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piles,dilatations of the veins about the anus (external hemorrhoids) or those higher up inside it (internal hemorrhoids). They appear as small, rounded, purplish tumors, often complicated by inflammation, clotting, and bleeding. Hemorrhoids are very common phenomena and are brought about by factors that produce venous congestion, such as constipation, diarrhea, or pregnancy. In some instances, the pain from inflamed hemorrhoids can be intense, and the bleeding so profuse as to pose the threat of anemia. Hemorrhoids that are uncomplicated or bleed only slightly at infrequent intervals do not require specific treatment except to improve the condition that may be causing them, such as constipation. Hemorrhoids that are very painful or bleed excessively are treated by warm baths and suppositories and, if necessary, by injection, laser surgery, or traditional surgery.
varicose dilatation of the rectal veins, mainly in the anal region. There are external (subcutaneous) and internal (submucosal) hemorrhoids. Those with hemorrhoids are usually middle-aged and elderly persons, males three times as often as females.
The development of hemorrhoids is promoted by factors that raise blood pressure and cause hemostasis in the veins of the lesser (pulmonary) circulation and venous plexus of the rectum (such as chronic constipation, prolonged standing during work, pelvic and abdominal tumors, cirrhosis of the liver, and, in females, improper position of the uterus or pregnancy). Hereditary or congenital structural weakness of the veins is another factor. As the disease develops, pruritus, a burning sensation, and pain appear in the anus. During defecation or strenuous exertions the hemorrhoids prolapse, and eventually this also happens during walking. The prolapsed hemorrhoids are often thrombosed and inflamed. They may become strangled and necrotic following constriction of the anal sphincter. Bleeding is one of the most prominent symptoms of hemorrhoids, and it may give rise to anemia. Treatment for hemorrhoids consists of eliminating the predisposing factors and taking overhead cold showers. In case of constipation, laxatives, enemas, and a restricted diet are recommended, and in severe cases, surgery. Preventive measures include the correction of constipation, abstention from alcohol and coarse or spicy food, and exercise therapy.