Thrombosed External Hemorrhoid – Even Experts Disagree
Saturday, February 6th, 2010Thrombosed external hemorrhoid, shortened to TEH by busy medical experts, has long troubled both men and women. Medical science has advanced in leaps and bounds over the last century. For that reason, one would expect that TEH, being generally classified as non-life threatening, would be a very straightforward medical condition with long established diagnostic and treatment methods. So it is rather surprising to learn that, as we begin a new decade in 2010, the experts continue to debate several controversies about TEH. Clarity is lacking to this day, as demonstrated by the hundreds of research papers hypothesizing differing views.
It is hardly surprising that thrombosed external hemorrhoid sufferers encounter differing viewpoints when they seek the advice of a specialist and be confronted with a confusing selection of treatment modes and medicines. Actual clinical practice of your doctor, his theoretical leanings and the foremost therapy dominating the medical circle of the day will determine the treatment you may receive. Discussing the causes and therapies with a doctor may provoke the thought of being a guinea pig. No disparagement of medical science and doctors is intended here, it is just one of those things, like the common cold.
Basic Controversy
The principal thrombosed external hemorrhoid argument to be surveyed is its etiology (US spelling) or aetiology (US spelling), the medical terminology for the causation of a disease. It is difficult to get any more foundational than this! Complexities in the human anatomy are so intricate that it is just impossible at this juncture to pin down one cause leading to TEH.
The consequence of this is a long list of factors that have been noted as contributing to its occurrence. Gebbensleben, Hilger and Rohde combed through 187 research papers on TEH spanning more than 40 years (Dec 1958 to Jan 2004), journal reference lists, standard textbooks and applied their own medical knowledge as practitioners before narrowing down the published etiological factors of thrombosed external hemorrhoid to 38.
In the period from Mar 2004 to Aug 2005, the 3 experts undertook an uncommon prospective cohort study involving 148 patients (72 with TEH, 76 without, of both genders and with ages from 16 to 80). As suggested by its name, a prospective cohort study is forward-looking and focused on a group of people with similar characteristics (the cohort) but differing in the factors being studied. Such a research method is superior to a retrospective cohort study where all the factors being studied had already taken place.
Thirty-eight Etiological Factors
The thirty-eight etiological factors giving rise to thrombosed external hemorrhoid identified by researchers from 1958 to 2004 can be broken down into 2 groups -
(1) Use of shower or wet wipes after defecation, assumption to have hemorrhoids, straining at defecation, sitting on cold surfaces, prior anal surgery, use of laxatives, hard bowels, diarrhea, spicy meals, pregnancy, menses, sneezing, coughing, nationality, gender, self-employed, employee, worker, housewife and lifting a heavy load;
(2) Age, body mass index (BMI), retirement, career as trainee, civil servant, pregnancy, excessive physical effort, sports, recent alcohol intake, ano-receptive sex, frequency of bathtub use, frequency of shower use, frequency of genital cleaning before sleep, use of dry toilet paper after defecation combined with wet cleaning, use of dry toilet paper only, use of soaps and gels after defecation.
Quite unexpectedly, thrombosed external hemorrhoid has minor statistical relation to Group 1. Further investigation of Group 2 factors was necessitated by apparent correlation to TEH as detected by the researchers. Interestingly, the study concluded that of the 16 factors in Group 2, only 6 were found to predict TEH correctly.
Three Group 2 factors associated with an elevated risk of contracting TEH were age of 46 or younger, use of dry toilet paper together with wet cleaning methods after defecation and use of excessive physical effort. 3 factors associated with a significantly reduced risk of developing thrombosed external hemorrhoid include weekly cleaning of genitals before sleep, use of bathtub and use of shower.
On the basis of the results, it is advocated that these 6 factors have earned the right to be included in further research of TEH optimal therapy (non-surgical or surgical treatment), prophylaxis (prevention) and etiology (causation). In an uncommon zesty call to action, the researchers pronounced that fact and fiction must be clearly delineated in risk factors. The researchers concede that several, and not one, risk factors are probably behind the appearance of TEH.
Alternative Treatment
Whilst mapping out the vast array of possible answers in a useful manner, the study also amplifies the confusion facing anyone suffering from thrombosed external hemorrhoid. Significant lack of consensus (40 years of research, 187 papers and 38 possible causes!) among medical professionals contribute to the various explanations proffered to laypersons. In now way is it being suggested that professional medical advice and diagnosis be ignored. All the same, it may be an opportune time for alternative medicine to be considered.
Among alternative treatments, H Miracle is one of the most highly regarded. Produced by an ex hemorrhoid sufferer, H Miracle has been the answer for numerous others who were willing to give alternative medicine a chance. Its natural foundation has been a source of attraction for H Miracle. Never failing to capture attention are the personal stories of thrombosed external hemorrhoid sufferers warranting that H Miracle is a permanent solution.
Reference:
O. Gebbensleben, Y. Hilger & H. Rohde: Etiology of thrombosed external hemorrhoids: results from a prospective cohort study. The Internet Journal of Gastroenterology. 2009 Volume 8 Number 1
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