2020年10月25日星期日

hemorrhoids in children,Pregnancy, childbirth, and the onset of hemorrhoids

    Hemorrhoids are anal diseases with the highest incidence among anorectal diseases. Hemorrhoids rarely occur in children in the last year, but the incidence increases rapidly with age.

    Etiology The onset of hemorrhoids is related to anal hygiene and defecation factors, mainly some factors that are not conducive to anal health, which exist in defecation, diet, family life and occupation. Cold waist, eating irritating food, constipation, forced defecation, etc. can lead to hemorrhoids. In men, factors that aggravate hemorrhoids include fatigue, drinking, and irregular life, while in women, pregnancy and childbirth are factors. Age is also related to the occurrence and aggravation of hemorrhoids. The symptoms of hemorrhoids tend to get worse with age.

    1Pregnancy, childbirth, and the onset of hemorrhoids

    Analysis of the reasons that pregnancy and childbirth can significantly aggravate the hemorrhoids are: a. Compression of the enlarged uterus, leading to blood stasis in the hemorrhoidal vein; b. Arterial blood flow increases. According to Schottler's report, the blood flow in pregnancy increases by 25%. c. The enlarged uterus compresses the intestines and causes defecation disorders, hard stools and increased defecation effort; d pelvic organs become fragile or loose, so they are easily injured or inflamed; e hormone-related progesterone, lazyin and other pregnancy Hormones dilate blood vessels or soften tissues; f changes in diet during pregnancy, insufficient exercise can lead to blood stasis and constipation, and aggravate anal diseases. In the middle and late stages of pregnancy, the above tendencies are more obvious. Therefore, women who are about to become pregnant or pregnant, especially those who have hemorrhoids in the past, should pay attention to the hygiene of the anus, such as keeping the stool smooth and not excessively defecation; to avoid constipation, eat a high-fiber diet and avoid irritating food ; Do not use irritating laxatives but use laxatives; to avoid blood stasis, do not make cold below the waist; moderate exercise, etc.

    2 Defecation disorders and the onset of hemorrhoids

    3 The etiology of hemorrhoids

    Human beings have had submucosal venous plexus and subcutaneous venous plexus under the rectal mucosa and under the skin around the anus from childhood. As their volume gradually increased, internal and external hemorrhoids and nuclei were formed and symptoms appeared.

    Regarding the occurrence of hemorrhoids, there were three theories in the past: varicose veins theory; vascular hyperplasia theory; mucosal spondylolisthesis theory.

    Thomson's research on hemorrhoid tissue in 1975 found that the connective tissue surrounding the blood vessels under the human rectal mucosa is more developed, and he called this connective tissue a cushion. According to Hass report, this connective tissue is mainly composed of collagen or elastic fibers, and there are hemorrhoid blood vessels composed of small arteries and venules. Thomson refers to this supporting tissue as a cushion. The cushion or matrix containing the venous plexus is further supported by the Treitz ligament and fixed to the upper body (pelvis). Treitz ligament is a thin ribbon-like fibrous structure gradually formed during the descending process of the external longitudinal muscle of the rectum and the levator ani muscle between the internal and external sphincter. It penetrates the internal sphincter, extends radially along the lower anus, and is attached to the anal epithelium. As the hemorrhoids enlarge, and with each defecation, the Treitz ligament gradually lengthens and develops into a "prolapse" state. Based on this, Thomson proposed the "liner down shift theory."

    The theory of cushioning downward movement believes that the submucosal and subcutaneous venous plexus are innate and surrounded by strong connective tissue. Because the connective tissue is thicker, the shape and function are normal, the venous plexus will not develop It is a vein tumor. As the age increases, the connective tissue becomes fragile and destroyed. When over 20 years of age, this connective tissue begins to disintegrate and become a broken state. The venous plexus loses its restraint and expands into hemorrhoids and symptoms appear.

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