How are hemorrhoids diagnosed and treated?

Hemorrhoids are a common clinical disease, and there is a folk saying in China that “nine out of ten people have hemorrhoids”. A national survey in the 1970s showed that the incidence of anorectal diseases was 59.1%, of which hemorrhoids had the highest incidence, accounting for 87.25% of the total number of anorectal diseases. The majority of patients are internal hemorrhoids (59.86%), external hemorrhoids (16.01%) and mixed hemorrhoids (24.13%). The above situation is sufficient to show that hemorrhoids are a common and frequent disease. In addition, in terms of gender and age, the incidence ratio of men to women is about 4:5, with a slightly higher incidence in women, and the age of onset is mostly between 20 and 50 years old, and can gradually increase with age. Internal hemorrhoids are venous masses formed by dilated and flexed submucosal veins at the end of the rectum above the dentate line, while external hemorrhoids are masses or superfluous organisms caused by inflammation, venous dilatation and stasis, thrombosis or proliferation of connective tissue below the dentate line, and mixed hemorrhoids are formed when internal hemorrhoids and external hemorrhoids in the corresponding area fuse with each other and involve the upper and lower dentate line. The diagnosis of hemorrhoids is generally not difficult and can be made with reference to the characteristics of various hemorrhoids and based on history, symptoms, and signs. Internal hemorrhoids are located above the dentate line and are hemispherical in shape. In mild cases, there are no obvious symptoms, but in larger and more severe cases, blood in the stool and prolapse of the hemorrhoid nucleus can occur, which can also be complicated by thrombosis and impaction. External hemorrhoids are formed by varicose veins outside the hemorrhoid plexus or inflammation of the anal verge, connective tissue hyperplasia and subcutaneous blood stasis. The hemorrhoids are clinically classified into 4 categories: 1. External connective tissue hemorrhoids: surface folds, similar or slightly darker in color to the perianal skin, varying in size and irregular in shape. There are no or only few varicose veins in the hemorrhoids, and the connective tissue hyperplasia is more obvious; 2. Varicose external hemorrhoids: caused by varicose hemorrhoidal plexus below the dentate line, forming a ring or other shaped elevation along the anal verge with a soft texture. It can be aggravated after squatting or making other movements that cause increased abdominal pressure, mostly without obvious symptoms. The hemorrhoid is a mass of varicose and stagnant veins; 3. Thrombosed external hemorrhoid: a round or sub-circular bulge under the perianal skin, with significant local distension and pain. The hemorrhoids are usually found at the anal verge truncation points 3 and 9; 4. Inflammatory external hemorrhoids: the anal verge skin flaps or skin wrinkles are formed due to inflammation stimulation, and local redness, swelling, heat and pain are obvious. Mixed hemorrhoids consist of two parts: internal and external hemorrhoids, which have the characteristics of both internal and external hemorrhoids, respectively. Treatment of hemorrhoids includes conservative treatment and surgical treatment. Conservative treatment can temporarily relieve the symptoms such as blood in the stool and swelling and pain caused by hemorrhoid attacks, but generally cannot be cured. Commonly used medications include various hemorrhoid creams, hemorrhoid suppositories, and herbal tonics for sitz baths. Surgical methods are used for those with recurrent episodes of bleeding and swelling pain, prolapse or even impaction, large hemorrhoids causing foreign body sensation and reduced quality of life. Surgical methods for treating hemorrhoids in An’s therapy include the peony-bet injection method, external peeling and internal ligation plus peony-bet injection method.