Haemorrhoids

ma‟ (blood) and „rhoos‟ (flowing), and it was probably Buqrat (Hippocrates 460 BC) who was the first to apply this name to the flow of blood from the veins of the anus. [1] The term „„piles‟‟ is derived from the Latin “pila” (a ball) and was widely used by the public at the time of John of Arderne (born: 1307 AD). In his treatise of 1370 he mentioned that the „common people call them piles, the Aristocracy call them haemorrhoids and the French call them figs (figer, to clot). [2,3,4,5]. According to Unani (Greeco-Arabic) literature haemorrhoids are known as “Bawaseer”. Bawaseer is the plural of baasoor which means wart or polyp like swelling. They are specialized highly vascular cushions of discrete masses of thick sub mucosa containing blood vessels. Haemorrhoids are classified into either internal (located proximal to the dentate line) which usually don’t hurt or itch., external (located distal to the dentate line) which cause most of the symptoms we commonly hear about — pain, burning, swelling and itching or mixed (located both proximal and distal to the dentate line) . Depending on the degree of prolapse, internal haemorrhoids are classified into four categories (I to IV):

Grade I: The haemorrhoids do not prolapse.

Grade II: The haemorrhoids prolapse upon defecation but spontaneously reduce.

Grade III: The haemorrhoids prolapse upon defecation, but must be manually reduced.

Grade IV: The haemorrhoids are prolapsed and cannot be manually reduced

Prevalence

Hemorrhoidal disease is ranked first amongst diseases of the rectum and large intestine, and the estimated worldwide prevalence ranges from 2.9% to 27.9%, of which more than 4% are symptomatic .1 Age distribution demonstrates a Gaussian distribution with a peak incidence between 45 and 65 years with subsequent decline after 65 years 2,3 Men are more frequently affected than women 6

In the United States, haemorrhoids are the third most common outpatient gastrointestinal diagnosis with nearly 4 million office and emergency department visits annually.7 In Japan the prevalence of haemorrhoids ranges from 4 to 55% .8 Regarding subcontinent , India has 75% population affected9

Haemorrhoid is a common disease with a prevalence of 4.4% with a peak occurring in both sexes between 45-65 years10

References

  1. Douglas Mackay. “Haemorrhoids and varicose veins: A review of treatment options. Alternative medicine review 2001 April; 6(2): 126-140.
  2. Khubchandani I, Paonessa N, Khawaja A. Surgical treatment of hemorrhoids. 2nd edition. Springer, London (2009)1.
  3. Russell RCG, Norman SW, Christopher JKB. Bailey and Love‟s Short Practice of Surgery. 25th edition. Arnold Publication, London, 2008; 1253-1262.
  4. Gami Bharat. Hemorrhoids – a common ailment among adults, causes & treatment: a review. International Journal of pharmacy and pharmaceutical sciences, 2011; 3(5): 5-12.
  5. Rizwan Mansoor Khan, A.H. Ansari, Malik Itrat, M. Zulkifle A Comprehensive Review of Haemorrhoids with Unani (Greeco-Arabic) and Modern Description International Journal of Basic Medicine and Clinical Research, 2014; 1(3)
  6. Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation: an epidemiological study. Gastroenterology. 1990;98(2):380–386.
  7. Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation: an epidemiological study. Gastroenterology. 1990;98(2):380–386.
  8.  Parks AG. De Hemorrhoids. A study in surgical history. Guy’s Hospital Report. 1955;104:135–150.
  9. Keighley MRB. Vol. 1. WB Saunders publishers; 1993. Surgery of Anus, Rectum and Colon. 1; pp. 295–298.
  10. 10. Yang JY, Peery AF, Lund JL, Pate V, Sandler RS. Burden and cost of outpatient hemorrhoids in the United States employer-insured population, 2014. The American journal of gastroenterology. 2019 May;114(5):798.