Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “HEMORRHOIDS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

[Hemorrhoids: epidemiology and correlation with chronic constipation].

Following a review of international literature, AA report main results and refer their opinion about the correlation of hemorrhoidal disease with constipation, considering some variants as well as age, sex, breed, social-economic condition and geographic distribution in USA, England and Wales. Epidemiologically ten millions of people, in USA, are affected by hemorrhoidal disease; the incidence rate is 4.4% with an age distribution that shows a prevalence between 45-65 years old subject while constipation has an exponential increase with aging. Hemorrhoidal disease is significantly influenced by sex and geographic distribution that is in white breed more than in black, in social high class and in men more than women. In black breed constipation and hemorrhoidal disease present especially in lower social classes. Based on these results hemorrhoidal disease shows on epidemiological pattern that differ from constipation's one. Many questions are still present about correlations between hemorrhoidal disease and chronic constipation regarding etiopathogenesis. Only future case-control studies will solve the problem.

Chronic Disease↗
PubMedDate not supplied

[Hemorrhoids--diagnosis and treatment options].

Hemorrhoids are a common condition in adult population with prevalence of about 4%. Only a third of patients with symptomatic hemorrhoids seek medical help. The annual rate of office visits for hemorrhoids is 12 for every 1000 patients in the United States. Hemorrhoids consist of connective tissue cushions surrounding direct arteriovenous communication. They can cause bleeding, pain and itching but other anorectal diseases should be ruled out. Current guidelines recommend a minimum of anoscopy and flexible sigmoidoscopy for bright-red rectal bleeding. Care depends on the extent of hemorroids. First-degree hemorrhoids can be managed with medical treatment. Surgery is reserved for patients with third and fourth-degree hemorrhoids and failure of nonoperative treatment. A new method of the stapled hemorrhoidectomy has been introduced which significantly reduces postoperative pain, hospital stay and use of analgesics with results that are equal to excisional hemorrhoidectomy.

Hemorrhoids↗
PubMed2006

[Effect of the width of excisional mucosa stoma ring on postoperative results of procedure for prolapse and hemorrhoids method].

OBJECTIVE: To explore the effect of the width of excisional mucosal stoma ring on postoperative results of procedure for prolapse and hemorrhoids (PPH) in the treatment of hemorrhoids. METHODS: Four hundred and eighty hemorrhoid patients were treated with circular stapler. Whether excisional mucosa stoma ring was regular or not, and its width were recorded. After follow-up from one month to 24 months,the outcomes were compared. RESULTS: The mean age of the patients was (46.6+/- 5.1) years. Regular mucosa stoma ring was excited in 303 cases,while irregular ring in 177 cases. Hemorrhoids prolapse occurred in 18 cases of the patients with irregular mucosal ring excited, while only 8 cases of the patients with regular ring excited (P< 0.01). There was significant difference in the incidence of hemorrhoids prolapse between the different groups according to different width of excisional mucosal stoma ring (P< 0.01), and the patients with postoperative hemorrhoids prolapse was lest with the width of excisional mucosal stoma ring more than 3 cm. CONCLUSIONS: The width of excisional mucosal stoma ring is one of the effecting factors of surgical outcomes. It is effective to excite mucosal stoma ring more than 2 cm,and most effective to excite mucosal stoma ring more than 3 cm.

Adult↗
PubMedDate not supplied

Hemorrhoids: an experimental model in monkeys.

PURPOSE: Hemorrhoids are a matter of concern due to a painful outcome. We describe a simple, easy and reliable experimental model to produce hemorrhoids in monkeys. METHODS: 14 monkeys (Cebus apella) were used. After general anesthesia, hemorrhoids were induced by ligation of the inferior hemorrhoidal vein, which is very alike to humans. The vein was located through a perianal incision, dissected and ligated with a 3-0 vicryl. The skin was sutured with a 4-0 catgut thread. Animals were kept in appropriate cages and evaluated daily. RESULTS: Nine days later there were hemorrhoidal piles in the anus in fifty percent (50%) of the animals. Outcome was unremarkable. There was no bleeding and all animals showed no signs of pain or suffering. CONCLUSION: This is an affordable and reliable experimental model to induce hemorrhoids for experimental studies.

Animals↗
PubMed1987

Hemorrhoids. A review of current techniques and management.

Most physicians see many patients with the chief complaint of hemorrhoids. The usual presentation is bleeding with bowel movements and prolapse. Of course, if there are no symptoms, invasive treatment should not be entertained. If the symptoms are due to hemorrhoids, the degree of prolapse should be established in order to guage the treatment. Mild symptoms of first- and second-degree hemorrhoids may be treated by diet modification or a fixation process such as rubber band ligation or infrared photocoagulation. Moderate prolapse as with large second-degree and third-degree hemorrhoids need the more certain fixation of rubber band ligation or an excisional technique. Large third-degree hemorrhoids and fourth-degree hemorrhoids require removal of a portion of the prolapsing tissue to achieve a stronger fixation within the proximal anal canal.

Anal Canal↗
PubMed1978

[Combined rubber band ligation and cryosurgery of hemorrhoids (author's transl)].

By means of the combined rubber band ligation and cryosurgery of hemorrhoids a good therapy result was achieved on more than 200 patients. For the treatment of not too large hemorrhoid nodes and confluent hemorrhoids the aspiration ligation is quite sufficient. In third degree hemorrhoids, particularly in large prolapsing hemorrhoids, the rubber band ligation should include also the cryodestruction. In some cases two or three weeks later the cryodestruction has to be carried out again, depending on the finding and stage progredience. The advantage of this combined method is that the treatment can be performed on outpatients, and without much pains it is an effective therapy in any kind of hemorrhoid ailments. In addition, the postoperative complaints are less than by using the cryosond only. The application of cryotherapy shows also good results in the case of marriscae and anal fissures.

Cryosurgery↗
PubMed1995

Nonsurgical treatment options for internal hemorrhoids.

Rectal pain and/or bleeding are common complaints among the general population. Hemorrhoids are the most common etiology for these complaints, but the family physician should always be alert to the possibility of other pathologic explanations, such as fissure, abscess, fistula, condyloma or cancer. Feelings of embarrassment or apprehension about surgery may make patients reluctant to discuss anorectal symptoms with their physician. A variety of outpatient methods is available to treat internal hemorrhoids. Rubber band ligation is widely used in the treatment of all grades of internal hemorrhoids. Infrared coagulation uses high-intensity light to treat grade I, grade II and some grade III internal hemorrhoids. Bipolar electrocoagulation is useful in all cases, while low-voltage direct current is useful in cases of more advanced hemorrhoids. Proper anal hygiene and correction of chronic constipation or diarrhea are essential to prevent recurrence of hemorrhoids.

Electrocoagulation↗
PubMedDate not supplied

[Interventional radiology of chronic hemorrhoids].

Basing on the concept of hemorrhoids from pathologically changed groups of cavernous bodies of submucous layer of rectal transitional zone, the author used for the first time selective dearterialization of hyperplastic cavernous bodies which were at the same time three internal hemorrhoidal nodes. The therapeutic method consisted in roentgenoendovascular catheterization of the superior hemorrhoidal artery and embolization of its distal branches delivering blood to the internal hemorrhoidal nodes. Results of roentgenoendovascular treatment of 34 patients suffering from chronic hemorrhoids are analyzed. The author emphasizes the advantages of roentgenoendovascular occlusion of the superior hemorrhoidal artery in comparison with traditional drug therapy and surgery. No recurrences were recorded over 24 months after the intervention.

Adult↗
PubMed1997

Comparison of hemorrhoidal treatments: a meta-analysis.

OBJECTIVE: To determine whether any method of hemorrhoid therapy has been shown to be superior in randomized trials. METHOD: A meta-analysis of all randomized controlled trials assessing two or more treatment modalities for symptomatic hemorrhoids. MAIN OUTCOME MEASURES: Response to therapy, the need for further therapy, complications and pain. RESULTS: Eighteen trials were available for analysis. Hemorrhoidectomy was found to be significantly more effective than manual dilatation of the anus (p = 0.0017) and associated with less need for further therapy (p = 0.034), no significant difference in complications (p = 0.60) but more pain (p < 0.001). Patients who underwent hemorrhoidectomy had a better response to treatment than did patients who were treated with rubber-band ligation (p = 0.001), although complications were greater (p = 0.02), as was pain (p < 0.0001). Rubber-band ligation was better than sclerotherapy in response to treatment for all hemorrhoids (p = 0.005) and for hemorrhoids stratified by grade (grades 1 and 2, p = 0.007, grade 3, p = 0.042), with no difference in the complication rate (p = 0.35). Patients treated with sclerotherapy (p = 0.031) or infrared coagulation (p = 0.0014) were more likely to require further therapy than those treated with rubber-band ligation, although pain was greater after rubber-band ligation (p = 0.03 for sclerotherapy, p < 0.0001 for infrared coagulation). CONCLUSIONS: Rubber-band ligation is recommended as the initial mode of therapy for grades 1 to 3 hemorrhoids. Although hemorrhoidectomy showed better response, it is associated with more complications and pain than rubber-band ligation. Thus, it should be reserved for patients whose hemorrhoids fail to respond to rubber-band ligation.

Diathermy↗
PubMedDate not supplied

[Interventional radiology for chronic hemorrhoids complicated by hemorrhage].

Based on the concept of the occurrence and development of hemorrhoids from the abnormally changed groups of cavernous bodies of the submucous membrane of the rectal transitional area, the authors used selective dearterialization of hyperplastic cavernous tissue that is simultaneously internal hemorrhoids. The essence of the new treatment is superselective X-ray endovascular catheterization of the superior hemorrhoidal artery and embolization of its distal branches which supply blood to rectal cavernous body. The outcomes of 337 Milligan-Morgan hemorrhoidectomies and 49 X-ray endovascular embolizations of the superior hemorrhoidal artery were analyzed in patients with chronic hemorrhoids complicated by hemorrhages. Emphasis is laid on the advantages of X-ray endovascular occlusion of the superior hemorrhoidal artery over conventional treatment.

Adult↗
PubMed1993

Complications of rubber band ligation of symptomatic internal hemorrhoids.

In a prospective study, 512 patients undergoing hemorrhoidal band ligation over a seven-year period were followed up to focus on complications. Thirteen patients (2.5 percent) were hospitalized: six with delayed massive rectal bleeding, three with urinary retention, pain, and fever (one developed perianal abscess), and three others with severe pain due to prolapsed thrombotic hemorrhoids (one developed difficulty in urination). One patient developed perianal abscess and perianal fistula two months after ligation. Twenty-four patients (4.6 percent) suffered from minor complications: 11 patients had painful thrombosed hemorrhoids; five experienced slippage of bands; three had mild bleeding; two developed band-related mucosal ulcer; one experienced each time, after two subsequent ligations, priapism lasting several hours; and difficulty in urination and tender induration above the dentate line occurred in two other patients. Rubber band ligation is, in effect, a miniature hemorrhoidectomy and has been considered, until recent reports of fatalities associated with this procedure, as an effective, safe, and efficient method of treating symptomatic second-degree and third-degree hemorrhoids. We conclude that the ability to handle complications that occur secondary to the rubber band ligation and, thereby, prevent sepsis and the low rate of major complications in our study justify reliance on this method of treating symptomatic hemorrhoids.

Female↗
PubMed2001

Day surgery for mucosal-hemorrhoidal prolapse using a circular stapler and modified regional anesthesia.

PURPOSE: In 1993, prolapse reduction using the circular stapler for the treatment of hemorrhoidal disease was proposed. The procedure is characterized by minimal postoperative pain. In this study we evaluated the above technique using regional anesthesia to identify the advantages and feasibility of stapled hemorrhoidectomy, with special focus on the efficacy of same-day discharge. METHODS: From December 1997 to November 1999, we performed 70 consecutive reduction corrections of mucosal hemorrhoidal prolapse using the circular stapler with regional anesthesia (a technical modification of Marti's posterior perineal block). Our series included 41 males and 29 females with a mean age of 43.4 (range, 25-74) years. Three patients were affected by second-degree hemorrhoids and 67 by third-degree hemorrhoids. RESULTS: Sixty-two patients were discharged three hours after the operation in good general condition and without pain, whereas eight patients were discharged the day after for early complications, consisting of two cases of early bleeding, three cases of urinary retention, and three cases of persistent severe pain requiring prolonged medical treatment. CONCLUSION: Our study shows that, in selected cases, it is possible to perform day surgery for patients with hemorrhoidal disease using a circular stapler device when combined with regional anesthesia.

Adult↗
PubMed1989

Prolonged ambulant assessment of anorectal function in patients with prolapsing hemorrhoids.

Six patients with prolapsing hemorrhoids and 12 control subjects had assessment of anorectal pressure and external sphincter electromyography performed over a prolonged period under ambulant conditions. Patients with prolapsing hemorrhoids demonstrated greater degrees of sampling responses, 12.9 +/- 1.9/hour, vs. 7.4 +/- 2.0/hour (mean +/- SEM) in controls (P less than .05). Ultraslow wave and giant ultraslow wave activity were seen frequently in the patient group occupying more than 30 percent of recording. The external sphincter demonstrated much greater electrical activity (spike potentials) in patients with hemorrhoids than in controls both by day, 24.9 +/- 11.0/10 min vs. 12.8 +/- 3.2/10 min (P less than .02), and by night, 7.4 +/- 2.6 min vs. 1.6 +/- 1.3/10 min (P less than .03). Sleep electrical activity in the presence of hemorrhoids did not differ significantly from that of controls during waking, 7.4 +/- 2.6/10 min vs. 12.8 +/- 3.2/10 min (P less than .1). No difference in phasic and periodic rectal motor activity was noted between patient and control groups. This demonstrates the application of prolonged assessment of anorectal motility and external sphincter activity in a patient group. Abnormalities previously documented in patients with hemorrhoids using conventional manometric tests were confirmed. In addition, evidence of increased external sphincter function during waking and sleep may have implications in the pathophysiology of this disorder.

Action Potentials↗
PubMed1986

Anorectal pressure in patients with symptomatic hemorrhoids.

This study was carried out on 30 patients with symptomatic internal hemorrhoids and 20 normal controls. The anal sphincter pressure was studied before and after surgery. A significantly high anal pressure was found in all patients with symptomatic internal hemorrhoids, when compared with normal controls, and there was no relation between this increase and the degree of hemorrhoids. One week following surgery, this high pressure was reduced significantly and was not affected by the type of operation. Thus, this increase in resting anal pressure is due to an overactivity of the internal hemorrhoids, which is secondary to the presence of the hemorrhoidal mass.

Adult↗
PubMed1986

Conventional vs. triple rubber band ligation for hemorrhoids. A prospective, randomized trial.

Two hundred five patients with symptomatic first- and second-degree hemorrhoids were randomized to receive either conventional rubber band ligation or triple rubber band ligation. In conventional rubber band ligation, the hemorrhoids were ligated at one primary site per session at intervals of four weeks until symptoms were relieved or when all three hemorrhoids were ligated. In triple rubber band ligation, all three primary hemorrhoids were ligated in a single session. After completion of treatment, the patients were examined every three months, or earlier if symptoms recurred. Both methods were effective in the treatment of early hemorrhoids and the incidence of postligation pain and complications was similar. The advantages of having the treatment completed at the initial visit in triple rubber band ligation are obvious. Furthermore, less treatment sessions were required for triple rubber band ligation to control symptoms than for conventional rubber band ligation. Triple rubber band ligation is more cost-effective and therefore is recommended.

Clinical Trials as Topic↗
PubMed1984

The pathogenesis of hemorrhoids.

The structure of the anal canal was examined in histology slides. Hemorrhoids are normal features of the human anatomy. They are pads that bulge into the lumen. Hemorrhoids have three parts: 1) the lining, which can be mucosa or anoderm; 2) the stroma with blood vessels, smooth muscle, and supporting connective tissue; and 3) the anchoring connective tissue system, which secures the hemorrhoids to the internal sphincter and the conjoined longitudinal coat. The anchoring and supporting connective tissue system deteriorates with aging. The hemorrhoids not only bulge, but descend into the lumen. This becomes observable in the third decade of life, with individual differences. The veins become distended as they lose their support. The descended loose lining becomes more sensitive to pressure from straining and to trauma from the stool. There can be a stasis in the veins, with clot formations and swelling, or erosions of the lining, with bleeding. The hemorrhoids become symptomatic.

Adolescent↗
PubMed1983

The prevalence of hemorrhoids.

The clinical records of 835 patients were reviewed. Five hundred ninety four had symptoms of hemorrhoids (symptomatic group) and 241 had no symptoms (asymptomatic group). Eight-six per cent of the entire group had hemorrhoids, 88 per cent among the symptomatic group and 82 per cent among the asymptomatic group. It was felt that if the prevalence rate of hemorrhoids in the symptomatic and asymptomatic groups is similar or close to similar in every age, it is likely that a certain number of people will have hemorrhoids in every age group irrespective of the presence or absence of symptoms. If the prevalence rate is high, it would seem to support the theory that hemorrhoids are normal parts of the human body, not a disease but a sign of aging. Although the difference in the prevalence rate overall in the symptomatic and asymptomatic groups, 88 versus 82 per cent was mathematically significant, this was due to the large sample size and it was small enough to be without clinical importance. No significant differences in the prevalence rate between symptomatic and asymptomatic patients within age groups were found.

Adult↗
PubMed2006

Rectal stenosis after procedures for prolapse and hemorrhoids (PPH)--a report from China.

OBJECTIVES: After it was introduced in China in 2000, the surgical procedure for prolapse and hemorrhoids (PPH) has become a widely accepted for third- and fourth-degree hemorrhoids. Stenosis of the lower rectum is one of the delayed complications. In order to evaluate this specific problem following PPH, we reviewed our data with special reference to potential predictive factors or stenotic events. METHODS: A retrospective analysis of 554 consecutive patients that underwent PPH from July 2000 to December 2004 was performed. Only patients with follow-up check were evaluated; therefore 65 patients (11.7%) Hwere lost to follow-up, and the analysis therefore includes 489 patients with a mean follow-up of 324 days (+/-18 days). For statistical analysis, the groups with and without stenosis were evaluated using the chi-square test; using the Kaplan-Meier statistic, the actuarial incidence for rectal stenosis was plotted. RESULTS: Rectal stenosis was observed in 12 patients (2.5%) in whom the median time to stenosis was 125 (89 approximately 134) days. All patients complained of obstructive defecation and underwent strictureplasty with electrocautery or balloon dilation through colonoscopy. A statistical analysis revealed that two factors were significantly more prevalent among patients with stenosis: prior sclerosis therapy for hemorrhoids (P=0.02) and severe postoperative pain (P=0.003). Other factors, such as gender (P=0.32), prior surgery for hemorrhoids (P=0.11), histological evidence of squamous skin (P=0.77) or revision (P=0.53) showed no significance. CONCLUSIONS: Rectal stenosis is an uncommon event after PPH. Early stenosis will occur within the first 4 months after surgery. In most cases, the stenosis can be cured through colonoscopy surgery. Predictive factors for stenosis are previous sclerosis therapy for hemorrhoids and severe postoperative pain.

Chi-Square Distribution↗