The Road to Health & Happiness

Thrombosed external hemorrhoid, shortened to TEH by busy medical experts, has long troubled both men and women. Eureka moments have abounded in medical science over the last hundred years or so. As a result, straightforward and uncomplicated treatment would be expected by anyone afflicted byTEH, typically also a non-life threatening ailment. Contrary to expectations, right this moment, there are several unsettled controversies among TEH experts. There are literally hundreds, if not thousands, of research papers offering divergent hypotheses, findings, and open-ended conclusions that only serve as a cue for further study.

Not unexpectedly, thrombosed external hemorrhoid patients have to cope with conflicting opinions when they seek the advice of a doctor and be presented with a confusing array of treatment modes and prescriptions. 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. A TEH patient can be forgiven for empathizing with the proverbial guinea pig, especially since TEH is generally seen as an ordinary ailment. Contempt of the medical world is never intended, merely a resignation to one of those situations in life, just like the common cold.

Basic Controversy

The leading thrombosed external hemorrhoid debate to be explored is its etiology (US spelling) or aetiology (US spelling), the medical designation for the cause of a disease. It cannot be more elemental than this! Intricate inter-relationships in the human anatomy may explain the lack of precision in identifying the root source of TEH.

As a result, there is an expanding list of probable and possible contributory causal factors. Gebbensleben, Hilger and Rohde studied 187 TEH research papers (published between Dec 1958 and Jan 2004), standard textbooks, journal reference lists and called on their own practical know-how before filtering the published etiological factors of thrombosed external hemorrhoid to 38.

The 3 gentlemen, in the months from Mar 2004 to Aug 2005, undertook an unusual prospective cohort study of 148 individuals, made up of males and females aged between 16 to 80, 72 with TEH and 76 without. A prospective cohort study is one that follows, over a period of time, a group of similar individuals (the cohort) who di ffer with respect to certain factors under study in order to determine how these factors affect rates of a certain outcome, contracting TEH in this case. Such a research method is superior to a retrospective cohort study where all the factors being studied had already taken place.

Thirty-eight Causal Factors

The 38 etiological factors giving rise to thrombosed external hemorrhoid pinpointed by researchers from 1958 to 2004 can be divided into 2 categories -

(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) frequency of shower use, frequency of bathtub use, frequency of genital cleaning before sleep, use of soaps and gels after defecation, use of dry toilet paper after defecation combined with wet cleaning, use of dry toilet paper only, sports, excessive physical effort, ano-receptive sex, recent alcohol intake, body mass index (BMI), age, pregnancy, career as trainee, civil servant and retirement.

Though many familiar factors appear on it, thrombosed external hemorrhoid has insignificant statistical relation to Group 1. Resulting from statistical correlation of Group 2 factors to TEH, the study focused on their effects on the cohort of 148. It may disturb some to know that only 6 out of 16 Group 2 factors can be depended on to predict whether TEH will ensue.

Age 46 or younger, use of excessive physical effort and use of dry toilet paper combined with wet cleaning methods after defecation are the three Group 2 factors discovered to correctly forecast the higher risk of TEH occurence. The 3 significant factors correlated with a lower risk of thrombosed external hemorrhoid include genital cleaning before sleep at least once weekly, use of shower and use of bathtub.

Future research, the researchers submit, must cover all 6 factors when establishing best therapeutic practice (surgical or otherwise), causes (etiology) and prevention (prophylaxis). With a spirited call, the researchers intoned that it is not an option that risk factors must be defined as real or mere fiction. Even so, the researchers acknowledge that more than one risk factor is behind the emergence of TEH.

Alternatives

The study, whilst conceded by the researchers as narrow in scope, serves the very useful purpose of highlighting the multitudinous decisions faced by anyone afflicted by 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. We cannot emphasize any more that the great work of medical professionals over the years has shed much light on treatment for laypersons. But the current circumstances suggests that perhaps alternative treatments may play a role as well.

Popularly favored by those open to alternative treatment is a system known as H Miracle. H Miracle is one of the best things in the alternative medicine niche that has catered to TEH sufferers. Natural and effective has been a key appeal factor for H Miracle. Equally attractive are the testimonials of recovered thrombosed external hemorrhoid sufferers attesting that H Miracle is a lasting answer.

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

Tags: external thrombosed hemorrhoid, hemorrhoid, hemorrhoids, thrombosed external hemorrhoid