The soft venous mass formed by the dilatation and flexion of the venous plexus under the mucous membrane at the end of the human rectum and the skin of the anal canal is called hemorrhoids, also known as hemorrhoids, hemorrhoids, hemorrhoid disease, hemorrhoid disease, etc. Hemorrhoids are a common and common disease that is unique to humans. According to the census data, the incidence of anorectal diseases is 59.1%, and hemorrhoids account for 87.25% of all anorectal diseases, of which internal hemorrhoids are the most common, accounting for 52.19% of all anorectal diseases. The incidence of hemorrhoids is 67% for women and 53.9% for men; they can develop at any age, and are more common in people aged 20-40, and gradually worsen with age, so there are “nine hemorrhoids in ten people”. Hemorrhoids include internal hemorrhoids, external hemorrhoids, and mixed hemorrhoids, which are a chronic disease of one or more soft venous masses formed by varicose veins at the base of the anorectum and anal mucosa. Usually when straining continuously during defecation causes a repeated increase in pressure in the veins here, the veins become enlarged. Hemorrhoids often occur in women during pregnancy due to compression of the pelvic veins, which hinders blood circulation, and many obese people also suffer from hemorrhoids. If you have hemorrhoids, the walls of the enlarged and twisted veins in the anus become very thin, so they can easily rupture during defecation. Internal hemorrhoids are those that grow at the beginning of the anal canal. If the swollen vein is located further down, almost over the opening of the anal canal, this varicose vein is called an external hemorrhoid. External hemorrhoids can sometimes protrude or protrude outside the opening of the anal canal. However, this only happens during a bowel movement, and it retracts back to its original position afterwards. Blood clots can occur in both internal and external hemorrhoids. In the event of a blood clot, the blood in the hemorrhoid clots and causes pain. The majority of medical doctors in China currently believe that hemorrhoids occur for the following reasons: a. Anatomical reasons: When a person is standing or sitting, the anorectum is located in the lower part, and the upward venous reflux is quite impaired due to gravity and the compression of the organs. Rectal vein and its branches lack of venous valves, blood is not easy to reflux, easy to stasis. Its vascular arrangement is special and crosses the muscular layer at different heights, which is easily compressed by the fecal mass and affects the blood return. The veins pass through the lax tissue of the submucosa and lack of scaffolding around them, so they are easily expanded and flexed. Second, the genetic relationship: the vein wall is congenitally weak, resistance is reduced, can not tolerate the intravascular pressure, and therefore gradually dilate. Third, occupational relationship: people standing or sitting, long-term weight-bearing distance, affecting venous reflux, so that the pelvic blood flow is slow and abdominal organs congestion, causing excessive filling of hemorrhoidal veins, the tension of the vein wall decreased, the blood vessels are easy to stasis expansion. And because of the lack of movement, intestinal peristalsis, stool downward slow, or habitual constipation, can compress and stimulate the veins, so that local congestion and blood return obstruction, causing hemorrhoid veins within the pressure rise, the vein wall resistance is reduced. Fourth, local stimulation and diet: the anal part of the cold, heat, constipation, diarrhea, excessive drinking and more spicy food can stimulate the anus and rectum, so that the hemorrhoid venous plexus is congested, affecting the venous blood flow back, so that the resistance of the venous wall is reduced. Fifth, the anal vein pressure increase: because of liver stiffness, liver congestion and cardiac insufficiency, etc., can make the anal vein congestion, pressure increase, affecting the rectal venous blood return. Sixth, intra-abdominal pressure increase: because of intra-abdominal tumor, uterine tumor, ovarian tumor, prostate hypertrophy, pregnancy, eating too much or squatting too long, etc., can make the intra-abdominal pressure increase, preventing the venous blood flow back. Seven, the anal infection: hemorrhoid plexus first due to acute and chronic infection and inflammation, the elastic tissue of the vein wall gradually fibrosis and weakness, lack of resistance, and the expansion of varicose, coupled with other reasons, so that varicose veins gradually aggravate, generating hemorrhoids. Hemorrhoid masses are mainly composed of dilated veins, spongy tissue and connective tissue interstitium. The veins become dilated and curved, their walls become thinner, the outer membrane and middle layer atrophy, and the elastic fibrous tissue within the wall becomes fibrous [ some veins do not change. There may be thrombosis within the vein and blood clots outside the vein. There is often acute and chronic inflammation, which is seen as a result of cellular infiltration, sometimes forming small abscesses. The spongy tissue, called the rectal spongiosa, consists of many vascular bullets with small short and bendable arteries within them. Sometimes there are arteriovenous fistulas, and arterial pulsations can be felt within the hemorrhoidal mass. The surface of internal hemorrhoids is columnar epithelium and the surface of external hemorrhoids is squamous epithelium. What are the risks associated with hemorrhoids? The most important symptoms of hemorrhoids are blood in the stool and prolapse. Repeated bleeding during stool can cause the body to lose a lot of iron and cause iron deficiency anemia. This is because under normal circumstances the absorption and excretion of iron remains in balance, the loss of iron is very small, normal adult men do not lose more than 2 mg of iron per day, while patients with blood in the stool, if the daily blood loss of more than 6 to 8 ml is more than 3 to 4 mg of iron loss. The total amount of iron in a normal human male is 50 mg/kg of body weight and in a female it is about 35 mg/kg of body weight. If you lose a lot of iron with long-term blood loss, the total amount of iron in your body is lower than normal and can cause iron deficiency anemia. Iron deficiency anemia due to blood loss from hemorrhoids generally develops slowly and can be asymptomatic or mild in the early stage, while when the anemia is heavier or progresses faster, pallor, lethargy, loss of appetite, palpitations, accelerated heart rate and shortness of breath after physical activity, swelling, etc. Some patients can develop neurological symptoms such as agitation, excitement, irritability, etc. Some people think it is due to the lack of intracellular iron-containing enzymes. All of these symptoms can disappear by correcting anemia and treating hemorrhoids. Therefore, if you are found to have hemorrhoids, you should treat them as early as possible to avoid complicating treatment with the above symptoms. Another major symptom of hemorrhoids is the prolapse of internal hemorrhoids. The internal hemorrhoids that are prolapsed outside the anus are held by the sphincter muscle, and the venous return is blocked, while the arterial blood is still being input to increase the size of the hemorrhoid nucleus until the arterial blood vessels are pressed shut and a thrombus is formed, resulting in a hard, painful hemorrhoid nucleus that is difficult to return to the anus. The traditional view is called “strangulated internal hemorrhoids”. However, in the case of external hemorrhoids, the formation of thrombus is more common and is therefore associated with pain, and when the hemorrhoid nucleus is prolapsed and cannot be returned, it is also called “embedded hemorrhoid”. If the hemorrhoid is embedded for a long time, the following pathological changes can occur: (1) Necrosis: the hemorrhoid is embedded outside the anus, and due to a series of pathological changes, local metabolites accumulate, further aggravating the local edema of the anus and aggravating the embedded hemorrhoid, which is a vicious circle. Therefore, if the internal hemorrhoid is embedded for a long time, necrosis is bound to occur. The necrosis is often confined to the mucous membrane part of the hemorrhoid nucleus, but there are also cases where it invades other parts of the body. There are reports from abroad that the thrombus in the hemorrhoid nucleus spreads upward and the necrotic area extends to the rectal wall, resulting in severe sepsis in the pelvis. This is a rare condition, but it must be taken seriously by clinicians. (2) Infection: After the hemorrhoid nucleus is embedded, there are many different degrees of infection, and the patient has symptoms such as urgency, anal swelling, etc. At this time, the infection is mostly confined to the anal area, and if it is strongly reset, it is easy for the infection to spread, causing submucosal, perianal or sciatic-rectal fossa abscesses, and if the dislodged bacterial embolus travels up the vein, coupled with improper use of antibiotics or no antibacterial drugs, portal vein bacteremia can form Even sepsis and liver abscess can be formed. Fatal portal vein sepsis has been reported abroad as a result of embedded hemorrhoids. In conclusion, hemorrhoids have many harmful effects on the human body and should be taken seriously by the majority of clinical workers who treat every patient with hemorrhoids. Patients with hemorrhoids do not have to be overly nervous, as long as they are treated early and appropriately, the above serious complications can be avoided.