Best Remedies for Hemorrhoids

Hemorrhoid No More

Hemorrhoid No More is a 150 page downloadable ebook, with all the secret natural Hemorrhoids cure methods, unique powerful techniques and the step-by step holistic hemorrhoids system discovered in over 14 years of research. This solution was developed by Jessica Wright and is an intelligent, scientific approach that gets hemorrhoids under control and eliminates its related symptoms within a few short weeks (depending on the severity). The Hemorrhoid No More program also teaches you how to prevent Hemorrhoids recurrence. It's a fact- curing Hemorrhoids can never be achieved by tackling one of the many factors responsible for Hemorrhoids. If you've ever tried to cure your Hemorrhoids using a one-dimensional treatment like pills, creams, or suppositories and failed it's probably because you have tackled only one aspect of the disease. Not only will this system teach you the only way to prevent your Hemorrhoids from being formed, you will also learn the only way to really cure Hemorrhoids for good the holistic way. This program contains all the information you'll ever need to eliminate your Hemorrhoids permanently in weeks, without using drugs, without surgery and without any side effects. More here...

Hemorrhoid No More Overview

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4.8 stars out of 47 votes

Contents: 150 Page Ebook
Author: Jessica Wright
Official Website: www.hemorrhoidnomore.com
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Highly Recommended

I usually find books written on this category hard to understand and full of jargon. But the author was capable of presenting advanced techniques in an extremely easy to understand language.

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Hemorrhoid Miracle Cure Hemorrhoids In 48 Hours

The Hemorrhoid Miracle Cure is an eBook packed with insightful information about the cause of hemorrhoids, why traditional treatments dont work, and natural methods that not only alleviate the symptoms for hemorrhoids but keeps them from coming back. The book was written by Holly Hayden who discovered she had hemorrhoids while hiking. After spending hundreds of dollars on over-the-counter and pharmaceutical products that only addressed the symptoms and sometimes caused side effects, Holly finally conducted her own investigation and discovered a series of simple home remedies that eliminated hemorrhoids quickly. The system includes ingredient resources, charts, audio lessons and basically everything you need to cure your hemorrhoids one and for all. I really recommend it and just see the testimonials from users who have triumphed even severe hemorrhoids for good. More here...

Hemorrhoid Miracle Cure Hemorrhoids In 48 Hours Overview

Contents: EBook, Audio Lessons
Author: Holly Hayden
Official Website: hemorrhoidmiracle.com
Price: $37.00

Hemorrhoids Made Easy

A Step By Step Guide To Getting Rid Of Hemorrhoids Permanently- Never To Return- No More Pain Ever Again. In his hemorrhoids e-book he goes in depth and explains explicitly each stage step by step, all the way for you to become hemorrhoids free holding back on nothing. His expertise has developed over many years during his battles with hemorrhoids. It is because of this suffering that he became obsessed to search high and low determined to find a permanent cure for his hemorrhoids. Within one week of downloading this hemorrhoids e-book your Pain will subside and your hemorrhoids will settle down, until they will finally disappear completely. I have disclosed and included in this Hemorrhoids E-book: The Cure for the most complex cases of hemorrhoids. The Easy method of evacuating on the toilet. Cures for any type of hemorrhoids. Prevention of hemorrhoids. Systems that work for any age, gender or race. More here...

Hemorrhoids Made Easy Overview

Contents: EBook
Author: Rudi Sturlese
Official Website: www.fresh-hemorrhoids-cure.com
Price: $37.00

Management of External Hemorrhoids

Patients who present with acutely thrombosed external hemorrhoids will typically complain of an intensely painful anal mass. Inspection of the perianal skin reveals the diagnosis with a swollen, tense external hemorrhoid. If such a lesion is not present, anal fissure or perianal abscess must be ruled out. Excision is recommended for a thrombosed hemorrhoid manifested with intense pain if duration is within 48 hours of onset, or if ulceration or rupture occurs. If pain is improving, symptomatic therapy with sitz baths, bulking agents, and analgesics is preferred. Excision may be performed in the office using local anesthetic. The wound is left open to heal by secondary intention. Larger, more broadly based thromboses may be managed by incision and evacuation of the clot to avoid creation of a large skin defect.

Hemorrhoidectomybanding

Operative hemorrhoidectomy and rubber band ligation are the two most-common interventions for symptomatic hemorrhoids today. Both are highly effective when utilized properly. Hemorrhoidectomy refers to the operative excision of the hemorrhoids, usually in the outpatient surgical suite, whereas rubber band ligation is performed in the office setting. Hemorrhoids are generally symptomatic with either bleeding (typically bright red, painless, and commonly dripping into the toilet bowl) or protrusion (occasionally associated with discomfort, itching, or irritation and burning). Pain is usually not a symptom of hemorrhoids unless thrombosis or strangulation has occurred.

Management of Internal and Mixed Hemorrhoids Nonsurgical Treatment

Physiologic mechanism of advanced hemorrhoidal disease. By promoting tissue fibrosis in various ways, the vascular cushions become fixed to the underlying muscular tissue. Injection sclerotherapy has been used for hemorrhoidal disease treatment for over 100 years. Indicated to treat bleeding first, second, or early third degree internal hemorrhoids, a small amount of a sclerosing agent is injected above the dentate line. Five percent phenol in vegetable oil has been traditionally used, but other agents such as quinine, urea hydrochloride, and sodium morrhuate, are available. It is a straightforward, quick, painless, and inexpensive method, with success reported in up to 75 of patients. Although complications of pelvic sepsis and perianal necrosis have been reported, sloughing of the overlying mucosa, local infections, and allergic reactions to the injected material are more commonly described side effects. Rubber band ligation is probably the most commonly used nonoperative modality...

Hemorrhoids Anal Fissures and Rectal Ulcers

The anorectum is a frequent source ofsignificant lower GI bleeding. It frequently manifests with small amounts of bright red blood noted on the toilet paper, coating the stool, or dripping into the toilet bowl. Many causes of anorectal bleeding, such as hemorrhoids and fissures, are recurrent. Constipation occasionally causes stercoral ulcers due to fecal impaction or the solitary rectal ulcer syndrome from mucosal trauma, rectal prolapse, or direct digital trauma to aid evacuation, which can lead to anorectal hemorrhage. In patients with portal hypertension, rectal varices can cause life threatening hemorrhage which often requires rectal packing or even emergent surgery to control. The finding of very prominent hemorrhoids should always prompt the question Does this patient have portal hypertension There is a separate chapter on hemorrhoids (see Chapter 92, Hemorrhoids).

Hemorrhoids

Is it prudent to perform a hemorrhoidectomy in a CD patient In the past, complications such as fistula, stricture, abscesses, and need for proctectomy (Jeffery et al, 1977) precluded hemorrhoidectomy in patients with CD. In contrast, Wolkomir reported successful outcomes in healing in 15 of 17 patients undergoing hemorrhoidectomy. Nonetheless, hemorrhoids generally are not removed in patients with CD, because of potential imperfect wound healing and stricture formation. There is a separate chapter on hemorrhoids (see Chapter 92, Hemorrhoids).

Sclerotherapy needle advanced

Endoscopic variceal ligation (EVL), also referred to as variceal banding, is an endoscopic therapy for acute esophageal variceal bleeding, and for elective eradication of varices after the initial episode of hemorrhage. EVL technique for the esophageal varices is similar to endoscopic treatment of rectal hemorrhoids. The ligation is accomplished by placement of an elastic band on the varix, which strangulates a blood vessel, resulting in vessel thrombosis. The thrombosed varix undergoes necrosis and sloughs off, to be replaced by fibrous tissue in the process of mucosal healing.

Supplemental Reading

Multiple hemorrhoidal ligation a prospective, randomized trial evaluating a new technique. Dis Colon Rectum 2003 46 179-86. Guy RJ, Seow-Choen F. Septic complications after treatment of haemorrhoids. Br J Surg 2003 90 147-56. Johanson JF. Nonsurgical treatment of hemorrhoids. J Gastrointest Surg 2002 6 290-4. Johanson JF, Rimm A. Optimal nonsurgical treatment of hemorrhoids a comparative analysis of infrared coagulation, rubber band ligation, and injection sclerotherapy. Am J Gastroenterol 1992 87 1600-6. Loder PB, Kamm MA, Nicholls RJ, Phillips RK. Hemorrhoids pathology, pathophysiology and aetiology. Br J Surg 1994 81 946-54. Sardinha TC, Corman ML. Hemorrhoids. Surg Clin North Am 2002 82 1153-67. Sutherland LM, Burchard AK, Matsuda K, et al. A systematic review of stapled hemorrhoidectomy. Arch Surg 2002 137 1395-406. The Standards Task Force American Society of Colon and Rectal Surgeons. Practice parameters for the treatment of hemorrhoids. Dis Colon Rectum 1993 36...

Anatomy and Physiology

Hemorrhoids are cushions of vascular tissue that are present from birth and are therefore considered normal anatomy. Internal hemorrhoids arise from the superior hemorrhoidal vascular plexus cephalad to the dentate line and are covered by mucosa. External hemorrhoids are dilations of the inferior hemorrhoidal plexus. Located below the dentate line, they are covered with anoderm and perianal skin. Because these plexuses communicate, a combination of external and internal hemorrhoid (mixed hemorrhoids, Figure 92-1) is often seen. There are three major hemorrhoidal cushions, which appear in the left lateral, right anterior, and right posterior positions however, intervening minor hemorrhoidal complexes may obscure this order. Although the exact role of hemorrhoidal cushions has yet to be defined, it is generally accepted that these vascular cushions contribute to continence by partially occluding the anus. Additionally, they may protect the anal canal during defecation.

Nir WasserbergMD and Howard S KaufmanMD

Hemorrhoidal disease is a very common medical disturbance, equally distributed among males and females. Incidence peaks at middle age, and declines after the age of 65 years. Because many patients attribute anorectal symptoms to hemorrhoids, the precise occurrence of hemor-rhoidal disease is difficult to compute. The probable prevalence of this condition as estimated by questionnaires is between 4 to 40 , with approximately 1,100 medical office visits per 100,000 persons annually (Sardinha and Corman, 2002).

Diagnosis and Initial Management

In all patients with lower GI bleeding, fluid resuscitation and correction of coagulopathy or thrombocytopenia take precedence over diagnostic or therapeutic procedures. Nasogastric (NG) lavage is performed looking for fresh blood, clots, or coffee grounds suggestive of an upper GI source. The absence of blood on NG lavage does not exclude upper GI bleeding, unless bile is obtained. Evaluation of the anorectum should include digital rectal exam and anoscopy. The latter will allow identification of internal hemorrhoids, fissures, or fistulas. After this point, the decision between further diagnostic studies will depend on the severity of bleeding, overall condition of the patient and comorbid diseases, and the availability of each diagnostic tool in a specific hospital. Available options include colonoscopy, tagged red blood cell (RBC) scan, and

Preoperative Evaluation

Verification of the rectal prolapse and differentiating it from hemorrhoids and or mucosal prolapse is usually the first step in the examination of patients with a history suggestive of rectal prolapse. Rectal prolapse is identified as a circular, full-thickness prolapse extending outside the anal verge when the patient strains. Occasionally the patient is unable to reproduce their prolapse at clinical examination in the left lateral position. Examination in the sitting position on a commode or diagnosis using defecography may then be quite helpful (Mellgren et al, 1994).

Patients complaining of rectal bleeding consider

Blood spotting after anal sex and or blood spotting on the toilet paper is a common compliant in the GU clinic, and is usually the symptom of minor conditions such as haemorrhoids, anal fissures, genital trauma, or genital warts -which can be associated with pruritus (Rhodes & Hsin, 1995). Blood separate from faeces is most commonly due to haemorrhoids, but may also be due to a variety of other causes, including rectal carcinoma and proctitis, which can be associated with a mucous discharge. Is the blood fresh - bright red, or old - darkish brown this can help indicate where the bleeding is from. When does the patient notice it A proctoscopy should be carried out, but it may be that further investigation may be needed outside of our realm of care, in which case refer appropriately. Blood mixed with faeces may be due to Crohn's disease, or inflammatory bowel disease, carcinoma or vascular abnormalities, and the patient should be referred for careful investigation via a...

Sigmoid Colon Infection

Cytomegarovirus Colitis Pathology

The causes of lower gastrointestinal bleeding in patients with HIV differ from those in other patients. The most common are cytomegalovirus colitis (25 ), lymphoma (12 ), and idiopathic (unidentifiable) colitis (12 ) (7). The first two causes are especially pronounced in patients with a CD4 lymphocyte count below 200 mm3. If cell count is greater than 200 mm3 the most common bleeding sources are idiopathic colitis, diverticula, and hemorrhoids. Rebleeding is not uncommon. Thirty-day mortality related to bleeding is around 14 , whereby patients with concomitant medical problems, rebleeding and those requiring operative intervention are especially at risk. In a study by Bini et al. (7), bleeding was controlled endoscopically in nearly all patients by means of bipolar thermocoagulation probes, with or without epinephrine injection. In a study by Chalasani et al. (12), the most common cause of bleeding was also cytomegalovirus infection, followed by hemorrhoids and anal...

Actual Heated Cautery

The application of heat by iron cauteries is noted by Hippocrates, principally as a method of counter-irritation against internal diseases, or to dry up ulcers and wet gangrene, to destroy tumours and to treat haemorrhoids he does not describe heat coagulation of bleeding vessels. Celsus in the 1st century a.d.15 and Archigenes in the 2nd century a.d.16 give early references to the application of heated cauteries to control haemorrhage this is mentioned again by Paul in the 7th

Inspection and Palpation

The examination begins with an inspection of the perianal region. The patient should be in the left lateral position with his knees bent and pulled up. A simple inspection can detect skin changes, scars, anal skin tags, hemorrhoids, anal fissures, anal venous thromboses, fistula, injuries, or prolapse (anal or rectal prolapse). Any findings must be noted later in the examination report. Figures 5.1, 5.2 show examples of pathologies detected during inspection. The diagnostic report should include exact localization for example, distance from the anus or a description of location as if the patient were in the dorsal recumbent position (at the 12-o'clock position ventral to the anus). Hemorrhoids

Procedure for Prolase and Hemorroids

Cosa Instrument Liver

Recently, an alternative technique has been developed and tested that is associated with markedly reduced postoperative pain (Sutherland et al, 2002). The procedure for prolapse and hemorrhoids (PPH), or stapled hemorrhoidectomy, employs a circular stapler with a hollow head to excise a cuff of tissue at the most superior aspect of hemorrhoidal complexes and create a superficial end-to-end anastomosis (Figure 92-2). During this procedure, a submucosal purses-tring is placed 4 cm above the dentate line and is secured to the post of the anvil of the stapler. The excess tissue is pulled into the hollow head of the stapler as the stapler is closed. As the stapler is fired, a circumferential cuff of tissue is excised, and the superficial anastomosis is created. In effect an anopexy is performed which lifts the prolapsed tissue into the anal canal. Randomized trials have reported significantly lower pain scores when compared to conventional hemor-rhoidectomy procedures. Although higher...

Harveys Paradoxical Influence Therapy By Leech And Lancet

Bleeding was recommended in the treatment of inflammation, fevers, a multitude of disease states, and hemorrhage. Patients too weak for the lancet were candidates for milder methods, such as cupping and leeching. Well into the nineteenth century, no apothecary shop could be considered complete without a bowl of live leeches, ready to do battle with afflictions as varied as epilepsy, hemorrhoids, obesity, tuberculosis, and headaches (for very stubborn headaches leeches were applied inside the nostrils). Enthusiasm for leeching reached its peak during the first half of the nineteenth century. By this time, leeches had to be imported because the medicinal leech, Hirudo medicinalis, had been hunted almost to extinction throughout Western Europe. Francois Victor Joseph

The Discovery Of Artemisinin

Qing Hao is a herb commonly used in China with a long history of use as an antipyretic to treat the alternate chill and fever symptoms of malaria and other heat syndromes in the traditional Chinese medical system. The name Qing Hao first appeared in a silk book excavated from the tomb at Mawangdui belonging to the Han dynasty it was entitled Wu Shi Er Bin Fang (Prescriptions for Fifty-two ailments) and dated from as early as 168 BC, and described the use of Qing Hao for the treatment of haemorrhoids. In 340 AD, Qing Hao was recorded for the first time as a treatment for fevers in a medical book, Zhou Hou Bei Ji Fang (Handbook of Prescriptions for Emergency Treatment). In this work, the author, Ge Hong, recommended that, to reduce fevers one should soak a handful of Qing Hao in one sheng (approx. 1 L) of water, strain the liquor and drink it all. Li Shi-Zhen, the author of the famous materia medica Ben Cao Gang Mu (1596 AD), based on the former medical text records and his own...

Findings on anal inspection

Pruritus ani, perianal warts, perianal abscess, perianal haematoma, prolapsing haemorrhoids, thrombosed haemorrhoids, skin tags, anal discharge, anal fistulas, anal fissures, anal cancer, rectocele, rectal prolapse, threadworms, faecal soiling of the perineum are all possible findings (Rhodes & Hsin, 1995 Barkauskas, 2002). The anal tone can be observed at rest and on voluntary contraction. The patient should be asked to strain down as if opening bowels to show perianal descent, prolapsing haemorrhoids or protruding lesions such as tumours or rectal prolapse (Barkauskas, 2002).

Rubber Band Ligation

Rubber band ligation is performed for internal hemorrhoids with bleeding or minor degrees of protrusion. It is not performed for external hemorrhoids in patients with coagulopathies, or generally in patients taking anticoagulants (banding is performed in the office or the outpatient clinic and requires no specific preparation). The patient is placed in the knee-chest or lateral position, an anoscope is inserted, and the hemorrhoidal group to be ligated is visualized. Using a ligator placed through the anoscope, the redundant portion of the mucosa at the upper portion of the hemorrhoid is grasped and a constricting elastic band is placed around it. If the band is placed lower, significant pain may result (Fig. 6). The hemorrhoid will slough in 7-10 d leaving a small, ulcerated area to heal.

Classification

Hemorrhoids are classified by location as internal, external or mixed in relation to the dentate line, and by the degree of prolapse. External hemorrhoids are located below the dentate line, are covered by squamous mucosa, and are painful when thrombosis occurs. Internal hemorrhoids are located above the dentate line and may prolapse, thrombose, or bleed. The degree of prolapse is staged as follows

Anorectal Procedures

Anorectal afflictions have troubled the human race for millennia, but remain somewhat of an enigma to a majority of both physicians and laypersons. First described formally in the Chester Beatty Medical Papyrus, written about 1250 bc and further defined by Hippocrates around 400 bc (19), the treatment of these disorders has progressively improved with the wider dissemination of knowledge regarding them and the development of an increasing number of physicians trained specifically in their care (two of the most common anorectal conditions seen in the clinician's office are anal fissure and hemorrhoids). They are not uncommonly confused with one another as both can present with rectal bleeding. Their proper differentiation is crucial to the selection of the appropriate treatment modalities.

Anorectal Disease

Hemorrhoidal disease also is seen frequently. Factors predisposing to hemorrhoids may have predated the HIV infection. Severe diarrhea or proctitis may promote local thrombosis, ulceration, and secondary infection. Fleshy skin tags, resembling those seen in Crohn's disease, are also seen. Thrombosed hemorrhoids occur frequently, but it is unclear if the incidence is higher in AIDS patients than in a comparable population.

Diverticulosis

Diverticulosis Angiodysplasia Cancer Polyps Inflammatory bowel disease Radiation proctocolitis Infectious colitis Ischemic colitis Anorectal disease Hemorrhoids Anal fissures Rectal ulcers Fistula in ano Rare Causes Portal hypertensive colopathy Small bowel varices Colonic and rectal varices Endometriosis

Surgical Treatment

Indications for surgical hemorrhoidectomy include advanced third or fourth degree piles, mixed hemorrhoids, extensive thrombosis, ulceration, and gangrene. The choice of surgical procedure depends upon the patient's condition, and surgeon and patient preferences. Similarly, anesthetic choices include local anesthesia plus monitored sedation, regional techniques, and general anesthesia. Traditionally, regional training and culture have influenced the choice of operation. Most surgeons in the United States practice the closed technique, or Ferguson hemorrhoidectomy, where following hemorrhoidal excision, the rectal mucosa and anoderm are closed with an absorbable radial suture line beginning at the apex of each hemorrhoidal complex. Recurrence rates are < 2 . Scissors, electrocoutery, laser, and scalpel may be used however, none have been proven to be superior over other means of excision. Hemorrhoidectomy using advanced technologies such as harmonic scalpel and ligasure have been...

Proctoscopy

Note on inspection Faecal matter (if present), odour and consistency. Rectal discharge, threadworms, inflammation, mucosal ulceration, bleeding, haemorrhoids and any other abnormalities. Slowly withdrawing the proctoscope observe the haemorrhoidal cushions, the dentate line, and the anal epithelium.

Detachable Snare

Suction Band Ligator

Procedure for hemorrhoid ligation Under visualization with a proctoscope, suction is applied using a special applicator (Fig. 20.30) to an internal hemorrhoid localized above the dentate line. A rubber band is then placed around the base of the suctioned hemorrhoid pile, ligating it (Figs. 20.29, 20.31). The band falls off after a few days leaving a small ulceration. Complications include pain, rebleeding, or, in rare cases, abscess formation. After about three weeks, the ablation site has healed and the next session can proceed. Rubber band with ligated hemorrhoid pile Fig. 20.29 Schematic illustration of ligation of internal hemorrhoids. a Suction is applied to the internal hemorrhoid and a rubber band is placed over the hemorrhoid. b Hemorrhoid ligated with rubber band around its base. Rubber band with ligated hemorrhoid pile Fig. 20.29 Schematic illustration of ligation of internal hemorrhoids. a Suction is applied to the internal hemorrhoid and a rubber band is placed over the...

Daniel H Present MD

Since the classic paper published by Crohn and colleagues in 1932 describing the chronic inflammatory process of the bowel there have been multiple articles published on the complications of this illness. The description of perianal fistula was followed 6 years later with the incorrect concept that the inflammatory process extended from the bowel down to the perianal area. There are multiple problems that can affect the perianal area, including simple skin tags, fissures, hemorrhoids, high and low fistulas, strictures, rectovaginal fistulas, and, finally, neoplasia. Severe perianal skin excoriation can result in significant discomfort and impaired quality of life. The main purpose of this article is to review the perianal complications with a focus on management of fistulas.

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