The structure of the anal canal was examined in histology slides. Hemorrhoids are normal features of the human anatomy. They are pads that bulge into the lumen. Hemorrhoids have three parts: 1) the lining, which can be mucosa or anoderm; 2) the stroma with blood vessels, smooth muscle, and supporting connective tissue; and 3) the anchoring connective tissue system, which secures the hemorrhoids to the internal sphincter and the conjoined longitudinal coat. The anchoring and supporting connective tissue system deteriorates with aging. The hemorrhoids not only bulge, but descend into the lumen. This becomes observable in the third decade of life, with individual differences. The veins become distended as they lose their support. The descended loose lining becomes more sensitive to pressure from straining and to trauma from the stool. There can be a stasis in the veins, with clot formations and swelling or erosions of the lining, with bleeding. The hemorrhoids become symptomatic.
Hemorrhoids Etiology of hemorrhoids Pathogenesis of hemorrhoids
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McGivney J. A reevaluation of etiologic factors of hemorrhoidal disease. Ariz Med 1967;24:333–6.PubMedGoogle Scholar
Hansen HH. Neue Aspekte zur Pathogenese und Therapie des Hämorrhoidalleidens. Dtsch Med Wchnschr 1977;102:1244–8.CrossRefGoogle Scholar
Lord PH. Approach to the treatment of anorectal disease with a special reference to hemorrhoids. Surg Annu 1977;9:195–9.PubMedGoogle Scholar
Eisenhammer S. Internal anal sphincterotomy plus free dilatation versus anal stretch with special criticism of the anal stretch procedure for hemorrhoids: the recommended modern approach to hemorrhoid treatment. Dis Colon Rectum 1974;17:493–522.PubMedGoogle Scholar