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Abstract
Hemorrhoids, which remain one of the most common colorectal complaints, have been classified into three types: (1)internal, (2)external, and (3)internal-external (mixed). Currently there are a variey of therapeutic options for hemorrhoids, and the severity of hemorrhoidal disease determines the proper therapy. Added to the present armamentarium of therapies is a uniquely designed suppository that is used primarily to treat internal and external hemorrhoids and also is used for the treatment of anal fissures. The Rectal Rocket, designed by compounding pharmacists Robert and Jerry Boudreaux, delivers lidocaine and hydrocortisone directly to the site of inflammation and heals injured tissue. In this interview Robert Boudreaux, RPh, and his son, Douglas Boudreaux, PD, discuss the history, design, mode of action, and availability of this unique preparation.
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Hemorrhoids remain one of the most common colorectal complaints. They are defined as a pathologic engorgement of the submucosal vascular plexus. Although they are often asymptomatic, hemorrhoids may cause bleeding, prolapse and, less commonly, pain. This review gives an update on various treatment options for symptomatic hemorrhoids, which include conservative treatments, office interventions, and surgical procedures, depending on the individual constellation of symptoms. Objective findings and expectations are also addressed. Recent advances (eg, stapled hemorrhoidectomy and use of alternate energy sources) are emphasized, and treatment under special circumstances (HIV, pregnancy, inflammatory bowel disease, and liver disease) is outlined.
In this report the authors outline the main historical aspects of haemorrhoids after a thorough review of the literature. The first texts concerning haemorrhoids are the ancient Egyptian papyruses. The twenty centuries of the history of haemorrhoids are marked by multiple pathogenetic theories, and of these the vascular and the sliding of the anal mucosa are still valid. From an analysis of the historical texts and the most recent publications, we deduce that the principles of therapy are substantially unchanged since the days of Hippocrates. In conclusion, we can say that, as in ancient times, the therapy of haemorrhoids is based on three fundamental approaches: surgical treatment, ambulatorial non-surgical treatment and medical treatment.