Before surgery, patients always come to me and ask: Why do I have hemorrhoids? Can my hemorrhoids be removed? Will my hemorrhoids come back after the surgery? My answer is: we try to get rid of symptomatic hemorrhoids as much as possible, but the recurrence after surgery has a lot to do with lifestyle and bowel habits. This time some friends may be unhappy, no hurry, slowly listen to me to tell. First of all, it is important to understand what exactly the concept of “hemorrhoids” is. This is defined in the guide: hemorrhoids are divided into internal, external and mixed hemorrhoids. Internal hemorrhoids are pathological changes and displacements of the supporting structures of the anal cushion (vascular cushion of the anal canal), vascular plexus and arteriovenous anastomosis; external hemorrhoids are dilated subcutaneous vascular plexus on the distal side of the dentate line, stagnant blood flow, thrombosis or tissue hyperplasia, according to the pathological characteristics of the tissue, external hemorrhoids can be divided into four categories: connective tissue, thrombotic, varicose veins and inflammatory external hemorrhoids; mixed hemorrhoids are the mutual fusion of internal hemorrhoids and external vascular plexus in the corresponding area . The masses are mentally rejecting something so specialized! Then I’ll take some simple ones. 1, “anal cushion” is the normal anatomical tissue of the anal canal area of normal people, consisting of a network of blood vessels and support structures, to assist the normal closure of the anus, to play a role in regulating defecation, as if the role of the faucet washer general. 2, hemorrhoids is the anal cushion tissue pathological changes (hypertrophy, vascular brittle bleeding), after the formation of the downward shift, the implication is that the predecessor of hemorrhoids is the normal tissue structure of our anus. Still don’t get it? Well, for example: breast sagging get it? Long-term gravity + relaxation of breast support structures in old age cause them to sag. If you compare the anal cushion to a breast, then hemorrhoids are sagging breasts, and when the cushion is subjected to long-term gravity combined with the impact of daily bowel movements and no good lifestyle habits, the normal anal cushion tissue will slowly change pathologically and move down to form hemorrhoids. This results in two common symptoms: prolapse of the anal swelling during defecation and bright red blood during defecation. In fact, there are many reasons for the development of hemorrhoids. Genetic factors have something to do with it, and some patients will come to the clinic and say, “My family has hemorrhoids, so I have them too. In terms of diet, eating irritating food and drinking alcohol for a long time is also one of the reasons for the onset. In addition, abnormal bowel movements, such as long-term constipation, repeated diarrhea may also lead to the development of hemorrhoids. In terms of lifestyle habits, people who stay in one position for a long time, such as squatting, sitting, standing or walking, are also prone to hemorrhoids. Long-term increased abdominal pressure is also a factor in the development of hemorrhoids, with pregnant women being the most common example, in addition to people with chronic coughs and prostate lesions. For the treatment of hemorrhoids, the “Hemorrhoid Clinical Diagnosis and Treatment Guidelines (2006 Edition)” guidelines have made it very clear that the principles of hemorrhoid treatment are: asymptomatic hemorrhoids do not require treatment. The aim of treatment is to eliminate and reduce the symptoms of hemorrhoids. Relieving the symptoms of hemorrhoids is more meaningful than changing the size of the hemorrhoid body and should be considered as a criterion for the effectiveness of treatment. Therefore, symptomatic hemorrhoids we are able to cut cleanly, and to really cut cleanly and completely without the possibility of recurrence, it is probably necessary to gut the anus to do so! And to avoid recurrence after surgery, it is actually very important: a good routine and good bowel habits.