Hemorrhoids are cushions of nonpathologic vascular tissue in the anal canal, which microscopically are sinusoids because they do not have any muscle as do veins. Hemorrhoidal tissue is thought to contribute to anal continence because fifteen to twenty percent of resting anal pressure derives from these cushions. Hemorrhoids may protect the sphincter during defecation, and could operate as plugs to permit the anus to completely close while at rest.
Three main cushions are found in the left lateral, the right anterolateral, and the right posterolateral portions of the anal canal. The symptoms of hemorrhoidal disease are caused by pathologic and dilated changes in hemorrhoidal tissue. Multiple studies have shown elevated anal resting pressure in patients with hemorrhoids. Whether the elevated resting pressure is due to enlarged hemorrhoids is unknown, but resting tone does become normal after a hemorrhoidectomy.
Proposed etiologic factors include vascular congestion and mucosal prolapse. Vascular congestion could derive from prolonged straining or increased intra-abdominal pressure due to ascites, obesity, or pregnancy. Mucosal prolapse may develop secondary to derangement of the internal sphincter or through aging causing the anatomic structures supporting the muscularis submucosa to weaken, leading to prolapse of the hemorrhoidal tissue.
Patients often self-refer with symptoms of itching, pain, or bleeding per the rectum. To the general population, anything problematic around the anus is often suspected to be hemorrhoids. Internal hemorrhoids may prolapse or bleed, but rarely become painful unless they develop thrombosis or necrosis. Thus, anal pain usually suggests other pathology and mandates closer investigation.
As many as twenty percent of patients with hemorrhoids have concomitant anal fissures. Usually, painless bright red bleeding that stains the water in the toilet occurs from internal hemorrhoids. This bleeding is arterial, from presinusoidal arterioles, and is mostly associated with bowel movements where the stool is itself brown. If rectal bleeding is not typical for hemorrhoidal bleeding as described, a prompt and thorough medical evaluation is warranted.
Thrombosed external hemorrhoids cause significant pain because the anoderm is richly innervated which is exactly why external hemorrhoids should not be ligated or excised without adequate local anesthetics. Skin tags are often confused with symptomatic hemorrhoids. A skin tag is redundant fibrotic skin at the anal verge, often persisting as the residual of a thrombosed external hemorrhoid. It is important to note that there is no increased risk of cancer in hemorrhoids.
Because hemorrhoids are a normal part of anorectal anatomy, treatment is only indicated if they become symptomatic. However, in the general management of hemorrhoids, colorectal surgeons agree that all painful thrombosed hemorrhoids should be excised. Some patients present at a time after thrombosis when symptoms have actually begun to subside. Excision is not mandatory in these cases, especially in the absence of erosion or significant tenderness to touch.
Along with over-the-counter topical agents, there are several modalities at the disposal of physicians to treat hemorrhoids. But many of the modalities can be distressing for the patient. The conservative medical hemorrhoids treatment methods demand specialized equipment and training. They carry risks: if such treatment fails, then expensive surgery will become a necessity. Plant medicine is an attractive addition to the traditional treatment of hemorrhoids.
Use of plant medicine can help prevent the onset of hemorrhoids, while also fighting recurrence of the disorder. With this treatment for hemorrhoids, application of plant medicine treats the problem on a cutaneous level utilizing the powerful forces of monoterpenes. These micro particles provide the most rapid absorption; they enter cell membranes with incredible swiftness and have a direct antispasmodic and analgesic effect against hemorrhoids.
Plant medicine has anti-inflammatory mediator that will recruit and activate neutrophils, which then enter the venous wall, destroying unwanted components of the extracellular matrix. The botanical extracts improve microcirculation, capillary flow and vascular tone, helping cure hemorrhoids. Thus, plant medicine can provide undeniable and profound pharmacological effects against hemorrhoids. To learn more, please go to http://www.naturespharma.org.