History of research of hemorrhoids is a history of one great mistake        

 History of treatment of hemorrhoids is history of needless invasive treatment.

Hemorrhoid stapling Is More risky than  the surgical removal 

Stapling of hemorrhoids -- a relatively new and increasingly popular procedure is associated with a higher risk of recurrence and prolapse than conventional hemorrhoid removal surgery, investigators report in a comprehensive review of clinical studies.

In contrast to removal (excisional) surgery, circular stapling (hemorrhoidopexy) does not remove hemorrhoids but treats them by inhibiting blood flow to the tissue.

"This study shows that stapled hemorrhoidopexy is associated with a greater risk of hemorrhoid recurrence and the symptom of prolapse in long-term follow-up compared to conventional excisional surgery," said lead investigator Shiva Jayaraman Colquhoun, M.D.

"If surgeons are to offer this novel technique to their patients, there should be an informed discussion of the risks," said Colquhoun, a resident in general surgery at the Schulich School of Medicine and Dentistry, University of Western Ontario, in Canada.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.

Hemorrhoid disease is known to affect more than 15 million people annually in the United States, a number believed to be low since an estimated one-third of patients with symptoms of hemorrhoids do not seek a physician's care for the condition.

Stapling was introduced in the late 1990s, and in some small studies was shown to be less painful and faster to heal than conventional surgery. A few short-term studies -- with less than a year of follow-up -- suggested that stapling is equal to excision for controlling further hemorrhoid symptoms. These results helped lead to growing demand for the stapling procedure.

For this new review, the investigators analyzed seven randomized clinical trials involving 537 participants and found that patients who had undergone circular stapling were significantly more likely to have recurrent hemorrhoids in the long term than those whose hemorrhoids were surgically removed.

Out of 269 stapling patients, 23 suffered recurrences, compared with four recurrences among 268 patients in the surgical-removal group.

The investigators also found that a significantly higher proportion of stapling subjects complained of prolapse (protrusion outside the anus) both within 12 months and longer.

In favor of stapling, results were better in terms of less pain, itching or bowel-movement urgency; however, these were data "trends" that did not reach the level of significance All other clinical outcomes favored excisional surgery.

The authors suggested that rather than simply offering stapling to all patients with hemorrhoids, there may be a subset of patients for whom it is more beneficial, and that identifying this subset will require further research. "If hemorrhoid recurrence and prolapse are the most important clinical outcomes," they said, "then conventional excisional surgery remains the 'gold standard' in the surgical treatment of internal hemorrhoids."

"This paper directly confronts the major concern with stapled hemorrhoidectomy, namely the long-term outcome," said Joshua Katz, M.D., in private practice with Montgomery Colorectal Surgery in Rockville, Md. "Proponents of this procedure argue it provides similar results to the open procedure with less pain, less disability and more rapid return to work. This paper states that the decreased pain and disability may entail increased risk of recurrence. As the authors note, patients must be advised of this increased risk."

"In all fairness," Katz added, "the increased risk, although statistically significant, is still clinically acceptable, 23 of 269 [stapled] patients versus four of 268 patients with conventional hemorrhoidectomy. Physicians and patients will therefore choose between a procedure carrying increased morbidity and disability with a low recurrence rate, and a procedure with decreased morbidity and disability and a higher recurrence rate."

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Constipation & Hemorrhoids

The widespread use of the sitting toilet bowels began during the 19th century. As early as the beginning of 20th century Hurst in his book on constipation (1) and Bockus 50 years later (2) ascribed the constipation to the sitting toilets. Tagart R.E. explained the principal advantage of the squatting defecation posture over the sitting posture (3). He found that the recto-anal angle (at rest 80-90), which is an important factor in anal continence, maximally straightens out only in a squatting posture, thus permitting smooth bowel emptying. Showdown came from the two works (4, 5) which confirmed that the average man spend at least twice more straining during defecation in the sitting comparatively to the squatting posture. Medical world in the mean time continue advice to the patient with constipation artificially means for alleviation of this disorder. Establishing a daily routine for defecation at a given time each day was widely accepted prescription for constipation and from middle of 20th century most physicians are advising high fiber diet and different kind of laxatives. The first remedies act to relaxate the anal sphincters while main factor of anal continence for solid rectal content is not the anal sphincters but the locking effect of recto-anal angle, and the use of chemical laxatives is a burdening deviation from normal life.
The only way to resolve the problem of constipation, hemorrhoids as well as the other related problems is to return to a natural squatting defection posture.
A practical step was done and designed a new squatting device tailored for the Western world sewage system. You are welcoming to take part in the enormous project to supply this device to Western world by investing into the production and marketing. The details are on the page:
video-film of a new squatting device.
But until a new squatting device will be available please use for defecation in the squatting posture only any flat container; it is not aesthetic, but don't use the toilet bowl as a squatting device (it is not permit natural squatting thus may be not helpful and dangerous, as it can break).

1. 
   Hurst A. Constipation and Allied Intestinal Disorders London 1919;
2. 
   Bockus H Gastroenterology, 1964
3. 
   Tagart R. Dis. colon and Rectum 9:449-452, 1966;
4. 
   Sikirov Digestive diseases and Sciences 48: 1201-1205, 2003
5. 
   Sikirov Isr. J Med Sci. 25:55-56, 1989    
   
   

History of hemorrhoid research it is a history of great mistakes.

Hemorrhoids are enlarged veins around anus or the rectal area. Hemorrhoids can be of three types:-

• External Hemorrhoids:- They are the fleshy growth or the enlarged veins outside the anus or the rectal area
  
• Internal Hemorrhoids:- Internal hemorrhoids are the enlarged veins that grow inside the anus and slip to outside
  
• Bleeding Hemorrhoids:- Hemorrhoids can bleed whether located internally or externally. Such condition can be termed as a critical condition.
  

What can cause Hemorrhoids?

• A common cause for hemorrhoids is your sitting posture. Don’t sit for too long. Prepare a habit to go for a break of 5 minutes from your work after every one hour.
• When Standing for too long can be another cause of hemorrhoids. As during standing position all the blood above the rectum exerts pressure on rectal area.
• in times Poor bowel movements can contribute to hemorrhoids too. Don’t wait when there is a nature’s call.
• Also Constipation, pregnancy,obesity can be the other causes of hemorrhoids.
  

• Hemorrhoids Bleeding: - Hemorrhoids can bleed in critical conditions whether located internally or externally. In these condition hemorrhoids needs immediate medication.
  
• Hemorrhoids Severe pain: - Hemorrhoids located internally or externally can cause 
  
• Hemorrhoids Itching and irritating: - External or internal hemorrhoids leads to itching and irritation and causes severe pain.
• Hemorrhoids embarrassment.
  

• do Eat lot of fibrous food, and avoid processed food. As hemorrhoids is common in developed countries, because they consume lots of processed food.
• do Keep the anal area clean, dry and use a mild soap.
• Don’t wait when there is a nature’s call.
• Daily two to three time’s bath in warm water will provide relief from pain and promotes healing.
  
  

• is done When there is continuous bleeding from hemorrhoids
  
• is done Large hemorrhoids that needs immediate surgery.
  
• is done When other treatments are unsuccessful.
  

• Do Include lots of fibrous food in your diet.
  
• Do not delay or try to prevent a bowel movement.
  
• Do Drink lots of water and take your meals on time.
  
• Do Exercise everyday as it is also useful for good health.
  
• Do Keep the rectal area clean and dry.