1, what is hemorrhoids? We must know “sucking carbuncle licking hemorrhoids” this idiom, the Warring States period, Zhuangzi Song’s envoy Cao Shang went to Qin to flatter the king of Qin is very disgusted, mocking said: “The king of Qin has a disease Yan doctor, can break pus ulcer acne, can get a car a ride; can lick hemorrhoids with the mouth boils, can get a car five times. The more you can cure, the more cars you can get. The more you get, the more cars you get. You get a lot of money, but is it possible that you are licking hemorrhoids for the King of Qin?” That period of time people on the hemorrhoids of this disease has been recognized. Hemorrhoids, also known as hemorrhoids, the professional name is hemorrhoids. Let’s look at the origin and meaning of the word “hemorrhoids”. As early as 3,000 years ago in the oracle bone inscriptions can be found in its earliest prototype, in the Spring and Autumn period of some medical books appeared on some not with sick character side of the “temple”, “face” and so on to describe this disease, experienced to the late Warring States period of the “fifty-two disease prescription” before the real The present word “hemorrhoid” appeared in the late Warring States period of the “52 Diseases Formulas”. The Ming Dynasty’s “Medical Compendium” in explaining the meaning of this word is said: “Dazawa in a small mountain protruding for the standoff, in the human nine orifices where there is a small protruding flesh are said to be hemorrhoids. Therefore, in ancient China, people’s most important understanding of hemorrhoids is a class of diseases characterized by localized protrusions in the anus. There are two English words for hemorrhoids, one is from the ancient Greek Hemorrhoids, which means bleeding or bleeding. The other is from the Latin word pile, which means globular or protruding. The two words describe the symptoms and the shape, respectively. So this “protrusion” localized in the anus must be hemorrhoids? No. 2,500 years ago, the ancient Chinese used the words “寺” and “峙” without the Chinese character “疒”. And almost the same period of Hemorrhoids although it refers to bleeding or bleeding, but at that time is not as a disease to view, because the ancient Western scholars hemorrhoidal bleeding as a kind of self-purification of life phenomenon. 1975, the American scholar Thomson in 42 cases of normal people in the lower rectum found spongy body-like raised tissue, and was 3, 7, 11 arranged. He believes that the organization is not only not a disease, but also can play the role of cushion, help the anus closed tightly, so he named it “anal cushion”. So what are hemorrhoids? Traditional textbooks say: “hemorrhoids is the anal margin, the anal canal and the lower end of the rectum veins tortuous expansion of the formation of raised tissue”, this definition in the development of the site and the nature of the disease to give a clear definition. However, since Thomson’s “anal cushion” said, this definition has been subverted, professional books, industry organizations have amended the definition of hemorrhoids; such as “anal cushion tissue abnormalities and combined with the symptoms of hemorrhoids”, “hemorrhoids Is the anal cushion pathological hypertrophy, displacement and perianal subcutaneous vascular plexus blood flow stagnation mass”, “internal hemorrhoids is the anal canal above the dentate line, rectal mucosa under the vascular cushion pathologically dilated or proliferative elevated tissue”. Our study confirms four pathological changes in hemorrhoids, namely, significant dilatation of venous vasculature, intravascular or thrombosis, tissue edema, and inflammation. From these new definitions we can easily see, the lower end of the rectum, anus localized general bulging formed by the anal cushion is not a disease, nor hemorrhoids, only when the anal cushion excessive bulging, pathological hypertrophy, displacement or accompanied by hair issued by the hemorrhoid is a disease, only called hemorrhoids. 2, hemorrhoids have several kinds? Hemorrhoids can be divided into internal hemorrhoids, external hemorrhoids and mixed hemorrhoids according to the different parts of the occurrence of hemorrhoids (see Figure 1, Figure 2, Figure 3). In about 3 to 4 centimeters from the anal verge, there is a jagged rectal mucosa and skin demarcation line, called the dentate line. With the dentate line as the boundary, occurring above the dentate line, the lower end of the rectum is called internal hemorrhoids, occurring below the dentate line of the anal canal and around the anal verge is called external hemorrhoids, in the same place across the dentate line above and below the hemorrhoids is called mixed hemorrhoids. Internal hemorrhoids can be divided into three stages according to their severity. Stage I: blood in bowel movements, no prolapse, and nodular elevation of the mucosa on the tooth line. Phase II: blood in bowel movement, dripping or ejected blood, prolapse of internal hemorrhoids, which can be self-contained. Stage III: internal hemorrhoid prolapse occurs during defecation or when abdominal pressure increases due to coughing, exertion, or weight bearing. External hemorrhoids are subdivided into connective tissue external hemorrhoids, varicose external hemorrhoids, inflammatory external hemorrhoids, and thrombosed external hemorrhoids according to their nature. In a person, these kinds of hemorrhoids can be single or multiple. 3, how do you know you have hemorrhoids? The most important manifestation of hemorrhoids is bleeding in the stool, blood dripping in the process of defecation or blood staining of the handkerchief at the end of defecation, if the bleeding is jet-like, you can basically be sure that it is hemorrhoidal bleeding. Blood color blood, there is a certain periodicity, bleeding for a long time can cause anemia, dizziness, shortness of breath, fatigue, poor spirit and other symptoms. Hemorrhoids develop to the middle stage, in addition to bleeding, there will be a soft swelling (hemorrhoids) out of the anus during bowel movements, and this swelling can be restored to its original position by itself after a bowel movement. If after the stool this swelling out of the anus can not return to the original position, need to use the hand to push back, even in coughing, walking will also be out, it shows that has been very serious. Some people may also experience anal moisture, itching and constipation. If the anus suddenly appeared swelling and accompanied by severe pain, most of the external hemorrhoids inflammation or formation of thrombus, or internal hemorrhoids prolapse incarcerated, but should pay attention to the difference with the anorectal peripheral infectious diseases. 4, why will ten people nine hemorrhoids? Although said “ten people nine hemorrhoids” some exaggeration, but the high incidence of hemorrhoids is recognized, then why the human body will be so easy to suffer from hemorrhoids? It is generally believed to be the result of a combination of internal and external factors. The appearance of hemorrhoids, its internal must appear two pathological changes, one is the expansion of blood vessels, one is fixed these blood vessels of the tissue problems, such as aging, decreased elasticity or fracture. The degree of dilatation of the blood vessels determines the size of the hemorrhoids, and problems with the fixing tissues can lead to prolapsed hemorrhoids. So any factor that can lead to changes in these two areas is the reason why hemorrhoids occur. 5, hemorrhoid bleeding how to identify? A medical expert who has given others a lifetime of medical treatment when diagnosed with advanced rectal cancer said sadly: “If I had paid attention to the blood in the stool, it would not have been so”. In fact, two years ago, when he just appeared blood in the stool, if he did not treat it as hemorrhoids, and did the corresponding examination in time, timely surgery, can have a better result. In fact, and not only this medical experts, such a lesson clinical and many, many people think that blood in the stool is just hemorrhoids, tolerate or use some medicine on the past, there is no need to go to the “big deal”. Blood in the stool is the signal of no less than dozens of anal and digestive tract diseases, we can make self-judgment based on the way of blood in the stool, how much, the color and the accompanying symptoms of a comprehensive analysis. Hemorrhoids is the most common cause of blood in stool, this blood occurs in the process of defecation or after defecation, the blood is bright red, blood and feces do not mix, was a drip and down, there is also a jet, the amount of bleeding can be large or small, after the stool to stop, some also show a certain periodicity. Some patients have small lumps protruding outward from the anus when defecating with force and anger, but without anal pain. Anal fissure can also produce bright red blood, dripping or wiping blood with hand paper, but it is different from hemorrhoids in that it often has severe pain in anus after defecation. Among the intestinal tumors, rectal cancer is most similar to hemorrhoidal bleeding due to its lower location, which causes blood in the stool. The blood in stool is bright red and attached to the surface of stool in the form of drops, but most of them are mixed with mucus and dark-colored blood clots in blood or stool, accompanied by bad smell and persistent. In the late stage with anorectal fall and generalized emaciation, increased frequency of stools, constipation and diarrhea alternately, according to these can be initially distinguished from hemorrhoids. Rectal polyps, children blood in the stool is mostly caused by this disease. Polyps caused by blood in the stool, blood color bright red, painless, small amount, some patients in the surface of the stool with grooves, polyps grow to a certain length can be out of the anus with the stool. Ulcerative colitis, dysentery and other diseases can also cause blood in the stool, this kind of colorectal inflammatory diseases caused by blood in the stool is mostly mixed with mucus or pus and blood stool, and accompanied by lower abdominal pain, fever, frequent stools and symptoms, such as acute and severe, more common in adults. In addition, some rare diseases, such as intestinal typhoid fever, intestinal tuberculosis, intussusception, etc., also have symptoms of blood in stool. Systemic diseases such as leukemia, aplastic anemia, primary thrombocytopenic purpura, hemophilia, disorders of the coagulation mechanism, collagen disease, uremia, and certain rare infectious diseases such as bubonic plague, typhus, and so on, will have blood in the stool. However, in these diseases, blood in stool is only a part of systemic bleeding, blood in stool will be accompanied by bleeding in other parts of the body, so it is not difficult to identify. 6, hemorrhoids can be cured? Many hemorrhoid patients will always ask before receiving treatment: “Will it recur later?” Some doctors, in order to keep patients will always say: “will not, once on the root of the cure”. There is such a once-and-for-all method? Hemorrhoids is actually the anorectal local vascular expansion and displacement, as long as the cause of this change still exists, it will inevitably regenerate, surgery and other methods to solve the lesions that have occurred, but did not eliminate the cause of the onset of the disease, so it can be cured, but the root cause, to ensure that the future will never regenerate is difficult. Some patients choose not to treat the disease when they hear that it cannot be cured, which is also wrong. Here we do not use the word “recurrence”, but the word “regeneration”. First of all, the incidence of regeneration is very low, and even if regeneration occurs, it will take a longer period of time. Secondly, regeneration is not the fault of surgical treatment, if we give up the treatment because of this, we are actually choking on our own food. The scientific attitude is to solve the problem in time, and then develop good habits, learn preventive measures, so that the real cure. 7, hemorrhoids have what non-surgical treatment? There is a wide range of non-surgical methods, which can be categorized into three main groups: general drugs, drug intervention and physical methods. These methods can relieve or eliminate symptoms within a certain range, and some can even serve the purpose of cure. (1) General drug therapy The internal and external use of drugs for symptomatic treatment can temporarily relieve symptoms and reduce pain. Mainly used for mild hemorrhoids or heavier hemorrhoids and not suitable for surgery patients. Frequent blood in the stool, you can take elm acacia horn pill, Yunnan Baiyao or lotus leaf pill and other proprietary Chinese medicines; with acacia flowers brewed water tea; with taining suppository, Puji hemorrhoid suppository, such as the anus or with the Jiuhua cream, ma yinglong musk hemorrhoidal ointment can also be applied externally. The blood in the stool is more service four things soup plus the lieutenant charcoal and Xianhecao, or with Anluo blood and vitamin K. Anemia service rich in blood iron. Repeated prolapse of hemorrhoids, after the stool with five times the seeds, alum, Park Nitrous, thorns each 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 Wu Wei Sterilizing Drink, Pain Relieving Ru Shen Tang, and locally use Dispelling Poison Soup or Pepper Salt Water to externally wash the hemorrhoids. If there is a lot of secretion, take Dioscorea Dampness-expelling Soup. When infected, take San Huang Liquid or use antibiotics. Frequently constipated patients, can take Ma Ren Lun intestinal pill, Fangfeng Tongsheng Pill, laxative, liquid paraffin and other laxative drugs, or lactulose and Dupuytol to soften the stool, can also be used senna, loquat leaves, almonds, 3 grams of each daily brewing tea drink. (2) Drug intervention therapy Injecting or inserting drugs into hemorrhoids to make hemorrhoids shrink or fall off can have a curative effect. Mainly applicable to light and moderate internal hemorrhoids. Withered hemorrhoid therapy: is some corrosive effect of drugs made of nails, these nails will be inserted into the hemorrhoid nucleus to make it wither and fall off. 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. Injection therapy: is made of drugs injected directly into the hemorrhoids, or hardened atrophy, or necrosis off to play a therapeutic purpose. According to the characteristics of the injected drugs can be divided into sclerosing agent, necrosis agent and softening and shrinking agent (peony times injection). As this method is less painful, short treatment course, for simple mild to moderate internal hemorrhoids, it can also achieve the effect of cure, so it is widely used in the clinic. However, attention should be paid to the selection of high safety agents, master the operation of the essentials, but also to prevent infection after the operation, to avoid bleeding, necrosis, to prevent the occurrence of rectal stenosis. (3) Physiotherapy 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 and shedding atrophy, part of which can be achieved curative effect. At present, it is mainly applied to the treatment of external hemorrhoids. Now roughly liquid nitrogen freezing, laser, microwave, infrared coagulation, Doppler, electronic (low-frequency, high-frequency, radiofrequency, capacitance field, iontophoresis, electric oscillation) and so on. It should be emphasized that physical therapy can only be used for mild hemorrhoids or as a device used in surgery, and should strictly control the use of skills and indications, otherwise not only the pain is great, there will be some serious complications and sequelae. Don’t be confused by those “no hospitalization, no surgery, no pain” advertising slogan. 8, hemorrhoids have what surgical treatment? Many patients “talk about surgery”, the moment they hear about surgery, instinctive fear, in fact, it is not necessary, the patient’s most worried about the pain and post-operative anal incontinence in the regular professional departments, hospitals have been well resolved. For really serious patients, surgery is a hurdle that cannot be overcome. Surgery is currently the main and most reliable clinical method, and the vast majority of patients ultimately rely on surgery to obtain a cure. The principle of surgical treatment is to remove the hemorrhoids through scalpel excision or ligation of the lesion, which can be applied to all kinds of hemorrhoids. The final result of the surgery depends on the specific type of surgery and the clinical experience and proficiency of the surgeon. At present, the most commonly used clinical procedures are external hemorrhoidectomy, external hemorrhoidal stripping, internal hemorrhoidal ligation and mixed hemorrhoids external stripping and internal ligation, etc., the application of a good grasp of the indications and operating techniques. 9, hemorrhoids should be how to prevent? Although the incidence of hemorrhoids is high, but if the cause of the disease can be actively prevented, it can be prevented before it happens. ①Actively participate in 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. 10.What are the current misconceptions about hemorrhoids? Myth one: hemorrhoids will be cancerous The answer is undoubtedly negative, hemorrhoids are hemorrhoids can never become cancerous, like a mule can not change the same as a horse. This misunderstanding is a result of misleading medical advertisements that intimidate you into accepting their treatment. Secondly, hemorrhoids are easy to confuse with rectal cancer, treating bleeding rectal cancer as bleeding hemorrhoids, and then thinking that hemorrhoids are the cause of rectal cancer. Although hemorrhoids will not become cancerous, but blood in the stool must not be careless, timely examination to clarify the cause is the most important. Myth 2: Hemorrhoid bleeding is a small matter Xiao Li has hemorrhoids for many years, recently every time after bleeding, today he as usual after defecation just want to stand up, suddenly a black eye, fell headlong on the ground, good thing that his family found him in time, send him to the hospital emergency rescue. When he woke up, the doctor told him it was caused by severe anemia. He did not understand, hemorrhoid bleeding will have such consequences? Like Xiao Li such a situation I often see in the clinic, these people think that hemorrhoids is not a big disease, on the hospital for treatment and fear of pain, even if it is always bleeding, but also think that it is a small matter and do not go to the hospital for treatment. In fact, this is a misunderstanding. Bleeding hemorrhoids should never be underestimated, a person bleeding hemorrhoids if it lasts more than 10 days, there may be anemia, and once the anemia, relying on its own recovery alone will take months. Anemia is also very harmful to the human body. Not only will there be sleepiness, debility, weakness, fatigue, palpitations, shortness of breath, dizziness, blurred vision, tinnitus, etc., like Xiao Li, seriously affecting the work and life, for children and teenagers, anorexia and partiality, stunted growth, memory loss, poor academic performance, difficulty in falling asleep, susceptible to a variety of infections, prone to fever, colds, diarrhea, dizziness, headache, and so on. For women, there will also be inexplicable irritability, easy to get angry, and in severe cases, dysmenorrhea and irregular menstruation. For pregnant women it can affect the development of certain vital organs of the fetus such as brain tissue and nervous system. It is also more dangerous during delivery, and anemia complications are a major cause of death for pregnant women and newborns. Myth three: hemorrhoid surgery the world’s first pain Many hemorrhoid patients do not dare to walk into the hospital, the main reason is afraid of pain, and even on the Internet, some people say that hemorrhoid surgery is the world’s first pain, which is of course in the alarmist. This misunderstanding is due to the fact that some of the old, backward treatment methods are really damaging and painful, coupled with some of the low level of doctors or quacks of the messy treatment. On the other hand, some medical advertisements, in order to publicize their own therapies, use surgery as a comparison and deliberately expand the pain of surgery. The human body in the process of long-term evolution, due to the need for defecation function, the local anal nerve is unusually rich, unusually sensitive to a variety of stimuli, so relatively speaking, this local, whether it is sick or surgical treatment, the pain will indeed be slightly larger, but in recent years, with the continuous improvement of the treatment method and many new analgesic methods of the application of hemorrhoid surgery to achieve a basically painless has become a reality. Myth 4: Coating treatment is painless The medicine applied here is not a general hemorrhoid medicine, is a kind of medicine that can make the hemorrhoids fall off. Some advertisements say that this is a painless and advanced alternative to surgery. Typically, people are afraid of hearing surgery, and now say that the medicine can be applied, just to cater to the psychology of many hemorrhoid patients, many people to try the medicine, the results of how? Scam. The method of using medicine to make hemorrhoids fall off can be traced back to the last century five, six years popular Chinese medicine withered hemorrhoid therapy, this method is corrosive medicine made of nails, the use of inserted into the hemorrhoids to make them necrotic fall off, then mainly used for internal hemorrhoids, due to infection, bleeding and other complications are more in the clinic has slowly been eliminated. The principle of applying medicine to cure hemorrhoids is also withered hemorrhoids, through the corrosive effect of drugs to achieve the purpose of getting rid of hemorrhoids. In fact, the method is not painless and non-safe, corrosion and ulceration process will continue to be localized pain, and at the same time due to the poor localization of the coating, often hemorrhoids and the surrounding normal skin together with the ulceration, resulting in anal skin defects and anal stenosis. Many experts call for clinical should be eliminated as soon as possible this method. Myth 5: high-tech effect is good In recent years, the treatment of hemorrhoids of high-tech new terms continue to appear, laser, infrared, microwave, Doppler, copper ion, HCPT, PPH, etc., some also crowned South Korea, Japan, the United States and other titles, it seems to be not in the treatment of disease, but in the fight against hemorrhoids of a United Nations high-tech war. The patient fainted, looking at these strange, tempting new methods, thinking, high-tech cutting-edge Well, foreign goods Well, it should be good, believe it. Atomic bomb powerful, but it can not distinguish between good people and bad people, will become its victims. In fact, these so-called “high-tech” is not as magical as advertised, in the clinic they caused more and more trouble or simply do not cure the disease. Like hemorrhage, anal and rectal stenosis, anal skin defects, rectal drop, pain and so on, patients suffer greatly. Some of these are the defects of the equipment itself is not suitable for use in the treatment, such as laser, now the clinical has been basically eliminated. Some of them are doctors unreasonable and over the scope of the indiscriminate use caused by, such as PPH, was only applicable to the treatment of internal hemorrhoids and rectal mucosal relaxation, and some units even fissure, and even abscess and anal fistula are used. There are many kinds of anal and intestinal diseases, that is, a disease also has a different degree of severity, treatment also has its own method, for example, the same is hemorrhoids, internal hemorrhoids and external hemorrhoids treatment method is very different. The treatment is a complex integrated project, in which the doctor plays a decisive role, a doctor if there is no solid basic theoretical knowledge and many years of clinical experience, and then good medicine will become poison, and then good equipment can only be used to hurt people. Therefore, the glorification of a method and an instrument and equipment advertising, to be viewed with caution, never blindly follow.