1. What are hemorrhoids? How many kinds of hemorrhoids are there? Hemorrhoids are also called piles. From the literal interpretation, hemorrhoids is the meaning of protrusion, where the soft swelling inside and outside the anus protrudes are called hemorrhoids. The essence of the protrusion is mainly the varicose and enlarged venous plexus localized in the anorectum. Hemorrhoidal tissue not only has a large number of highly tortuous dilated veins, at the same time the hemorrhoidal interstitial tissue edema, accompanied by inflammatory cell infiltration, part of the blood vessels within the thrombus formation. Hemorrhoids are divided into internal hemorrhoids, external hemorrhoids and mixed hemorrhoids by the dentate line. The dentate line is the junction line between the anus and the rectum, about 3 to 4 centimeters from the anal verge, shaped like a serrated tooth. The internal hemorrhoids occurring on the dentate line are called internal hemorrhoids, the external hemorrhoids occurring under the dentate line are called external hemorrhoids, and the mixed hemorrhoids occurring above and below the dentate line are called mixed hemorrhoids. External hemorrhoids are divided into connective tissue external hemorrhoids, varicose external hemorrhoids, inflammatory external hemorrhoids and thrombosed external hemorrhoids according to their nature. 2, hemorrhoids is what causes? The reason for the formation of hemorrhoids is very complex, generally believed to be the result of a variety of reasons for long-term effect. From the internal point of view, because the human body is upright, the anus is located in the body cavity of the lowest end, the pressure is the largest, the resistance of the blood return is also large, and the anal veins are not like the veins of the lower extremities to prevent reflux in the vein flap, over time, it is easy to cause vascular tortuous expansion of hemorrhoids. The fact that reptiles do not suffer from hemorrhoids can also prove this. From the external point of view, the anus is the human body’s “exit”, every day there are feces from this discharge, if long-term constipation, diarrhea, or squatting in the toilet for a long time of bad habits, will inevitably be overly squeezed, friction anus, on the one hand, resulting in a more difficult to return the blood flow, on the other hand, the cause of the local chronic infections, the end of the day will make the blood vessels brittle, lose elasticity, thus causing hemorrhoid bleeding and prolapse of the hemorrhoid. This will lead to hemorrhoidal bleeding and prolapse. In addition, dietary disorders (clean), excessive fatigue, old age and some other chronic diseases can become the cause of hemorrhoids. 3, how do I know I have hemorrhoids? The most common performance after getting hemorrhoids is to bring out or spurt blood in the anus during bowel movement, and in serious cases, there is a soft swelling prolapse, anal moisture or itching, or pain from a swelling outside the anus. Early internal hemorrhoid’s main manifestation is anal bleeding during stool, the amount of blood is more, the blood color is bright red, sometimes dripping down, sometimes like an arrow jet, no pain and other discomforts, there is a certain periodicity. Bleeding for a long time can cause anemia, patients feel dizziness, shortness of breath, fatigue and poor spirit. Internal hemorrhoid development to the middle stage, in addition to bleeding, stool will have hemorrhoid core out of the anus, hemorrhoid core can be restored to its original position after stool. Internal hemorrhoids development to the late stage, stool hemorrhoids out of the anus can not return to its original position, need to use the hand to push back. In serious cases, coughing and walking can also cause the hemorrhoids to come out of the anus. Often due to increased secretions stimulate the anus and feel anal moisture, itching. If the hemorrhoid core is not sent back in time after prolapse, it will swell up and even become necrotic over time. External hemorrhoids in inflammation or the formation of thrombus will feel severe pain. 4, why some hemorrhoids pain, and some hemorrhoids do not pain? Painless hemorrhoids are mainly internal hemorrhoids, because internal hemorrhoids are located in the dentate line, is innervated by visceral nerves, visceral nerves are not sensitive to pain, so despite the internal hemorrhoids bleeding and other symptoms, but do not feel pain. Cause pain hemorrhoids are mainly external hemorrhoids and mixed hemorrhoids and internal hemorrhoids embedded, especially thrombosed external hemorrhoids and inflammatory external hemorrhoids pain is the most obvious, this is because the external hemorrhoids are located below the dentate line, innervated by the spinal nerves, the nerves are nociceptive nerves, so the disease is sensitive to pain. 5, hemorrhoids when necessary treatment? In 1980, a foreign scholar in a hemorrhoid symposium concluded that: “do not treat the symptoms without anal signs, and do not treat the anal signs without symptoms”. Anal signs are hemorrhoidal changes found on local anal examination, and symptoms are blood in the stool, prolapse, anal moisture, anal itching, and anal pain. This passage means that only symptoms and anal signs at the same time have therapeutic significance. It is generally believed that hemorrhoids only have local signs, is not the need for immediate treatment, but when hemorrhoids clinical symptoms appear as early as possible treatment is still very beneficial. Such as hemorrhoid bleeding, day long untreated will lead to pernicious anemia, causing serious damage to the body; hemorrhoid prolapse, if not treated in time, it is likely that the hemorrhoid core prolapse incarcerated necrosis, not only the pain is severe, but also cause hemorrhage, after the surgery to leave aftereffects. However, one point must be corrected, some advertisements say that untreated hemorrhoids will cause or induce rectal cancer, this statement is wrong, rectal cancer is misdiagnosed as hemorrhoids cases exist, but there is no causal relationship, which is confusing the concept. 6. What are the methods of treating hemorrhoids and what are the advantages and disadvantages of each? The treatment methods for hemorrhoids are varied and diverse, but they can be roughly summarized into three categories: drug therapy, surgical therapy and physical therapy. Drug therapy is mainly used for mild hemorrhoids or heavier hemorrhoids and should not be operated on patients, can alleviate the symptoms, temporary relief of pain. Frequently constipated patients, you can take Ma Ren Lun intestinal pill, Fangfeng Tong Sheng Pill, laxative, liquid paraffin and other laxative drugs, or lactulose and Dupuytol to soften the stool, can also be used to senna, loquat leaves, almonds, 3 grams of each daily brewing tea to drink. Frequent blood in the stool, you can take elm acacia horn pill, Yunnan Baiyao or lotus leaf pills and other proprietary Chinese medicines; with acacia flowers brewed tea; with hemorrhoidal suppositories in the anus or with the Jiuhua cream, Ma Yinglong musk hemorrhoidal ointment can also be applied externally. Blood in the stool more service four things soup plus the lieutenant charcoal and Xianhe Cao, or with the blood and vitamin K. Repeated prolapse of hemorrhoids, after the stool with the five times, alum, Park Nitrogen, thorns 10 grams of decoction fumigation, and then gently send it back to the anus. If it is difficult to return, you can first use paraffin oil or Jiuhua cream external, and then slowly push and knead to send back to the anus. Prolapsed hemorrhoids can also be combined with the service of tonifying the middle and benefiting the qi soup, ten whole dazhan pill and so on. If the hemorrhoids are inflamed and swollen and painful, take five flavors disinfectant drink, pain relief such as Shen Tang, local use of expectorant soup or peppercorn salt water external cleansing. If there is a lot of secretion, take Dioscorea Dampness-expelling Soup. When infected, take San Huang Liquid or use antibiotics. Take iron rich blood for anemia. Injection therapy is a special class of drug therapy, is made of drugs injected directly into the hemorrhoids, or hardened and atrophied, or necrotic shedding to play a therapeutic purpose. For simple light to moderate internal hemorrhoids, the injection method can completely achieve the effect of cure. The advantage is less pain, short course of treatment, but improper operation will bleed or rectal stenosis. Withered hemorrhoid therapy also belongs to the drug therapy, is some corrosive effect of drugs made of nails, these nails will be inserted into the hemorrhoid nucleus to make it withered and fall off. Such as the Song Dynasty’s medical work “Taiping Sheng Hui Fang” recorded with arsenic yellow wax stirred evenly, twisted for the strip treatment of hemorrhoids, is this therapy. This method in our country in the 70’s clinical use is more common, due to the treatment process is easy to cause local necrosis infection hemorrhage, now has been rarely used. It is worth mentioning here that this method has been gradually eliminated, and now in some places have been transformed into a paste for external application, and said that there is no pain and no after-effects. In fact, after treatment with this method, a large number of patients experienced severe pain, local hemorrhage, anal skin defects and other adverse reactions. Surgical treatment is the most important method used in the clinic at present, and its principle is to remove hemorrhoids directly by excision or ligation. Its advantage is high precision and thoroughness, but the specific operation style and the operator’s clinical experience and proficiency will have a great impact on the effect. Physical therapy is the use of sound, light, electricity, heat, magnetism and other physical effects, so that the local tissue protein coagulation, electrocoagulation hemostasis, electrocautery cutting, tissue denaturation, necrosis, shedding and atrophy to get the treatment of hemorrhoids purpose. Now there are roughly liquid nitrogen freezing, laser, microwave, infrared coagulation, electronic (low-frequency, high-frequency, radio frequency, capacitance field, ion penetration, electric oscillation) and so on. It should be noted that physical therapy can only be used for mild hemorrhoids or as a supplement to surgical therapy, some of these methods of pain and complications not only exist and to be greater than the surgical method, do not be confused by its “no hospitalization, no surgery” veneer, the machine is not omnipotent. 7, what is hemorrhoid injection therapy? What are the advantages of injection therapy? Hemorrhoid injection therapy is the use of a syringe to inject drugs directly into the hemorrhoidal nucleus, so that the hemorrhoidal nucleus necrosis, hardening or atrophy to achieve the therapeutic purpose of the treatment method. This therapy originated in England in 1869, when the injected drugs were mainly necrotizing agents, only applicable to the initial stage of internal hemorrhoids. After the introduction of this method in China in the 70’s, not only the operation method is improved, but also many developments are carried out for the foreign injected drugs. Such as the use of traditional Chinese medicine for injection, so that the hemorrhoidal nucleus hardening and atrophy. These improvements and developments have expanded the scope of adaptation of this treatment, and also reduced the complications and sequelae after injection to some extent. However, these sclerosing agents used in China still have not completely jumped out of the category of necrosis, increasing the concentration of sclerosing agents and the amount of injections that become necrotic, so there are still serious clinical complications and sequelae, the most common is hemorrhage, anal stenosis. From the treatment of internal hemorrhoids pain, course of treatment, convenience, safety, and even efficacy, injection therapy than other therapies is the best, currently the most widely used in the clinic is also the injection therapy, but the current use of injectable drugs still need to be improved and perfected. 8.How to prevent hemorrhoids? Although the incidence of hemorrhoids is high, if you can actively prevent the cause of the disease, it is possible to prevent the disease before it occurs. If you can do according to the following methods, basically can achieve the purpose of prevention. ①Actively participate in various physical exercise, enhance the physical fitness of the whole body, and maintain an optimistic mood. ② Eat more vegetables and fruits. Don’t read when you are having a bowel movement, and don’t squat for a long time or exert yourself too much. Drink a glass of cool water in the morning to help prevent constipation. Avoid prolonged sitting, standing and walking, and actively treat heart, lung and liver diseases. ④Treat inflammation in the intestinal tract and around the anus in time. Avoid drinking a lot of alcohol, eating chili peppers, etc., take sitz bath with warm water and change underwear frequently. ⑤ Do anal health exercises and self-massage. Here we introduce a kind of post-stool and pre-bedtime health care exercises. Post-poo exercise is to wash the anus after the bowel movement, and then use the tip of the right index finger to press on the anus edge, gently push the anus upward, while contracting the anus, and then relax, so repeat 30 times. Bedtime exercise is before going to bed, two knees kneeling on the bed, two elbows on the bed, head down, waist bending down, buttocks a little high, straighten up the abdomen deep inhalation, at the same time powerful contraction of the anus, and then relax. So repeat 30 times, can effectively evacuate the local congestion, on the old, weak, sick people more applicable. You can also do half an hour of daily anal lifting exercise or directly use the index finger to rub the anus.