Thrombosed external hemorrhoid, or TEH, has been the subject of decades if not centuries of intensive medical research. Just retracing back a few decades will leave one in awe at the advances in medical research. As a consequence, one would not be unreasonable to expect that the diagnosis and treatment of TEH, frequently seen as non-life-threatening, would be routine and uncomplicated. On the contrary, it surprises that many unresolved debates make their rounds among the most brilliant TEH experts all over the world. Hundreds, if not thousands, of divergent hypotheses presented in research journals point to the need for more clarity.
Not unexpectedly, thrombosed external hemorrhoid sufferers encounter opposing guidance when they seek the advice of a doctor and be faced with a overwhelming selection of treatment procedures and prescriptions. Prevalent dominance of the therapy among doctors of the day, the doctor’s personal training and real-life consultation of TEH patients will greatly influence the treatment you receive. Poor guinea pigs, the TEH patient may begin to empathize after a session with the doctor to discuss a seemingly minor medical condition. It is never the intent here to cast aspersions on medical science, merely acceptance of one of those things in life, something like the common cold.
Fundamental Controversy
The leading thrombosed external hemorrhoid controversy to be considered is its etiology (US spelling) or aetiology (US spelling), the medical description for the origin of a disease. Seen from any perspective, the controversy will not be any more elemental! So complicated is the human anatomy that it has been extremely tough to pinpoint a precise cause for TEH.
The offshoot of this is an extensive list of potential factors that qualify as causes. 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.
Between 18 March 2004 to 18 Aug 2005, the 3 gentlemen initiated a rarely-done prospective cohort study of 148 individuals (72 with TEH and 76 without TEH, aged between 16 and 80 and of both genders). As its name suggests, a prospective cohort study is performed on a group of similar individuals (the cohort) who differ from one another in certain factors that are the subject of the study. By not relying on past events, like in a retrospective cohort study, the prospective model finds greater levels of acceptance.
Thirty-eight Etiological Factors
The thirty-eight causal elements giving rise to thrombosed external hemorrhoid pinpointed by researchers from 1958 to 2004 can be divided 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) retirement, career as trainee, civil servant, age, body mass index (BMI), pregnancy, recent alcohol intake, sports, excessive physical effort, frequency of shower use, frequency of bathtub use, ano-receptive sex, use of dry toilet paper only, use of dry toilet paper after defecation combined with wet cleaning, use of soaps and gels after defecation and frequency of genital cleaning before sleep.
Though many familiar factors appear on it, thrombosed external hemorrhoid has little or no statistical relation to Group 1. The researchers discovered adequate correlation in Group 2 factors with TEH to justify further investigation in the test cohort. Amazingly, of the 16 group 2 factors or 38 in the original list of factors, only 6 were eventually deemed accurate predictors of TEH.
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 three factors most closely related to diminished risk of thrombosed external hemorrhoid include use of bathtub, weekly cleaning of genitals before sleep and use of shower.
The researchers concluded that these 6 factors should be considered in future research on the etiology (causes), prophylaxis (prevention) and optimal therapy (conservative or surgical treatment) of TEH. Somewhat melodramatically, the researchers stated that the line between fact and fiction must be clearly drawn in investigating risk factors. Regardless, several rather than one major risk factor is believed to cause TEH.
Alternatives
This study, though acknowledged by the researchers to be small in sample size, illustrates to some degree the difficulty faced by sufferers of thrombosed external hemorrhoid. Laypersons should not be surprised to hear differing opinions from medical professionals given that the controversy is fairly far-reaching (38 possible causes studied over 40 years!). There is absolutely no intention here to disdain proper medical diagnosis in any manner. It is submitted that now is the time to offer other non-pharmaceutical treatments a fair hearing.
Among others, H Miracle is an alternative remedy with many adherents. H Miracle is one of the best things in the alternative medicine niche that has catered to TEH sufferers. H Miracle has found support on the basis of its claim to being natural. Especially captivating are the success stories of thrombosed external hemorrhoid sufferers confirming 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