Thrombosed external hemorrhoid, shortened to TEH by busy medical experts, has long troubled both men and women. A quick lookback over the last hundred years or so would leave one in no doubt of the incredible advances made in medical science. For that reason, straightforward and uncomplicated treatment would be expected by anyone suffering fromTEH, typically also a non-life threatening ailment. Interestingly, we learn that several TEH controversies continue to be actively debated by medical experts around the world. Clarity is lacking to this day, as demonstrated by the hundreds of research papers hypothesizing differing views.
Not surprisingly, thrombosed external hemorrhoid patients meet with opposing recommendations when they seek the advice of a doctor and be met with a overwhelming lineup of treatment modes and prescriptions. Theoretical preference and real-life clinical experience of your doctor in conjunction with the ascendant TEH therapy of the day will likely influence the treatment recommended for you. A consultation with the doctor may well leave a TEH patient feeling a little like the experimental guinea pig. Whilst not reproaching the medical community, the TEH patient may be tempted to equate the state of research in TEH to that in the common cold.
Fundamental Controversy
The initial thrombosed external hemorrhoid controversy to be investigated is its etiology (US spelling) or aetiology (US spelling), the scientific nomenclature for the causation of a disease. It cannot be more basic 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. After examining 187 research papers on TEH spanning more than 40 years (Dec 1958 to Jan 2004), journal reference lists, standard textbooks and their own medical knowledge as practitioners, Gebbensleben, Hilger and Rohde narrowed down the published etiological factors of thrombosed external hemorrhoid to 38.
From Mar 2004 to Aug 2005, the 3 TEH experts committed to an unusual prospective cohort study of 148 individuals, comprising 76 without TEH, 72 with TEH, both male and female and with ages ranging from 16 to 80. Consistent with its name, a prospective cohort study of similar individuals (the cohort) examines the development of certain factors over a future period of time. With its reliance on future events to draw conclusions, the prospective cohort study is considered superior to the retrospective version.
Thirty-eight Etiological Factors
The 38 causal elements contributing to thrombosed external hemorrhoid pinpointed by researchers from 1958 to 2004 can be broken down into 2 categories -
(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) excessive physical effort, sports, pregnancy, recent alcohol intake, ano-receptive sex, frequency of bathtub use, frequency of shower use, frequency of genital cleaning before sleep, body mass index (BMI), age, career as trainee, civil servant, retirement, use of soaps and gels after defecation, use of dry toilet paper only and use of dry toilet paper after defecation combined with wet cleaning.
Even though many oft-quoted factors are included in it, thrombosed external hemorrhoid has little convincing statistical relation to Group 1. Consequent to discovering statistical correlation of Group 2 factors to TEH, the researchers turned their attention to the effects of these factors on the 148-member cohort. Intriguingly, the study found that only 6 of the 16 factors in Group 2 reliably predicted the occurrence of TEH.
Of the 6 factors in Group 2, the 3 found to significantly increase the risk of TEH were use of excessive physical effort, age 46 or younger and use of dry toilet paper combined with wet cleaning methods after defecation. 3 factors associated with a significantly reduced risk of developing thrombosed external hemorrhoid include weekly cleaning of genitals before sleep, use of bathtub and use of shower.
Future research, the researchers submit, must cover all 6 factors when establishing best therapeutic practice (surgical or otherwise), causes (etiology) and prevention (prophylaxis). In daring manner, the researchers called for risk factors to be clearly identified as real or fictional. However, they do concede that it is most likely a spectrum of various factors, as opposed to one main culprit, that contribute to TEH formation.
Alternative Therapy
The researchers of this study admit that it is narrow in coverage but it is instructive in laying out the wide array of options for anyone suffering from 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. Please note that in no way are we saying that anyone should disregard professional diagnosis and recommendations. It is submitted that now is the time to offer other non-pharmaceutical treatments a fair hearing.
One such alternative treatment regime is H Miracle, easily the most favoured by TEH sufferers. A product by an ex TEH sufferer, created for the TEH sufferer, H Miracle has found many adherents. H Miracle has found support on the basis of its claim to being natural. Of particular interest are testimonies of thrombosed external hemorrhoid sufferers sanctioning that H Miracle is a enduring 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
