Skip to main content

Advertisement

SpringerLink
Log in

What are hemorrhoids and what is their relationship to the portal venous system?

  • Guest Editorial
  • Published:
Diseases of the Colon & Rectum

Abstract

New concepts of the pathophysiology of hemorrhoids have been defined during the past eight or more years, yet medical education at the undergraduate and graduate levels has not kept pace with the newer concepts. The traditional concepts are being perpetuated in all medical dictionaries and in most textbooks of surgery, medicine, anatomy, and pathology. Hemorrhoids are not varicosities, but rather are vascular cushions composed of arterioles, venules, and arteriolar-venular communications which slide down, become congested and enlarged, and bleed. The pathogenesis begins in the fibromuscular supporting layer in the submucosa, above the vascular cushions. The bright red bleeding, which accompanies hemorrhoidal disease, is arteriolar in origin. Portal hypertension has been shown not to be the cause of hemorrhoids. The use of rubber bands, sclerosing solutions, cryosurgery, or the infra-red beam in the early stages of hemorrhoidal disease can take care of prolapse and bleeding and can prevent the development of third and fourth degree hemorrhoids.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Dorland's Medical Dictionary. 26th ed. Philadelphia: WB Saunders, 1981:700.

  2. Buie LA Sr. Practical proctology. 2nd ed. Springfield: Charles C Thomas, 1960.

    Google Scholar 

  3. Goligher JC. Surgery of the anus, rectum and colon. 3nd ed. London: Bailliere Tindall, 1975.

    Google Scholar 

  4. Thomson WH. The nature of haemorrhoids. Br J Surg 1975; 62:542–52.

    PubMed  CAS  Google Scholar 

  5. Gass OC, Adams J. Hemorrhoids: etiology and pathology. Am J Surg 1950;79:40–2.

    Article  PubMed  CAS  Google Scholar 

  6. Treitz. Ueber einen neuen muskel am duodenum des menschen, über elastische sehnen und einige andere anatomische verhältnisse. Verhaltnisse Viertel Jahrschrift Prar. Heilkunde (Prager) 1853;1:113–44.

    Google Scholar 

  7. Alexander-Williams J, Crapp AR. Conservative management of haemorrhoids. Clin Gastroenterol 1975;4:595–601.

    PubMed  CAS  Google Scholar 

  8. Stelzner F, Staubesand J, Machleidt H. Das corpus cavernosum recti: die grundlate der inneren hammorrhoiden. Langenbecks Arch Chir 1962;299:302–12.

    Article  PubMed  CAS  Google Scholar 

  9. Spiro HM. Clinical gastroenterology. 2nd ed. New York: Macmillan, 1977.

    Google Scholar 

  10. Sleisinger MH, Fordtran JS. Gastrointestinal disease. 2nd ed. Philadelphia: WB Saunders, 1978.

    Google Scholar 

  11. Schwartz SI. Principles of surgery. 3rd ed. New York: McGraw-Hill, 1979.

    Google Scholar 

  12. Goldberg SM, Gordon PH, Nivatvongs S. Essentials of anorectal surgery. Philadelphia: JB Lippincott, 1980.

    Google Scholar 

  13. Nivatvongs S, Goldberg SM. An improved technique of rubber band ligation of hemorrhoids. Am J Surg 1982;144:379–80.

    Article  Google Scholar 

  14. Hiller RI. Internal hemorrhoids. Am J Surg 1932;16:64–6.

    Article  Google Scholar 

  15. Haas PA, Fox TA. Age-related changes and scar formations of perianal connective tissue. Dis Colon Rectum 1980;23:160–9.

    PubMed  CAS  Google Scholar 

  16. Anderson WA, Kissane JM. Pathology. 7th ed. St. Louis: CV Mosby, 1977. Vol. 1.

    Google Scholar 

  17. Liebowitz HR. Bleeding esophageal varices: portal hypertension. Springfield: Charles C Thomas, 1959.

    Google Scholar 

  18. Hunt AH. A contribution to the study of portal hypertension. Edinburgh: Livingstone, 1958.

    Google Scholar 

  19. Jacobs DM, Bubrick MP, Onstad GR, Hitchcock CR. The relationship of hemorrhoids to portal hypertension. Dis Colon Rectum 1980;23:567–9.

    Article  PubMed  CAS  Google Scholar 

  20. Levy JS, Hardin JH, Shipp H, et al. Varices of cecum as unusual cause of gastrointestinal bleeding. Gastroenterology. 1957; 33:637–40.

    PubMed  CAS  Google Scholar 

  21. Lopata HI, Berlin L. Colon varices: a rare cause of lower gastrointestinal bleeding. Radiology 1966;87:1048–50.

    PubMed  CAS  Google Scholar 

  22. Izsak EM. Finlay JM. Colonic varices. Am J Gastroenterol 1980;73:131–6.

    PubMed  CAS  Google Scholar 

  23. Anson BJ, ed. Morris' human anatomy. 12th ed. New York: McGaw-Hill, 1966.

    Google Scholar 

  24. Quénu E, Hartmann H. Chirurgie du rectum. Paris: G Steinheil, 1895:335–73.

    Google Scholar 

  25. Johansen K, Bardin J, Orloff MJ. Massive bleeding from hemorrhoidal varices in portal hypertension. JAMA 1980;244:2084–5.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Colon and Rectal Surgery; Department of Surgery, University of Minnesota, Box 327 Mayo, 55455, Minneapolis, Minnesota

    William C. Bernstein M.D.

Authors
  1. William C. Bernstein M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Read at the meeting of the American Society of Colon and Rectal Surgeons, Boston, Massachusetts, June 5 to 9, 1983.

This study was conducted under a grant from the Phillips Family Foundation, Minneapolis, Minnesota.

About this article

Cite this article

Bernstein, W.C. What are hemorrhoids and what is their relationship to the portal venous system?. Dis Colon Rectum 26, 829–834 (1983). https://doi.org/10.1007/BF02554764

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02554764

Key words

Search

Navigation