HEMORRHOIDS: A COMPREHENSIVE REVIEW OF ETIOLOGY, PATHOPHYSIOLOGY, RISK FACTOR AND TREATMENT OPTION
DOI:
https://doi.org/10.22159/ijms.2025v13i1.53391Keywords:
Hemorrhoids, Herbal treatment, Allopathy treatment, Phytotherapy, PathophysiologyAbstract
One of the most prevalent anorectal illnesses is hemorrhoids. And it has placed a formidable medical and social burden on millions worldwide. The correct etiology of hemorrhoids is still unclear, but it’s related to various factors such as irregularity, constipation, obesity, pregnancy, and idle lifestyle adaptation. The pathophysiology of hemorrhoids consists of inappropriate dilatation and distortion with destructive changes in vascular channels that support the connective tissue of the anal cushion. The classification can be done on the basis of region and level of usual prolapse occurrence; there are internal, external, and mixed types. The risk factors for hemorrhoids include obesity, constipation, pregnancy, and a lazy lifestyle. The symptoms vary from rectal bleeding and pain to itching, swelling, and discomfort. Regarding treatment, it is possible to refer to both non-surgical and operative care, including topical and oral medications, lifestyle modifications, and herbal remedies. A complete treatment approach should deal with a combination of natural therapeutic options for the sake of allopathic drug therapies that enhance the chance of life with hemorrhoids.
References
Lohsiriwat V. Hemorrhoids: From basic pathophysiology to clinical management. World J Gastroenterol 2012;18:2009-17.
Duarte PM, Adesola RO, Priyadarsini S, Singh R, Shaheen MN, Ogundijo OA, et al. Unveiling the global surge of Mpox (monkeypox): A comprehensive review of current evidence. Microbe 2024;4:100141.
Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation. An epidemiologic study. Gastroenterology 1990;98:380 6.
Sheikh P, Régnier C, Goron F, Salmat G. The prevalence, characteristics and treatment of hemorrhoidal disease: Results of an international webbased survey. J Comp Eff Res 2020;9:1219-32.
Gami B. Hemorrhoids-a common ailment among adults, causes and treatment: A review. Int J Pharm Pharm Sci 2011;3:5-13.
Sandler RS, Peery AF. Rethinking what we know about hemorrhoids. Clin Gastroenterol Hepatol 2019;17:8-15.
Talley NJ, Lasch KL, Baum CL. A gap in our understanding: Chronic constipation and its comorbid conditions. Clin Gastroenterol Hepatol 2009;7:9-19.
Banov L Jr., Knoepp LF Jr., Erdman LH, Alia RT. Management of hemorrhoidal disease. J S C Med Assoc 1985;81:398-401.
Goenka MK, Kochhar R, Nagi B, Mehta SK. Rectosigmoid varices and other mucosal changes in patients with portal hypertension. Am J Gastroenterol 1991;86:1185-9.
Morgado PJ, Suárez JA, Gómez LG, Morgado PJ Jr. Histoclinical basis for a new classification of hemorrhoidal disease. Dis Colon Rectum 1988;31:474-80.
Vivarelli M, Montalti R, Risaliti A. Multimodal treatment of hepatocellular carcinoma on cirrhosis: An update. World J Gastroenterol
;19:7316-26.
Sun Z, Migaly J. Review of hemorrhoid disease: Presentation and management. Clin Colon Rectal Surg 2016;29:22-9.
Huang J, Gui Y, Qin H, Xie Y. Causal association between adiposity and hemorrhoids: AMendelian randomization study. Front Med (Lausanne) 2023;10:1229925.
Yu M, Shang Y, Han L, Yu X. Bowel habits, obesity, intestinal microbiota and their influence on hemorrhoidal disease: A Mendelian
randomization study. Clin Exp Gastroenterol 2024;17:157-64.
Riss S, Weiser FA, Schwameis K, Mittlböck M, Stift A. Haemorrhoids, constipation and faecal incontinence: Is there any relationship?
Colorectal Dis 2011;13:e227-33.
Gutin I. In BMI we trust: Reframing the body mass index as a measure of health. Soc Theory Health 2018;16:256-71.
Gallo G, Martellucci J, Sturiale AE, Clerico G, Milito G, Marino F, et al. Consensus statement of the Italian society of colorectal surgery
(SICCR): Management and treatment of hemorrhoidal disease. Tech Coloproctol 2020;24:145-64.
De Marco S, Tiso D. Lifestyle and risk factors in hemorrhoidal disease. Front Surg 2021;8:729166.
Avsar AF, Keskin HL. Haemorrhoids during pregnancy. J Obstet Gynaecol 2010;30:231-7.
Wald A. Constipation, diarrhea, and symptomatic hemorrhoids during pregnancy. Gastroenterol Clin North Am 2003;32:309-22.
Salgueiro P, Caetano AC, Oliveira AM, Rosa B, Mascarenhas-Saraiva M, Ministro P, et al. Portuguese society of gastroenterology
consensus on the diagnosis and management of hemorrhoidal disease. GE Port J Gastroenterol 2020;27:90-102.
Park JH, Moon JH, Kim HJ, Kong MH, Oh YH. Sedentary lifestyle: Overview of updated evidence of potential health risks. Korean J Fam
Med 2020;41:365-73.
Diaz KM, Duran AT, Colabianchi N, Judd SE, Howard VJ, Hooker SP. Potential effects on mortality of replacing sedentary time with short
sedentary bouts or physical activity: A national cohort study. Am J Epidemiol 2019;188:537-44.
Chren MM, Landefeld CS, Murray TH. Doctors, drug companies, and gifts. JAMA 1989;262:3448-51 25. Jalwal P, Singh B, Kumar A. A comprehensive review on dissolution testing 26. Olędzka AJ, Czerwińska ME. Role of plant-derived compounds in the molecular pathways related to inflammation. Int J Mol Sci 2023;24:4666.
Chugh A, Singh R, Agarwal PN. Management of hemorrhoids. Indian J Clin Pract 2014;25:577-80.
Barron J. Office ligation of internal hemorrhoids. Am J Surg 1963;105:563-70.
Siddiqui UD, Barth BA, Banerjee S, Bhat YM, Chauhan SS, Gottlieb KT, et al. Devices for the endoscopic treatment of hemorrhoids.
Gastrointest Endosc 2014;79:8-14.
Walker AJ, Leicester RJ, Nicholls RJ, Mann CV. Aprospective study of infrared coagulation, injection and rubber band ligation in the treatment of haemorrhoids. Int J Colorectal Dis 1990;5:113-6.
Khoury GA, Lake SP, Lewis MC, Lewis AA. A randomized trial to compare single with multiple phenol injection treatment for
haemorrhoids. Br J Surg 1985;72:741-2.
Singal R, Gupta S, Dalal AK, Dalal U, Attri AK. An optimal painless treatment for early hemorrhoids; Our experience in Government
Medical College and Hospital. J Med Life 2013;6:302-6.
Guindic LC. Treatment of uncomplicated hemorrhoids with a Hemor-Rite® cryotherapy device: A randomized, prospective, comparative study. J Pain Res 2014;7:57-63.
Goligher JC. Cryosurgery for hemorrhoids. Dis Colon Rectum 1976;19:213-8.
Smith LE, Goodreau JJ, Fouty WJ. Operative hemorrhoidectomy versus cryodestruction. Dis Colon Rectum 1979;22:10-6.
Yang R, Migikovsky B, Peicher J, Laine L. Randomized, prospective trial of direct current versus bipolar electrocoagulation for bleeding internal hemorrhoids. Gastrointest Endosc 1993;39:766-9.
Fowler GE, Siddiqui J, Zahid A, Young CJ. Treatment of hemorrhoids: A survey of surgical practice in Australia and New Zealand. World J Clin Cases 2019;7:3742-50.
Zagriadskiĭ EA, Bogomazov AM, Golovko EB. Conservative treatment of hemorrhoids: Results of an observational multicenter study. Adv Ther 2018;35:1979-92.
Song SG, Kim SH. Optimal treatment of symptomatic hemorrhoids. J Korean Soc Coloproctol 2011;27:277-81.
Palumbo VD, Tutino R, Messina M, Santarelli M, Nigro C, Lo Secco G, et al. Altered gut microbic flora and haemorrhoids: Could they have a possible relationship? J Clin Med 2023;12:2198.
Kunnumakkara AB, Sailo BL, Banik K, Harsha C, Prasad S, Gupta SC, et al. Chronic diseases, inflammation, and spices: How are they linked. J Transl Med 2018;16:14.
Wirfs MJ. The APRN and PA’s Complete Guide to Prescribing Drug Therapy. New York: Springer Publishing Company; 2024.
Misra MC, Imlitemsu. Drug treatment of haemorrhoids. Drugs 2005;65:1481-91.
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