8/8/2023 0 Comments Best hemorrhoid otc2 The patient may describe this to the pharmacist as a soft bit of tissue that shrinks back to normal shortly after defecation or requires the patient to manually push the tissue back into its normal position above the dentate line after each bowel movement (in more severe cases).Įventually, the patient with long-standing prolapse may discover that the tissue can no longer be replaced, a condition known as permanent prolapse. The internal tissues may enlarge and push below the dentate line to protrude from the anal opening, especially after defecation. 6 The patient does not usually bleed at other times. When they cause bleeding, it is usually bright red and seen on the outer part of stools after defecation. Internal hemorrhoids lack nerves and are painless. The degree of discomfort experienced by the patient is dependent on the type of hemorrhoids and the extent of their severity. 2,6 External hemorrhoids originate below the dentate line. 4 If the hemorrhoidal tissue originates above the dentate line, it is classified as an internal hemorrhoid, even if some of the tissue extends below. Hemorrhoids are divided into three broad categories, depending on the point of origin. 2 The exact cause of the enlargement is open to further dispute, although the “straining” theory asserts that straining interrupts the tissues that support the vascular bundles, displacing them and leading to their congestion. When these beds enlarge, the result is hemorrhoids. Groups of normal submucosal vascular beds composed of supportive connective tissue, smooth muscle, and blood vessels surround the anal canal. Approximately 2 to 3 cm above this is an anatomical landmark known as the dentate or pectinate line, which is distinguished by a circular row of glands that secrete mucus that acts to lubricate the anal canal. The anal opening is also referred to as the anal verge. However, at least 50% of people will have experienced hemorrhoidal symptoms by the time they reach the age of 50 years. The number of people with hemorrhoids is impossible to determine, as many who experience the symptoms consider them too embarrassing to share with a physician or pharmacist. Unfortunately, many patients who initially seek relief through the use of a nonprescription product will require referral to a physician. 1,4,5 Some persons may put off a pharmacist or physician consultation until the symptoms become unbearable. 1-3 Anorectal problems such as hemorrhoids cause untold misery for many people at one time or another. Hemorrhoids are swollen veins in the anal canal that cause a variety of symptoms.
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