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Monday, June 2, 2014

How hemorrhoids were treated in historical times



 A disgusting case of grade 4 hemorrhoids. Ugh. (Image from: Wikipedia)


Hemorrhoids are vascular structures in the anal canal which help maintain stool continence. As a person gets older, they may become swollen, inflamed and bleed or protrude from the anus. It is estimated that about half the population has hemorrhoid-related problems by the age of 50 years; in the USA, around 58% of people aged over 40 years suffer from this condition. There are two types of hemorrhoids: external and internal.
 
Hemorrhoids can occur at any age, and they affect both men and women. They can either be asymptomatic or cause itching, pain, bleeding (fresh red blood visible on the surface of stool and/or on toilet paper after defecation) and fecal soiling. Inflamed, painful hemorrhoids, also known as piles, can be treated conservatively (fluids and a fiber-rich diet to avoid constipation, medicated creams and suppositories to relieve pain, swelling and itching). Patients are also advised to avoid straining during defecation and reading on the toilet. If these dietary and lifestyle modifications have no effect, the patient must consider a more radical method of treatment, e.g. phenol oil injection or a procedure called rubber band ligation (which involves, basically, tying a rubber band around a hemorrhoid until it becomes necrotic and sloughs off). Both procedures are available on an outpatient basis. Studies show that band ligation is the most effective outpatient procedure for hemorrhoids, providing a cure in 79% of patients with first to third degree hemorrhoids. If this method fails, however, surgery is advised.

This unpleasant condition has affected humanity since ancient times. The first recorded treatment for hemorrhoids was described in an Egyptian papyrus dated 1700 BC: “… Thou shouldest give a recipe, an ointment of great protection; acacia leaves, ground, triturated and cooked together. Smear a strip of fine linen therewith and place in the anus, that he recovers immediately."

In 460 BC, Hippocrates described a method for treating hemorrhoids which sounds similar to today's rubber band ligation procedure: “And hemorrhoids in like manner you may treat by transfixing them with a needle and tying them with very thick and woolen thread, for application [...] and always leave one behind; and when the patient recovers, let him be put on a course of Hellebore.” Hellebore, a poisonous plant, was used in ancient Greece as a purgative.

A Roman physician named Celcus (25 BC - AD 14) described the ligation and excision surgeries, as well as possible complications. The famous Greek physician Galen (AD 129 - ca. AD 200) also promoted severing the connection of the arteries to veins in order to reduce pain and avoid spreading gangrene.

The Indian Susruta Samhita, an ancient Sanskrit text dated between the fourth and fifth century AD, described treatment procedures comparable to those in the Hippocratic treatise, but with advancement in surgical procedures and emphasis on wound cleanliness.

In the Middle Ages in Europe, a popular treatment for hemorrhoids was cauterization with a hot iron and/or making an incision with a sharp knife. Sufferers could also pray to St. Fiacre, the patron saint of this unpleasant condition, hoping for a cure.



A 13th-century illustration depicting a surgeon operating an unfortunate patient with hemorrhoids. The procedure must have been excruciatingly painful. Note the blood running down into a dish.


During the 19th century, hemorrhoids were often treated by anal stretching. In the USA, carbolic acid was first used for injecting hemorrhoids in 1871. In 1888, Fredrick Salmon, the founder of St. Marks’ Hospital, expanded the surgical procedure for hemorrhoids into a combination of excision and ligation. The diathermy hemorrhoidectomy by Alexander Williams, rubber band ligation by Barron, and the stapled hemorrhoidectomy by Longo were three additional developments in the late 20th century.

 If you want to avoid hemorrhoids, try not to strain while attempting to defecate, avoid sitting on the toilet for long periods, and maintain regular bowel movements through eating a high-fiber diet, drinking plenty of fluid and getting sufficient exercise.



Literature:
Agbo SP. (2011) Surgical Management of Hemorrhoids. J Surg Tech Case Rep. 3(2): 68–75.

Nisar PJ, Scholefield JH. (2003) Managing haemorrhoids. BMJ. 327(7419): 847–851. 

Wikipedia: Hemorrhoid



8 comments:

  1. It seems to me that the key to getting Hemorrhoids to go away and stay away is to lower the amount of straining. Now you can do this with an enema but no one can or wants to do an enema every time they have to go. So it you can get some water up the pipes like an enema you can loosen things up the same way and ease the strain. How? With a Hand Bidet Sprayer. Not a bidet, a Hand Bidet. With this you can shoot a controlled spray of water inside, as much or as little as desired and when it comes back out, well you get the picture. It’s also a dream for cleaning yourself instead of all that rubbing (and irritating) with toilet paper. This is no “miracle cure” it’s a logical, practical, everyday approach that can help anyone. See www.bathroomsprayers.com.

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  2. Thanks goodness there are other methods these days!! Withe the THD method I went home right after procedure and the hemorrhoids were history within a week. Lucky to live in 20th century!

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  3. There are three of the greatest hemorrhoids treatment around and will help avoid a few of the hemorrhoid pain you are suffering from. It normally takes a couple weeks for piles to diminish totally. If your hemorrhoids tend to be serious and no over counter-top goods are providing you with alleviation, call your personal doctor to allow them to determine your condition and suggest the very best hemorrhoid therapy for you, that might consist of piles laser surgery.

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  4. If the swollen hemorrhoids ruptured the blood starts to pour out of the hemorrhoid. This can happen with both internal hemorrhoids and external hemorrhoids. If the bleeding increase then first thing is to go to the doctor for complete checkup. Take care of the constipation to avoid this type of situation. For the treatment of the haemorrhoids and constipation visit the blog home remedies for constipation . Thank you for this blog

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  5. Hi, I am 38 years old female. I have hemorrhoid for almost 8 years, it developed after I gave birth to my son. Finally decided that I had enough so I undergo surgery. I'm so sore down there, the doctor said that it's normal and recommended Calmovil. I taked it every night and I feel better in the morning. It is way better than surgery.

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  6. I've suffered from external hemorrhoid since I was pregnant a couple of years ago. I've tried getting more fiber into my diet, but I also have a desk job and spend hours at home on the computer. I searched at the internet and found several remedies. In my desire to get better, I tried dherbs Hemorrhoid Formula, the discomfort goes away and I feel better now. I think surgery is a drastic step, but seek advice from an expert and see what he/she recommends.

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  7. PILE EXTERNAL (HEAMOROID) is a very common problem for a very long time, and the medication to the cure is available by contacting Dr Benard on benardleo13@gmail.com or on +2349027116105

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  8. It is quite common for pregnant ladies to develop hemorrhoids within the later stages of their physiological condition. this is as a result of pressure on the blood vessels within the rectal area.
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