Hemorrhoids: history and epidemiology

By | September 18, 2016

Hemorrhoids are vascular structures, appearing in the anal canal of the human. When they are I their normal condition, these structures help with the control of stool. If they are swollen, inflamed or so on, they turn into disease. To mean this disease the word “hemorrhoid” is used by the patients themselves and by the doctors. The symptoms can differ and depend greatly on the kind and type. The symptom of the internal hemorrhoids is painless rectal bleeding accruing during the defecation. The main symptom of the external hemorrhoids is swelling and pain in the anus area. The blood occurring in this case is darker. As a rule in a few days the symptoms get better and the tag of skin can remain after the external hemorrhoids is cured.

history and epidemiology hemorrhoid

In Egyptian papyrus, dated 1700BC, there is an advice how to cure it: “The treatment should be prescribed immediately and consists of chopped acacia leaves and ground, mixed and stewed together. Apply the substance on the piece of linen and put on the anus area. The recovery will be immediate.”. Later, in 460 BC in Greece the treatment, close to modern rubber band ligation was discussed. “ Hemorrhoidis can be treated by transfixing it with a needle and then it should be tied with strong woolen thread. Don’t forment until they drop off. One of then should always be left behind. After the recovery the person must be put on a course of Hellebore”. The disease was also described in Bible and in early translations is called “emerods”.

Celsus not just discussed excision and ligation procedures themselves but also the possible complications after the treatment. Galen proposed an idea of connection between arteries, veins and increasing of pain. The Susruta Samhita offers treatment similar to one proposed by Hippocrates, but in this case a lot of attention is paid to the cleanliness of the wound and possible difficulties if they are not clean enough. 13th century was the time of great progress of surgery and surgical techniques thanks to Guy de Chauliac, Lanfranc of Milan and others.

During the Middle ages hemorrhoids was called Saint Fiacre’s after the saint with this disease following tilling the soil. In English the word “hemorrhoids” first occur in 14th century and was the variation of French word “emorroides” from Latin variant hæmorrhoida.

To determine how common the disease is is rather difficult because people don’t want to go to the doctor on the early stages and advice them when symptoms become worse. Anyway, it affects half of the population of the United States once-twice in their lifetime while near 10% are affected all the time and have chronic form of the disease.

Men and women are equally affected and the rates become higher in groups of people after 45 years. In the USA this disease is common for people of higher socioeconomic status.

The outcomes are good as a rule but recurrent symptomatic episodes can occur from time to time. The percent of people who really needs surgery, is really low.

Nowadays the scientists can’t name the exact causes of the illness, but there are some factors increasing the pressure on the abdomen and they are considered to be involved in hemorrhoids occurrence. They are constipation, diarrhea, pregnancy and so on. The exact diagnosis can be made only after looking at the area. Most people consider “hemorrhoids” any problem in anal area so the investigation should be run for ruling out more serious symptoms and diseases. To confirm the previous diagnosis colonoscopy and sigmoidoscopy should be done. It helps to exclude serious cases or start the treatment immediately.

Often it’s not needed to use special treatment. The measures include the increasing of fiber intake, maintaining hydration by taking fluids, taking painkillers to deal with pain and a lot of rest. If the symptoms are severe and do not get better after the conservative treatment a certain number of minor procedures can be performed. The surgery is not necessary as a rule and reserved for cases when these measures failed and the condition doesn’t improve.

Statistics says that more than half of people have problems connected with hemorrhoids. And the difference between males and females in this case is not essential so as they both affected equally. People after 45 are in the risk group. This disease is common in wealth countries. This disease was firstly mentioned in Egyptian papyrus 1700 BC and was considered a disease of rich people.




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