Haemorrhoids ( Piles )

Haemorrhoids or Piles are abnormal swellings of the vascular mucosal anal cushions around the anus Common in general population Have been treated by surgeons for centuries Affect between 4.4 and 36.4 % of the general population Cost range US $ 1-1.5 Billion dollars annually ( US )Exact incidence is difficult to quantify as people always do not seek help Peaks between 45-65 yrs and seen more in white people and people of higher socioeconomic group Evidence indicates that bleeding is arterial and not venous ( bright red colour and pH of blood ) Particularly common in women during pregnancy and post-partum Treatment based on degree of prolapse and severity of symptoms

Thomson was the first to introduce the concept of ' anal cushions ' usually 3 in number - in left lateral , rt anterior and rt posterior positions3 , 7 , 11 o clock These help maintain anal continenceWhen they become enlarged and symptomatic - they are called haemorrhoids

Classified by their anatomic origin within the anal canal ( see image ) by their position relative to the Dentate ( Pectinate in image ) line - patients can have both simultaneously External-Below the dentate line Develop from ectoderm squamous...