders I. Hemorrhoids

Hemorrhoids: which is the best therapeutic option?

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