Modern concepts of pathogenesis and treatment of haemorrhoids

Abstract

Haemorrhoid is conditioned by thrombosis of specific - cavernous - veins (bodies) of the rectum filled with arterial blood. Three internal haemorrhoids with external branches are formed on three terminal branches of rectal artery, at 3 o'clock, 7 o'clock and 11 o'clock positions in the anal canal. Haemorrhoids can be asymptomatic, acute, bleeding nonprolapsed and chronic bleeding prolapsed. Traditional conservative treatment is complemented by injections of sclerogenic substances and ligation of internal haemorrhoids. Radical surgery suggests en bloc resection of the three internal and affected external haemorrhoids. Before starting treatment of haemorrhoids, colonoscopy is indicated to exclude the risk of colon tumour, the incidence of which has dramatically increased in recent years, especially in elderly people with repeated haemorrhoids.