General Aspect of Hemorrhoids - Current View

Abstract The distal anal canal's submucosal vascular tissue dilates, causing haemorrhoids. When the connective tissue supporting this vascular tissue weakens, the haemorrhoids descend or prolapse. Internal haemorrhoids are viscerally innervated and, as a result, painless. They begin above the dentate line, which is the intersection of the columnar and squamous epithelium. External haemorrhoids can be painful, have somatic innervation, and start below the dentate line. Internal and external (mixed) haemorrhoids are present in certain patients. The majority of haemorrhoid sufferers typically have minor symptoms that can be managed with over-the-counter topical medications. When symptoms worsen, patients typically seek therapy. Prolapse or painless rectal bleeding are the usual symptoms of internal haemorrhoids. In addition to bleeding, external haemorrhoids can thrombose and cause excruciating agony. To reduce swelling and discomfort, medical therapy should begin with stool softeners and local therapy. Surgery is necessary if medical treatment is insufficient. The preferred method of treating haemorrhoids in grades 1 and 2 is rubber band ligation. Patients with grade 3 haemorrhoids may have stapled Hemorrhoidopexy, excisional haemorrhoidectomy, or rubber band ligation. Rubber band ligation has a higher recurrence rate than stapled Hemorrhoidopexy and excisional haemorrhoidectomy, but it also has less postoperative pain and fewer complications. For the treatment of grade 4 haemorrhoids, excisional haemorrhoidectomy or stapled Hemorrhoidopexy is advised. Although stapled Hemorrhoidopexy has a greater recurrence rate, it has a quicker postoperative recovery. Topical antispasmodics, fibre supplements, opioids, and nonsteroidal anti-inflammatory medications can all be used to relieve postoperative pain following an excisional haemorrhoidectomy. Conservative treatment or excision are two options for thrombosed external haemorrhoids.