Thrombosed External Hemorrhoid - Divergent Expert Views

Thrombosed external hemorrhoid, or TEH, has been the subject of decades if not centuries of intensive medical research. Medical science has made great advances, especially in the last century. For that reason, any TEH sufferer would reasonably anticipate straightforward diagnosis and treatment since it is also generally regarded as non-life threatening. On the contrary, it surprises that many unresolved debates make their rounds among the most brilliant TEH experts all over the world. Opposing views and hypotheses, presented by researchers in medical journals over many years, indicate that much more research is called for.

It is no surprise then that thrombosed external hemorrhoid sufferers have to deal with clashing instructions when they consult a doctor and be confronted with a perplexing multitude of treatment modes and medications. Your doctor’s personal training and actual practice together with the preeminent view of the medical fraternity will determine the TEH therapy you receive. The strange feeling of being a guinea pig may well up after a TEH patient finishes a discussion of the wide array of TEH issues with the doctor. 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 discord to be evaluated is its etiology (US spelling) or aetiology (US spelling), the clinical description for the causation of a disease. By any measure, the controversy cannot be more basic! The human anatomy is so complex that there has been no way to conclusively pin down one specific reason that results in TEH.

Not unexpectedly, a vacillating list of contributory causal factors is circulating. 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.

From Mar 2004 to Aug 2005, the 3 TEH experts undertook an unusual prospective cohort study of 148 individuals, comprising females and males from the ages of 16 to 80, 76 without TEH and 72 with TEH. A prospective cohort study looks ahead, focusing on certain factors in a group of individuals with otherwise similar characteristics (the cohort). The prospective, as opposed to a retrospective cohort study, does not rely on eliciting conclusions from past events.

38 Etiological Factors

The 38 etiological factors giving rise to thrombosed external hemorrhoid fingered by researchers from 1958 to 2004 can be broken down into 2 groups -

(1) Employee, self-employed, housewife, worker, nationality, gender, prior anal surgery, diarrhea, use of laxatives, spicy meals, assumption to have hemorrhoids, hard bowels, coughing, sneezing, pregnancy, menses, straining during defecation, use of shower or wet wipes after defecation, sitting on cold surfaces and lifting a heavy load;

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

Despite including many common factors, thrombosed external hemorrhoid has minimal compelling statistical relation to Group 1. Sufficient statistical correlation to TEH in Group 2 factors warranted further study in the 148-patients cohort. Surprisingly, of the 16 Group 2 factors that may predict TEH, the number which proved reliable was reduced to only 6.

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. The 3 Group 2 factors out of the 6 that closely forecasted waning risk of thrombosed external hemorrhoid included use of bathtub, use of shower and genital cleaning before sleep at least once a week.

Future research, the researchers submit, must cover all 6 factors when establishing best therapeutic practice (surgical or otherwise), causes (etiology) and prevention (prophylaxis). Fact or fiction, real or imagined, that is the question that the researchers believe must be applied to all risk factors. All the same, TEH occurrence is likely to be due to several as opposed to one major contributory factor.

Alternatives

Whilst the researchers acknowledge that the study is restricted in scope, it does highlight the dilemma for those seeking a solution for thrombosed external hemorrhoid. The extent of the controversy is so extensive (187 research papers spanning 40 years and 38 possible causes!) that it is no wonder that we may hear quite divergent views from medical professionals. There is to be no implication that conventional medical treatment is to be disregarded. It could well be the time has come for alternative treatment methods to play a more high profile role.

H Miracle comes highly recommended by those who kept an open mind about alternative medicine. A product by an ex TEH sufferer, created for the TEH sufferer, H Miracle has found many adherents. H Miracle finds its strength in being natural. Of special attention are the thrombosed external hemorrhoid sufferers attesting that H Miracle is a perpetual 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