Hemorrhoidal Pathology

CAUSES, SYMPTOMS, AND HOW TO TREAT HAEMORRHOIDS WITHOUT HOSPITALIZATION (*)
Haemorrhoids are a more common problem than one might think. In fact, 10% of the world’s adult population is affected by them, with the incidence being higher among those over 50 years of age living in some of the most developed areas of the planet. Many suffer from them, but not everyone is willing to talk to their doctor about it, either out of fear or simple embarrassment of undergoing an examination. Yet, it is a bothersome disorder that is easy to treat and prevent using simple and painless methods. Embarrassment, in reality, is not just about undergoing a specialist examination. Haemorrhoids are a disorder that can also heavily interfere with an individual’s social life due to the fear of discussing it. Many people hide haemorrhoids even from their relatives or partners. They are thus forced to limit activities and hobbies due to pain. Giving up feeling well and having a satisfying sex life (both for the person concerned and for the partner) is wrong and can eventually undermine the balance of the relationship. This aspect is very important to make known, precisely to raise awareness among those who still live with inflamed haemorrhoids and encourage them to seek help from their doctor or a specialist as soon as possible.Prevention is certainly the most powerful tool at our disposal, but it alone may not be enough. Maintaining a healthy lifestyle and proper nutrition is important both to prevent or at least delay the onset of the problem and to fight it once it has occurred. But what should we do when the discomfort increases? In this case, the specialist doctor, namely the proctologist, will be able to guide the patient towards the best possible therapy, which today, we repeat, involves extremely effective innovative intervention techniques. Healing from haemorrhoids without pain is possible, and it is a right for everyone. On the other hand, pain is precisely the predominant characteristic of haemorrhoids that, if neglected, interfere with common daily activities causing discomfort and irritability. The definition of the term haemorrhoids is very simple. They are dilations of the venous plexuses located in the tissues of the last portion of the rectum and anus. These small cushions full of blood vessels play an important role in blood circulation at the anal level and, in certain situations, can swell, causing pain. Hemorrhoids, also called varicose veins of the visceral extremity because they resemble dilations of blood vessels observed in the leg, can be internal or external, depending on the affected area. Internal haemorrhoids do not protrude from the anal orifice and are located above the sphincters that regulate the opening of the rectum in the underlying mucous membrane. This makes them visible from the outside only during bowel movements that cause them to protrude or through the exertion of strong pressure. External haemorrhoids, on the other hand, are generally visible from the outside, as they are located in the subcutaneous tissue of the sphincters. They are reddish in colour, which can turn blue, and are normally soft to the touch but become hard in the case of a clot.

CAUSES OF HEMORRHOIDS
Several factors can cause hemorrhoidal pain. In many cases, it is simply a stretching of the venous walls, which are located in the last portion of the rectum and physiologically tend to dilate due to blood pressure reaching the distal part of the body. The swelling of the veins consequently leads to a slowing down of blood flow, which can be considered the antechamber of clot formation. Several factors, such as obesity and prolonged constipation, can cause this prolonged state of pressure leading to the swelling of haemorrhoids. It is typical for pregnant women to often experience episodes of haemorrhoids that can regress spontaneously, although it is a discomfort that predominantly affects the adult male population. The underlying cause of persistent constipation may be an improper diet, excessive use of spices, chocolate, overly spicy foods, alcoholic beverages, and elaborately prepared dishes that slow down digestion. In some cases, haemorrhoids may be associated with heart disease or considered an early sign of cancer.
The actual pain experienced in the case of strangulation of haemorrhoids is not determined by the anal sphincter, as one might mistakenly think, but by thrombosis, i.e., the obstruction of blood circulation in the vein where the blood from the haemorrhoids converges. The obstruction causes the hemorrhoidal cushions to swell, causing pain. The procedure followed in emergency cases to alleviate the pain involves making a small incision to allow the clot to exit. While this operation can only be performed in a hospital setting, it cannot be considered a definitive solution to the disease.

The disease of haemorrhoids can present four degrees:

• Internal haemorrhoids;
• Internal haemorrhoids with slight protrusion;
• External haemorrhoids that can be reintroduced into the anal canal;
• External haemorrhoids that always remain outside the anus are often associated with mucus loss.

SYMPTOMS OF HEMORRHOIDS
It is not uncommon for haemorrhoids to cause no discomfort, and in this case, they are called blind haemorrhoids. However, more often than not, the common symptoms include a modest loss of blood with each bowel movement, itching, burning, and a feeling of rectal heaviness. Bleeding may also occur independently of defecation and may colour stools. The main aspect of paying attention to is the colour of the blood, which in this case should be bright red, as it comes from the last portion of the intestinal canal.
The general rule is that the darker the colour of the bleeding, the more internal the source of bleeding. Pain is another symptom commonly associated with this condition and can vary in intensity, from mild discomfort during defecation or sitting to severe pain if the haemorrhoids are inflamed. Regardless of the type of symptoms experienced, which may vary from case to case, it is always advisable to consult a specialist rather than rely on home remedies, which are often ineffective, if not counterproductive. The advice and intervention of an experienced doctor can help overcome these anal disorders easily, allowing a quick return to the habits of a healthy and normal life. Although each clinical case may
present specific and particular characteristics, it can be said that the most common symptoms, observable in both internal and external haemorrhoids, are rectal bleeding, pain, itching, and irritation.

HEMORRHOIDS: DOSAGE

HOW TO USE:
PROZON 75 ml
2 applications per day

ADMINISTRATION METHOD:
SOOTHING CREAM FOR TOPICAL USE

TREATMENT DURATION:
14 DAYS

EXCLUSION CRITERIA:
Glucose-6-phosphate dehydrogenase deficiency (G6PD deficiency).

TREATMENT OBJECTIVE:
The objective of the integrated treatment is to alleviate symptoms and act on inflammation.
Recommended as integrated therapy for: Hemorrhoids and anal fissures.

Haemorrhoids, despite being considered a benign and minor condition, can generate symptoms capable of affecting our daily lives. When talking about haemorrhoids it is commonly associated with a disease that causes significant anal pain, but such generalization is incorrect as it refers to a normal anatomical structure that only the presence of triggering factors, perhaps favoured by predisposing factors, can induce to become pathology: it is then more correct to speak of “hemorrhoidal disease”.
It affects more frequently males aged between 45 and 65 years and represents about 18% of surgical diseases of the digestive system. In addition to a family predisposition, lifestyle and diet are important, capable of conditioning the onset of hemorrhoidal disease: the irritating action on the entire digestive system of alcoholic beverages, spicy foods, chocolate, fried foods, a diet low in fibre and roughage is known; no less important is the lack of physical activity and sedentary lifestyle, working for many hours sitting at a desk or, conversely, standing still; however, sports activity can also be traumatic for our anal region: horseback riding, motorcycling, cycling, spinning can trigger a hemorrhoidal crisis. Other bad habits include straining during defecation, prolonged sitting on the toilet reading the newspaper, and conditions that increase abdominal pressure favouring stasis and hemorrhoidal prolapse. The increase in abdominal pressure is also noticeable during pregnancy, while the concomitance of even minimal discomfort during the pre-and menstrual period and after sexual intercourse is due to pelvic congestion. We are not aware of haemorrhoids until a complication such as a thrombosis or inflammation appears. Hemorrhoidal thrombosis, which can also affect all three hemorrhoidal cushions, is recognizable by its hard, bluish, extremely painful, and tender appearance, irreducible; hemorrhoidal inflammation is instead
a congestive state associated with edema of one or more hemorrhoidal cushions, causing bleeding and/or prolapse.
Thanks to new pharmacological acquisitions, the continuous therapeutic evolution has allowed us to constantly improve the medical approach to hemorrhoidal disease over the years.