Hemorrhoids, and Emorods, and Piles! Oh, My!

Symptoms of Internal Hemorrhoids

• Bleeding during a bowel movement. As the hard stool passes through the rectum, the swollen veins will begin to bleed. In most cases, there is no pain experienced because nerve endings are lacking in this area. The amount of blood loss is usually small, but it will be bright red in color.
• Mucus can be on the toilet tissue or on the bowel movement. Mucus can drain steadily from the anus.
• Rectal itching and burning from the drainage caused by the hemorrhoids. The skin around the anus can not handle the irritating fluids as the internal tissue can.
• Leakage of stool from the anus. Stool can escape with the drainage from this swollen area.
• An internal hemorrhoid can fall down (prolapse) and protrude outside the anus. Usually, there are two stages associated with prolapsed hemorrhoids. The first one is when the hemorrhoid will fall out of the anus during a bowel movement, but then it retracts back inside after defecation. The second stage is when the prolapsed hemorrhoid no longer retracts, and it remains outside the anus.
• A feeling of rectal fullness as if you need to have a bowel movement.

Symptoms of External Hemorrhoids

• A painful swelling or hard lump around the anus which results from a blood clot forming in the veins. These hemorrhoids are said to be thrombosed because the blood in them cannot return to circulation in the body and is strangulated. This can be a serious condition that leads to gangrene (tissue death).
• Pain can be severe because of the nerve endings around the outside of the anus.
• Skin irritation can cause itching, burning and bleeding.
• Drainage of mucus and stool.

Hemorrhoids Causes

Causes of Hemorrhoids May Include

The Hemorrhoid Information Center

• Constipation
• Straining during bowel movement
• Diarrhea
• Vomiting
• Excessive tissue paper cleaning
• Pregnancy
• Coughing
• Sneezing
• Sitting on the toilet too long
• Unnatural sitting habits
• Eating a low-fiber diet
• Overweight
• Standing for too long
• Lifting too much
• Cirrhosis of the liver
• Bad Diet
• Anal or rectal infections

History of Surgical Treatment of Hemorrhoids

How Hemorrhoids Have Been Treated Throughout Various Ages In The World

Hemorrhoids in plain English!

• The Eqyptians
  
  The earliest record of hemorrhoids comes from Egyptian Papyrus dated at 1700 BC. The document recorded the first treatment for piles, an herbal poultice: "if thou inspecteth a man in his anus, whether standing or sitting, suffering very greatly with seizures in both his legs. Thou shouldst give a recipe, an ointment of great protection; Acacia leaves, ground, titurated and cooked together. Smear a strip of fine linen therewith and place in the anus, that he may recover immediately."
• The Greeks
  
  Hippocrates wrote some of the earliest medical descriptions of hemorrhoids. The Hippocratic Treatises, written in 460 BC, described hemorrhoids as being caused by "bile or phlegm be determined to the veins of the rectum, it heats the blood in the veins; and being gorged the inside of the gut swells outwardly, and the heads of the veins are raised up, and being at the same time bruised by the faeces passing out, and injured by the blood collected in them, they squirt out blood, most frequently along with the faeces."
  
  Hippocrates also wrote of a hemorrhoid treatment similar to today's rubber band ligation procedure. He wrote "And hemorrhoids in like manner you may treat by transfixing them with a needle and tying them with very thick and woolen thread; for thus the cure will be more certain. When you have secured them, use a septic application, and do not foment until they drop off, and always leave one behind; and when the patient recovers let him be put on a course of Hellebore."
• The Romans
  
  In a medical treatise De Medicina, a Roman physician named Celcus (25 BC - AD 14) described the ligation and excision surgeries, as well as possible complications. Another description of hemorrhoids was provided by Galen (AD 131 - 201), who also promoted the use of severing the connection of the arteries to veins in order to reduce pain and avoid spreading gangrene.
• The Far East
  
  Hemorrhoid is not limited to the Western world - it is acknowledged as a disease in India by the Susruta Samhita, an ancient Sanskrit text dated between the fourth and fifth century AD. The description in this text is comparable to the Hippocratic Treatise, but with advancement in surgical procedures and emphasis on wound cleanliness.
• The Master & Barber Surgeons
  
  By the 13th century, there is a lot of progress in the surgical procedures, led by European physicians called the Master Surgeons. Renowned figures such as Lanfrank of Milan, Guy de Chauliac, Henri de Mondeville, and John of Ardene greatly expanded and refined surgical procedures.
  
  However, the progress of science & surgery stalled for about 350 years when barbers start to routinely conduct surgeries! Between 1500 and 1850 AD, in an era later known as the era of "Barber Surgeons", hemorrhoids are commonly called the "Curse of St. Fiacre". The story is that St. Fiacre, who later became the patron saint of gardeners, was told by his church that he could farm on all of the land that he could cultivate in a single day with a very small shovel. In his zeal to obtain the maximum amount of land, St. Fiacre developed a terrible case of hemorrhoids. According to legends, after praying for a miraculous relief, St. Fiacre sat on a stone and found that his problem was cured and an image of a hemorrhoid is imprinted on the stone. Today, hemorrhoid sufferers continue to sit on the stone and pray for relief!
• The Renaissance
  
  During the Renaissance, surgeries returned to the realm of the scientists. A celebrated physician, Lorenz Heister, wrote about the crudeness of past procedures to treat hemorrhoids, and described a detailed procedure for ligation: "he is then to tie up the bleeding tunercles with a needle and thread, cutting off those parts which are distended beyond the ligature, taking care at the same time to leave a few of the smallest veins open as before observed."
  
  Acknowledging that hemorrhoids and varicose veins seem to affect only the upright humans, a physician-scientist called Morgnani wrote: "without doubt, it was not very easy for the blood to pass through a liver of that kind. But why, then, you will say, did it not stagnate equally in the other veins which go to the trunk of the vena portarum? And for this very reason it was that I said you would immediately understand it, or at least in part. Add therefore, to omit other things, the very great length, which is peculiar to this one vein among others, so that it is much more difficult for the blood to be carried upwards, from this vein, than from the others, especially as the situation of the human body requires it, which without doubt is one of the reasons why other animals are not subject to piles. And if you ask why, in those bodies in which there is any impediment to the quick motion of the blood upwards, the veins of the legs in particular are dilated into varices, you will find the same thing to be the cause of them chiefly which we assign for the piles."
• The Eighteenth / Nineteenth Century
  
  In 1774, Jean Louis Petit wrote a three-volume treatise on surgery, in which he noted that the skin of the anus is very sensitive. He reasoned that excision surgery alone should be avoided due to the pain and the possibly fatal complication of hemorrhage, whereas ligation procedure alone should not be performed because of the pain and the possibility of gangrene.
  
  However, other physicians such as Brodie, disagreed with Petit's concern on ligation, noting that "the application of ligature to internal piles in general causes by little pain, and only a slight degree of inflammation follows, for the mucous membrane has nothing like the sensibility of the skin, and does not resent an injury in like manner." Sir Astley Cooper also supported ligation after complications from hemorrhoid excision surgeries claimed three of his patients' lives.
  
  During the nineteenth century, another treatment for hemorrhoids called anal stretching or rectal bouginage, became popular. In this treatment, a bougin - a cylindrical medical device used to stretch muscles and tissues, is inserted in the anal canal to enlarge the rectum as well as to "relax" the sphincter muscle and diminish hemorrhoids.
  
  In 1888, Frederick Salmon, the founder of St. Marks Hospital, expanded the surgical procedure of hemorrhoid surgeries into a combination of excision and ligation. In this technique, the perianal skin is incised, the hemorrhoidal plexus and the anal muscles are dissected, and the hemorrhoid is ligated.
• The Twentieth Century
  
  So successful is Salmon's excision/ligation surgery that it remained virtually unchanged since its introduction in late nineteenth century. Even today's Ferguson and Milligan Morgan hemorrhoidectomy - considered the gold standards in hemorrhoid surgery - was a modification on Salmon's techniques.
  
  In late twentieth century, three further developments were introduced: the diathermy hemorrhoidectomy by Alexander Williams, rubber band ligation by Baron, and the stapled hemorrhoidectomy or Procedure for Prolapse and Hemorrhoids (PPH) by Longo.

Natural Hemorrhoids Treatments

Herbal Hemorrhoids Remedies

For many people, herbal treatments can help alleviate the symptoms of hemorrhoids and provide lasting relief. Below is a list of natural hemorrhoids treatments.

Hemorrhoids in plain English!

• Japanese Pagoda Tree (Sophora Japonica)
  
  The extracts of the Japanese pagoda tree are proven to strengthen vein walls, fix the permeability of the veins and capillaries, and help maintain vein health. It has also been shown to relief the symptoms of hemorrhoids, such as the itching, pain, and discomfort.
  
  Clinical studies on Japanese pagoda tree extract have shown that:
  
  96% of men and women with varying severity of hemorrhoids have relief from the bleeding
  88% have a significant reduction of discharge
  95% have relief from inflammation
  90% have relief from itching
  Overall, 94% of people taking Japanese pagoda tree extract are symptom-free and cured of hemorrhoids or had significantly better conditions as compared to only 23% of those taking placebo.
• Butcher's Broom (Ruscus aculeatus)
  
  Butcher's broom is an evergreen bush with a stiff spine, which is used for making brooms in ancient times. It is closely related to asparagus, and has been used as vegetables as well as an herb.
  
  The extract of the root of the Butcher's broom bush, which contains the active ingredient ruscogenins, has the natural ability to narrow blood vessels, lessen inflammation and swelling, as well as strengthen and improve vein walls and tone.
• Horse Chestnut (Aesculus hippocastanum)
  
  The seed of the horse chestnut tree has been used since the 1800s to treat various vein conditions. Today, horse chestnut extract is commonly used in Europe and Asia for hemorrhoids.
  
  Horse chestnut extract contains aescin, which has been shown to reduce inflammation, improve vein elasticity, strengthen vein walls and improve vein tone. It is thought that aescin does this by plugging small leaks and holes in the veins and capillaries.
  
  Horse chestnut can also improve microvascular circulation, lessen the swelling and fluid retention.
• Witch Hazel (Hamamelis Virginiana)
  
  A popular astringent, witch hazel is a common ingredient in creams and ointments for hemorrhoids. Extracts of the leaf and bark of this medicinal shrub has been used for many years to reduce swelling and inflammation of external hemorrhoids.
• Cranesbill (Geranium maculatum)
  
  Cranesbill is a wild geranium plant that has been used by Native Americans to treat various digestive conditions. When used as a poultice, the root and rhizome of cranesbill has a potent astringent quality that can be used to treat hemorrhoids.
• Psyllium (Plantago ovata)
  
  Because of its high fiber and mucilage (gum-like residue) content, psyllium or flea seed is commonly used as a natural laxative to treat constipation. Here, the husk of the seed absorbs water and keep stool soft and moist.
  
  Chronic constipation often irritates existing hemorrhoids because it results in hard and dry stool that is difficult to pass. By reducing constipation, psyllium can help reduce hemorrhoid flare-ups and allow the hemorrhoid to heal naturally. Be sure to drink a lot of water to fully take advantage of psyllium's benefits.
• Aloe Vera
  
  Aloe has a long history of use as soothing and cooling astringent. Aloe gel, derived from the plant's leaf, can be applied to external hemorrhoids to relieve the swelling and pain.
  
  Another substance from aloe, called aloe vera latex extract, can also be used as a natural laxative. Similar to psyllium, natural laxative can be used to combat constipation and prevent hard, dry stool from irritating hemorrhoids. However, aloe extract is very potent - so be careful in using just a small portion and possibly in combination with other gentler herbs, to treat the occassional constipation.
• Pilewort (Ranunculus ficaria)
  
  PIlewort it is a traditional English herbs used to treat (what else?) piles or hemorrhoids. It got its name because early herbalists thought that the physical appearance of the plant signifies its function - here, pilewort tubers look like hemorrhoids.
  
  Pilewort can be used as a tincture to be applied directly to external hemorrhoids, or made into tea. However, due to possible side effects such as blisters, as well as lack of clinical studies showing benefits, pilewort has not been a popular choice.
• Plantain (Plantago major)
  
  The fiber-rich plaintain has been used as traditional medicine to treat hemorrhoids. A natural compound found in plantain, called allantoin, is an anti-inflammatory agent that can stimulate the immune system and help skin heal from wounds. In addition to hemorrhoids, powdered allantoin has been used to treat ulcers and skin lacerations.
• Bromelein
  
  Bromelein is actually a combination of digestive enzymes found in pineapple. It has the amazing properties of stopping swelling and inflammation, and has been used for treating hemorrhoids and other vein conditions, such as varicose veins and chronic venous insufficiency.