Hemorrhoids human rectal end of the submucosa and the anal canal skin under the venous plexus expansion and flexion of the soft vein mass, known as hemorrhoids, also known as hemorrhoids, hemorrhoids, hemorrhoidal disease, hemorrhoidal disease and so on. In the motherland medicine, the meaning of hemorrhoids discussed more, such as “Shuowen Jiezi” said: “after the disease also.” “Increase rhyme” said: “hidden sores also.” From the meaning of the word to explain, hemorrhoids and standoff synonymous, that is, the meaning of high protrusion. For example, “Medical Outline” says: “Intestinal tobacco step sole whisk fruit almond line ∩ yeast Huai Xin [stand], people in the nine orifices, where there is a small meat protruding are said to be hemorrhoids.” The miraculous prescription・Intestinal Sparrow ├óΓé¼╦£Screwed sub Xie Gu Tantan Wreck Dad escape 诟孛派撸蛟谕饷婊蛟谀冢兴剖笕檎撸奸兴朴L艺撸湫尾灰;其病有痛有痒,有硬有软, there is swelling and pain in the difficult to stool, there is more than one with the stool under the blood, and there is through the orifices of the blood out of the like a line.” Explained the hemorrhoid is inside and outside the anus small meat protruding superfluous, its shape is not one, its evidence is different. Hemorrhoids is a common disease unique to human beings, frequent diseases. According to the relevant census data show that the incidence of anorectal diseases for 59.1%, hemorrhoids accounted for all the anorectal diseases in 87.25%, which is the most common to the internal hemorrhoids, accounting for all the anorectal diseases of 52.19%. Both men and women can get sick, the incidence rate of women is 67%, the incidence rate of men is 53.9%; any age can be onset, of which 20-40 years old people are more common, and with the growth of age and gradually aggravated, so there are “ten people nine hemorrhoids” said. British, American and other countries scholars called Hemorrhoids or Piles, the former is bleeding for the clinical characteristics of the name, the latter is from the hemorrhoids of the external shape of the ball and named, referring to the internal and external hemorrhoids. At present, British scholars mostly called hemorrhoids for Piles, American scholars are called Hemorrhoids. Medical references to hemorrhoids, including internal hemorrhoids, external hemorrhoids, mixed hemorrhoids, is the bottom of the anorectal rectum and the mucous membrane of the anus of the venous plexus occurs varicose and the formation of a soft venous mass of one or more a chronic disease. The veins usually become enlarged when continuous straining during defecation causes repeated elevation of pressure within the veins here. Hemorrhoids often occur in women during pregnancy when the pelvic veins are compressed and blood circulation is impeded, and many obese people also suffer from hemorrhoids. If you suffer from hemorrhoids, the walls of the swollen and twisted veins in the anus become very thin, so they are very prone to rupture during defecation. Internal hemorrhoids are hemorrhoids that grow at the beginning of the anal canal. If the swollen veins are located further down, almost over the opening of the anal canal, these varicose veins are called external hemorrhoids. External hemorrhoids sometimes prolapse or protrude outside the opening of the anal canal. However, this only happens during a bowel movement, after which it shrinks back to its original position. Blood clots can occur in both internal and external hemorrhoids. In the event of a thrombosis, the blood in the hemorrhoid clumps together, which causes pain. Diagnosis of hemorrhoids Diagnosis is made on the basis of history and physical examination of the anus, anorectal finger test and anoscopy with reference to the classification of hemorrhoids. If the diagnosis cannot be confirmed further examination should be done to exclude benign and malignant tumors of the colon, rectum and anal canal and inflammatory diseases. When you see bleeding, dripping blood or feces with blood or pus blood, most of them are caused by hemorrhoids; anal fissure’s bleeding is bright red, accompanied by sharp pain in the anus; blood in the stool, dark red blood or dark stool, that is caused by gastrointestinal bleeding. When defecation, there is a swelling out of the anus, accompanied by anal moisture or mucus, most of the internal hemorrhoids prolapse or rectal mucosa prolapse; if there is a lump in the anus, pain intense, the lump surface dark, round, may be suffering from thrombosed external hemorrhoids; anal lump with localized fever and pain, is the symptom of perianal abscess; palpation of anus has a strip of mounted material, and there is a small amount of pus from the ulcerated mouth, is the manifestation of anal fistula. Internal hemorrhoids, external hemorrhoids difference reference Internal hemorrhoids refers to the hemorrhoids occurring above the pubic line, the surface of the mucous membrane, the main manifestation of varying degrees of bleeding, generally painless, but there is a thrombus formation into an incarceration, there is severe pain; external hemorrhoids refers to the hemorrhoids occurring below the pubic line, the surface of the skin, there are connective tissue, varicose veins, thrombosis, inflammation of the four, the skin does not occur in the ulceration of the blood when there is no bleeding. The first two generally have no obvious discomfort, the latter two have obvious pain. Reasons for the formation of hemorrhoids 1, anatomical reasons: people in the standing or sitting position, the anorectum is located in the lower part of the due to gravity and organ compression, venous upward reflux is quite impaired. Rectal vein and its branches lack of venous valve, blood is not easy to return, easy to stasis. Its vascular arrangement is special, and it passes through the muscle layer at different heights, which is easily compressed by fecal matter and affects the blood return. The vein also passes through the loose tissue of submucosa and lacks stent fixation around it, so it is easy to expand and flex. 2.Genetic relationship: the vein wall is congenitally weak, the resistance is reduced, it can’t tolerate the intravascular pressure, so it expands gradually. 3.Occupational relationship: people standing or sitting for a long time, long-term weight running, affecting the venous return, so that the pelvic blood flow is slow and intra-abdominal organs are congested, resulting in hemorrhoidal vein overfilling, decreased venous wall tension, the blood vessels are easy to stasis and dilatation. And because of the lack of movement, intestinal peristalsis reduced, feces downstream slow, or habitual constipation, can oppression and stimulation of the veins, so that the local congestion and blood reflux obstacles, caused by hemorrhoidal veins within the pressure rises, the vein wall resistance is reduced. 4, local stimulation and dietary disorders: the anal part of the cold, heat, constipation, diarrhea, excessive alcohol and spicy food, can stimulate the anus and rectum, so that the hemorrhoidal venous plexus is congested, affecting the venous blood reflux, so that the venous wall resistance decreases. 5, the anal vein pressure increases: due to liver cirrhosis, liver congestion and cardiac insufficiency, can make the anal vein congestion, pressure increases, affect the rectal vein blood return. 6, increased intra-abdominal pressure: due to intra-abdominal tumors, uterine tumors, ovarian tumors, prostate hypertrophy, pregnancy, overfeeding or squatting for too long, etc., which can increase intra-abdominal pressure and impede the venous blood return. 7, anal infection: hemorrhoidal venous plexus first due to acute and chronic infection and inflammation, the vein wall elastic tissue gradually fibrosis and weak, resistance is insufficient, and lead to the expansion of varicose, coupled with other reasons, so that the varicose veins gradually aggravate, generate hemorrhoidal mass. The staging and classification of hemorrhoids The causes of hemorrhoids are quite varied, sedentary, standing for a long time, exertion, etc. so that the body is in a fixed position for a long time, thus affecting the blood circulation, so that the pelvic blood flow is slow and the intra-abdominal organs are congested, resulting in hemorrhoidal veins overfilled, varicose, bulging, decreased tension in the vein wall and hemorrhoids is one of the important causes of the onset of hemorrhoids. If the movement is insufficient, intestinal peristalsis slows down, feces downward slow or due to habitual constipation, thus compression of the veins, so that the local congestion and blood reflux obstacles, caused by hemorrhoidal vein pressure, venous wall resistance is reduced, can also lead to hemorrhoids incidence increased. According to clinical observation and statistical census results analysis, the prevalence of different occupations in patients with significant differences, clinical cadres, automobile drivers, salesmen, teachers, the prevalence of significantly higher. Hemorrhoids located in the mucous membrane inside the anus is called “internal hemorrhoids”, located near the inner anal opening is called “external hemorrhoids”, both are called “mixed hemorrhoids”. Symptoms of hemorrhoids include pain in the affected area, blood in the stool, and in severe cases, the hemorrhoids will protrude out of the anus (prolapse) and retract after defecation. According to the symptoms of hemorrhoids and the degree of harm to human health, internal hemorrhoids can be divided into three stages: Stage I, painless, mainly in order to blood, discharge, itching; Stage II, there is blood in the stool, hemorrhoids with the prolapse of defecation, but can be returned to their own; Stage III (also known as the late stage), prolapse of internal hemorrhoids outside the anus or every time you defecate outside the anus, can not be returned to their own, you have to use a hand to support the return of the stage IV, the hemorrhoids protruding from the anus to the anus can not be returned to the anus, must use the hand to support the return of the stage. The internal hemorrhoid cannot be returned to the inside of the anus. This is the most serious condition of internal hemorrhoids. Hemorrhoids lightly bring inconvenience to the normal life of a person; seriously affect the health. Such as blood in the stool for a long time, can lead to varying degrees of anemia, and even hemorrhagic shock, life-threatening; hemorrhoid necrosis, infection is serious, can go through the blood system to cause systemic infection, the consequences are serious. Therefore, suffering from hemorrhoids, to actively deal with. Hemorrhoids more serious will lead to or induce cardiovascular and cerebrovascular diseases, especially elderly patients, such as Suffering from hemorrhoids produce psychological pressure, do not dare to go to the toilet, long this will aggravate constipation, when defecation occurs difficulty, the patient force to hold his breath, can make the heart beat faster caused by the rupture of cerebral blood vessels, causing cerebral hemorrhage or cerebral embolism; if there is a hemorrhoid embedded, the pain can also be triggered by angina pectoris attack; such as the formation of thrombosis, can trigger pulmonary embolism. Hemorrhoids subtypes Angiomatous type: internal hemorrhoids surface mucous membrane rough and soft, color dark red or vermilion, easy to touch bleeding, this type of bleeding as the main symptom. Varicose veins: the surface of internal hemorrhoids is hard, glossy, dark red or purple, the hemorrhoids for the varicose hemorrhoidal veins and hyperplasia of the connective. Fibrosis type: internal hemorrhoid surface hard, elastic, hemorrhoid body surface slightly white fibrous tissue hyperplasia, easy to prolapse, not easy to bleed. Thrombosed external hemorrhoids: the main morbidity characteristics for the sudden onset of the disease, severe pain, swelling and discomfort obvious, occasionally have systemic symptoms. Local examination can be seen in the parianal bulge swelling, can touch the subcutaneous hard and slippery mass, tenderness is obvious. Inflammatory external hemorrhoids: often caused by anal margin skin injury and infection, mostly anal pain, pain worsened during defecation, blood in the stool, a small amount of secretion from the anus. Local examination of the parianal bulge of the swelling, red color, congestion is obvious, there is tenderness, sometimes can be accompanied by general discomfort and fever. Varicose external hemorrhoids: the anal rim is elevated into an oval shape, soft to touch, painless, dark purple lumps can be seen when straining to defecate, after defecation or rest, the volume can be reduced, caused by subcutaneous varicose veins, but also for the development of advanced internal hemorrhoids. Generally only feel the swelling discomfort, when defecation aggravated, inflammation only when the pain symptoms. Connective tissue-type external hemorrhoids or dermatomal external hemorrhoids: the anal margin skin folds become larger, connective tissue proliferation, the formation of many different sizes and shapes of dermatomes. The difference between internal hemorrhoids, external hemorrhoids, mixed hemorrhoids internal hemorrhoids occur in the anal canal above the dentate line, internal hemorrhoids are generally painless, in order to blood, hemorrhoids prolapse as the main symptom, severe blood will be sprayed, hemorrhoids can not be self-contained after the prolapse of the hemorrhoids, as well as difficulty in bowel movements, after wiping unclean, a feeling of bloating, and so on. According to the degree of internal hemorrhoid lesions and clinical manifestations can be divided into three phases: a phase of internal hemorrhoids with blood when defecating, no prolapse, the mucosa on the tooth line was a nodular bulge; the second phase of internal hemorrhoids with blood when defecating, dripping or ejected blood, hemorrhoidal nucleus prolapse, can be self-recontained after defecating; the third internal hemorrhoids defecating or coughing, fatigue, weight-bearing caused by an increase in abdominal pressure, have occurred when the hemorrhoids prolapsed and need to be returned to the hand. External hemorrhoids are located below the dentate line, with pain, lumps as the main symptom, the anus around the growth of different sizes and shapes of the skin. According to its different pathological characteristics, it can be divided into four kinds: varicose, connective tissue, thrombosed and inflammatory. Inflammatory external hemorrhoids are the most common, the main manifestation of the anal margin of the skin folds protruding, redness, swelling, hot pain, edema, congestion is obvious, there is pressure pain, pain aggravated by defecation, and a small amount of secretion, some may be accompanied by general discomfort and fever. Mixed hemorrhoids both internal and external hemorrhoids dual characteristics, clinical rectal mucosa and skin prolapse, swelling, pain, recurrent infection as the main symptoms. Treatment of hemorrhoids The treatment of hemorrhoids has the traditional surgical treatment with scissors and clippers, as well as thermal coagulation, freezing, microwave, etc., but on the overall efficacy of the traditional postoperative recovery is still good, and the latter said that can not be used on a wide scale at present. Circumferential mixed hemorrhoids are relatively difficult to treat in hemorrhoids. The most advanced surgical treatment is PPH, that is, minimally invasive hemorrhoidal surgery, also known as anastomosis hemorrhoidal mucosal circumcision, 1993, the United States Johnson and Johnson was founded in 2000, introduced into the country, the advantage is that the patient’s pain is small, fast recovery, the disadvantage is that the price is expensive.