Abstract
Haemorrhoids are variceal Dilatation of anal and perianal venous plexus. Classically situated in the 3,7,11, o'clock position (left lateral, right posterior & right anterior respectively). Superior haemorrhoidal (vein) gives 2 branches on right side and 1 branch on left side. Hence, Piles are 2 on the right side and 1 on the left side. It was probably Buqrat (Hippocrates) (460 BC) who was the first to apply the name to the flow of blood from the veins of the anus. There is a detailed description of Bawaseer in classical books authored by ancient Unani physicians. Haemorrhoids are one of the most common anorectal disorders with a reported prevalence of 4.4% up to 36.4% of the general population. The peak prevalence occurs between 45 and 65 years of age. Anatomical classification of haemorrhoids includes internal and external haemorrhoids based on whether they are above or below the dentate line. Goligher's classification is the clinical staging of the prolapsing degree of internal haemorrhoids. Risk factors for hemorrhoidal disease are conditions associated with increased intra-abdominal pressures such as pregnancy, obesity, constipation and straining during defecation and sitting for a long time on the toilet seat, and chronic cough. Principal complaints of haemorrhoids include bleeding on defecation and prolapse of tissue. Haemorrhoid diagnosis involves taking a detailed history and conducting anorectal examinations (visual inspection, manipulation, digital examination, and anoscope. Report of first recorded treatment for haemorrhoids comes from the Egyptian papyrus dated 1700 BC: “… Thou shouldest give a recipe, an ointment of great protection; Acacia leaves, ground, titurated and cooked together. Conservative treatment is used in “Everyday Lifestyle Guidance. Drug therapy for haemorrhoids is typically utilized for bleeding, pain, and swelling. Operative hemorrhoidectomies are reserved mainly for third- and fourth-degree haemorrhoids.
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