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Mesothelioma Lawyer Information & Asbestos Cancer Information

admin — Sun, 25 Jul 2010 06:32:35 +0000

Mesothelioma is one of the deadliest forms of cancer known today – an incurable disease that claims the lives of thousands of victims in the United States each year.

While medical science continues to develop miraculous technology that prolongs many of the lives ravaged by this insidious condition, a cure for mesothelioma is still out of reach and the prognosis is always fatal.

Tragically, there is usually little time left after a mesothelioma diagnosis, and physicians are left with few options except to help alleviate physical suffering and ensure that a victim’s final days are as comfortable and pain-free as possible.

Within this site you’ll find facts and information about mesothelioma that includes :

What is Mesothelioma? Facts on Pleural, Peritoneal, and Pericardial mesothelioma
What is Asbestos? Asbestos in the home and workplace
Mesothelioma Symptoms
Mesothelioma Treatment and Treatment Options
Lung Cancer – Facts on causes, growth, metastasis, and lung cancer cell types
Mesothelioma Diagnosis – methods and tests for mesothelioma
Asbestosis – Facts, indications and symptoms of this non-cancer condition.

Proving the link between one’s illness and their asbestos exposure is a difficult and time-consuming responsibility. This is why the guidance of an experienced Mesothelioma lawyer is critical in helping victims and their families seek and receive financial compensation for their profound suffering.

People can be exposed to asbestos in their home, workplace, many workers in older factories, ore mines, and shipyards were at risk of asbestos exposure.

Other types of workers exposed to asbestos includes :

US Military and Navy personnel
Engineers
Construction workers such as pipefitters and steel workers
Auto mechanics -working on brakes containing asbestos
Insulation workers
Asbestos textile workers
Demolition workers

Mesothelioma Cancer :

Cancer can attack any system or organ in the body, and very often shows few external symptoms until it is too late.

Another lethal aspect of cancer derives from the nature of cancerous cells to spread to healthy surrounding tissues by means of the circulatory or lymphatic systems. This combination of factors has made cancers like mesothelioma the single greatest threat to health around the globe.

Mesothelioma is a particularly destructive cancer, for decades pass between exposure to the asbestos and appearance of cancerous symptoms.

Further complicating mesothelioma treatment is the malignant nature of the cancer, for once symptoms surface, current therapeutic treatments are usually no longer effective and post-diagnosis survival rates typically range from four months to a year.

Even though mesothelioma is a rather rare condition, there are a number of professions that exposed people to this deadly and incurable disease.

Many people who worked in or around military installations, or in the automotive, construction, or chemical industries now exhibit the first signs of mesothelioma.

Asbestos was used for decades as insulation or in building materials, which potentially exposed millions of workers to this deadly cancer. Most doctors and medical experts agree that there will be tens of thousands of new cases of mesothelioma in the years to come.

Facts about Asbestos and Mesothelioma :

There is only one known cause of mesothelioma : exposure to asbestos.

Asbestos is a naturally occurring mineral used for centuries in insulation, clothing, and fire-resistant materials.

Ancients praised this versatile material, but also decried the lethal nature of the small fibers easily inhaled by anyone who used it. It was not until the 20th century that X-Rays, computed axial tomography (CAT) scans, and magnetic resonance imagery (MRI) revealed the extensive damage caused by these microscopic fibers.

Even though advances are made every day in modern times, medical science is still only beginning to provide adequate treatment for mesothelioma.

Asbestos Exposure Facts :

Responsibility for deadly asbestos exposure is primarily due to the proliferation of asbestos related materials combined with the negligence of the injury to properly warn their employees and consumers about the dangers of their products.

For years the asbestos industry concealed or minimized the potential dangers their products posed in the name of profits, fearing lawsuits and diminished demand would ruin their businesses.

Ultimately, this deception and negligence virtually destroyed the industry and nearly bankrupted several prominent insurance companies responsible for protecting asbestos companies against potential lawsuits.

If you are suffering from mesothelioma, or have lost a loved one to the disease, you may have the right to receive reparations from the asbestos industry that failed to adequately warn consumers of the grave risks associated with their product.

A knowledgeable and understanding mesothelioma lawyer will help you fight for justice and the financial compensation to offset those spiraling medical expenses and to provide financial security for your family’s future. Don’t hesitate though, because the law limits how much time you have to file your claim – contact a mesothelioma lawyer today.

Mesothelioma Lawyers Legal Guide :

When you are faced with something as devastating as a Mesothelioma diagnosis, you have a right to seek answers about why you weren’t forewarned of the dangers of asbestos, and you have the right to seek reparations for you and your family.

If you are a grieving family member or executor of the will of a person who has died from asbestos-related disease or mesothelioma, you may be eligible to file a claim as well.

Legal details are understandably the last thing that someone wants to confront after the initial shock of an asbestos-related illness.

However, taking advantage of your legal rights can create the necessary funds to finance aggressive treatment, pay off huge medical bills incurred during diagnosis, and provide financial security for your family for years to come.

Mesothelioma Litigation Lawsuit :

A good Mesothelioma attorney understands the unique complexities involved in this kind of litigation lawsuit, including asbestos product identification, specific asbestos-related medical issues, and specific time constraints that narrow the window of opportunity to file a claim. It’s important to find the right Mesothelioma lawyer before your state’s statutes of limitations expire, leaving you and your family grieving and empty-handed. There’s no time to wait – contact our mesothelioma lawyers today for a free case review.

Mesothelioma lawyer and asbestos attorney guide in these States :

Alabama (AL), Alaska (AK), Arizona (AZ), Arkansas (AR), California (CA), Colorado (CO), Connecticut (CT), Delaware (DE), Florida (FL), Georgia (GA), Hawaii (HI), Idaho (ID), Illinois (IL), Indiana (IN), Iowa (IA), Kansas (KS), Kentucky (KY), Louisiana (LA), Maine (ME), Maryland (MD), Massachusetts (MA), Michigan (MI), Minnesota (MN), Mississippi (MS), Missouri (MO), Montana (MT), Nebraska (NE), Nevada (NV), New Hampshire (NH), New Jersey (NJ), New Mexico (NM), New York (NY), North Carolina (NC), North Dakota (ND), Ohio(OH), Oklahoma (OK), Oregon (OR), Pennsylvania (PA), Rhode Island (RI), South Carolina (SC), South Dakota (SD), Tennessee (TN), Texas (TX), Utah (UT), Vermont (VT), Virginia (VI), Washington (WA), Washington DC (DC), West Virginia (WV), Wisconsin (WI), Wyoming (WY).

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well i just about Mesothelioma Lawyer

505 Useful link for Diseases and Conditions (Complete)

admin — Tue, 06 Jul 2010 06:50:04 +0000

505 Useful link for Diseases and Conditions (Complete)

Below I summarize Useful links for Diseases and Conditions (Complete).

If you are one of the site owners that I mentioned below, and if you don’t want your site address appear on my blog, Please send your comments to me. Thank you.

Joint Health Supplements | Joint Health Products | Joint Strength
Joint strength should not be ignored. Our joint health supplements are for anyone, from the skier on the slopes every weekend to the casual walker. Our joint health products are for you.
http://www.jointsupplementbenefits.com
Mesothelioma Resource and Info
Mesothelioma resource and info
http://mesothelioma.orp.site11.com
Your Queen Creek Chiropractor
Our office, conveniently located in the center of Queen Creek, AZ provides members of the community with high quality, affordable health care in a comfortable and caring environment. Get the help you deserve for Neck/back pain, auto accident or headaches.
http://www.summithealthchiro.com
Prostate Cancer Surgery
Prostate cancer requires regular checkups to spot, especially in men over forty, so it’s essential to make regular visits to a physician to get prostate exams.
http://prostatecancersupportgroup.com
Ldl And Hdl Cholesterol
What Is Ldl Cholesterol And Hdl Cholesterol? Learn More About Cholesterol Levels On Our Website. We Often Post New Information On Our Website About Cholesterol
http://www.cholesterolbad.com
Acne Cream Treatment
We provide information on acne cream treatment, acne scar natural treatment, laser acne treatments and plenty of other information on acne and skin care treatment.
http://www.acnecreamsite.com/
Psoriatic Arthritis
Information on Arthritisbearthritisfree.com provides you important information on osteo arthritis, psoriatic arthritis, Flomax Arthritis, Rheumatoid Arthritis, arthritis diet, arthritis pain relief.
http://www.bearthritisfree.com
Migraine Information Center
The migraine freedom information center offers useful, practical information to help migraine sufferers win the battle against their migraines 100% naturally. We offer high quality information for all migraine sufferers.
http://www.absolute-migraine-freedom.com
Allergy and Asthma Watch
The latest information on anaphylaxis, food and skin allergies, rhinitis, corticosteroids, and more from the Journal Watch experts.
http://www.jwatch.org/cgi/collection/allergy-asthma
Aids
Resource guide on AIDS and HIV includes medical news, chat, message boards, information and articles, books, and links.
http://www.aidsworldcure.com
Basic Skin Care Secrets
Skin Care talks is a site that related with Skin care tips and techniques to help keep your skin healthy and beautiful.
http://www.skincaretalks.com
The CPAP Shop – Sleep Apnea Equipment
Quality discounted CPAP machines, masks, headgear, filters and tubing and other related Sleep Apnea products. All major manufacturers – Respironics, Resmed, Puritan Bennett, Fisher & Paykel, DeVilbiss, Viasys, Invacare, Medical Industries & Tiara Medical.
http://www.thecpapshop.com
Remedy For Eczema
A site dedicated to finding a remedy for eczema, advice and resources.
http://www.remedyforeczemablog.com
Hemorrhoids Relief
Free information on hemorrhoids relief that you can do at home. Get rid of your hemorrhoids today.
http://www.hemorrhoid-treatment.info
Asbestosis, Pleurisy, Mesothelioma Legal Help
Find how to compensate yourself for asbestos exposure leading to mesothelioma & lung cancer with legal information & attorneys. Learn about diagnosis & treatment and find out about your legal options.
http://www.mesothelioma-advice.org
New Mesothelioma Patient | Home
Information and resources for patients who have been diagnosed with mesothelioma cancer caused by asbestos exposure.
http://www.newmesotheliomapatient.com
Murad.com
Best acne treatments available. Murad acne treatments are clinically proven to help improve your acne.
http://www.murad.com
Vaginal Cancer Information
Vaginal-cancer.com provides informational resource for the patients of Vaginal Cancer. Other people can also take advantage of the site. The site has sections on causes of vaginal cancer, its symptoms, its treatment,
http://www.vaginal-cancer.com/
Uterine Cancer Site
Uterinecancersite.com provides informational resource for the patients of Uterine Cancer. Other people can also take advantage of the site. The site has sections on causes of uterine cancer, its symptoms, its treatment, its different stages,
http://www.uterinecancersite.com/
Fighting Pain
Pain management, for chronic pain, psychogenic pain. Physiology of pain.
http://www.painbusting.com
Thyroid Cancer Information
Thyroidcancersite.com provides informational resource for the patients of Thyroid Cancer. Other people can also take advantage of the site. The site has sections on causes of thyroid cancer, its symptoms, its treatment, its different stages,
http://www.thyroidcancersite.com
Thymoma Cancer
Thymoma-cancer.com provides informational resource for the patients of Thymoma Cancer.
http://www.thymoma-cancer.com/
Prostate Cancer Information
Theprostatecancer.com is an educational resource on Prostate cancer for its patients and other people. The site has detailed information on what is prostate cancer, how it happens, its types and its treatment.
http://www.theprostatecancer.com/
Bladder Cancer Information
Thebladdercancer.com provides excellent information on bladder cancer for patients and others. It has sections on what is bladder cancer, what are its stages, its symptoms and signs. It will also give you the options of its treatment.
http://www.thebladdercancer.com/
HemroidTreatmentNow.com
Complete resource for hemroids information including symptoms and treatment for both internal and external hemroids.
http://www.hemroidtreatmentnow.com
Hyperhidrosis Cure
How to safely prevent underarm sweating for good. There is a natural cure for hyperhidrosis. An ex-sufferer reveals the secrets they don’t want you to know about! Stop sweating and start living.
http://StopMySweat.com/
Libido Enhancers, Male Female Libido Enhancement
The comprehensive guide on men and women health problems. The website covers an extensive section of health supplements and guide on several health issues. It also gives useful advices and tips on dating and relationship.
http://www.howtoselfhelp.org
Local Alcohol Rehabilitation Center
Choosing a alcohol rehabilitation center is one of the most significant decisions to make for you or your loved one.
http://www.alcoholysis.com/
Cancer Patients Donate
Our lovely Graham was diagnosed in April 2007 with a deadly type of leukaemia that affects less than 6 adults a year in Australia and his only chance of survival was a bone marrow transplant.
http://www.adonorforgraham.com/blog/
How To Beat Chronic Urticaria & Angioedema
Copy This Simple Natural Method & Never Suffer With Chronic Urticaria Again
http://www.urticaria-relief.com
What is mesothelioma?
Diagnosis of mesothelioma or asbestosis is immediately followed by either a surgical procedure or chemotherapy. Mesothelioma and asbestosis treatments are expensive. Get help now!
http://www.asbestosismesothelioma.org
Michael Jackson Vitiligo
Michael Jackson has vitiligo and that is the truth, even now you will see brown spots on various parts of Michaels body, at his arms, hands, nose, lips etc. On February 10, 1993, he gave to the world an explanation about his skin disease like that,
http://www.vitiligos.com/people-with-vitiligo/famous-people/
Natural Treatment for Psoriasis
Looking for herbal treatment for Psoriasis, Eczema or Rosacea? We offer Natural and herbal Treatment for Psoriasis. Get a Natural Treatment for Eczema. We provide Baby Eczema Treatment and cure.
http://www.doctors-defense.com
Sinus Dynamics
Providing you with the latest information and treatment regarding sinus or sinusitis infection problems.
http://www.sinusdynamics.com
Ways To Stop Snoring
The article found at this URL explains about the inter-relationship between being over-weight and a person’s propensity to snore. It also outlines the significance of inappropriate lifestyle choices on whether a person snores or not.
http://www.stopmysnoringnow.com
Acneprecautions.com Is Your Guide For Acne Treatments, Causes And All Information About Acne
Learn all about acne, the different types of acne, how it develops, how it affects you, the treatments and medication, the precautions you can take to avoid it.
http://www.acneprecautions.com
Addiction Treatment Drug Rehab
A drug rehab and alcohol rehab center in Scottsdale Arizona that treats various addictions, including co occurring disorders. We believe our treatment program is one of the finest in the world.
http://www.affirmationsrehab.com/
How Long Cocaine is in your System
Find out how long cocaine could be detectable in your body for a drug test.
http://www.howlongdoescocainestayinyoursystem.org
Cure for heart disease
Learn about the cause and treatment for various types of heart diseases. Understand the facts and myths about heart diseases.
http://www.cureforheartdisease.org
Mobility Product Online – Great Value Electric Scooters, Wheel Chairs, Walking Sticks, Commode
Chair Welcome to Mobiliti.co.uk – UK based supplier. Comprehensive range of elderly and disabled Online mobility products. Including motorised scooters, wheel chairs, bathrooms aids, home and daily living aids, orthopaedic support and much more.
http://www.mobiliti.co.uk/
The Merrell Clinic
Sleep clinics specializing in oral appliance therapy for snoring and sleep apnea. Serving patients throughout Alberta and across Canada and the USA.
http://www.merrellclinic.com
Mesothelioma with Type, mesothelioma lawyers, Symptoms, mesothelioma attorney, Causes and Treatment Mesothelioma with Type, mesothelioma lawyers, Symptoms, mesothelioma lawyers, Causes and Treatment
http://www.atledo.com/cancer
Artherosclerosis
Website dedicated to explaining primary pulmonary hypertension, high blood pressure symptoms, causes, investigations and treatment. Ischaemic heart diseases such as hyperlipidemia and artherosclerosis and high blood pressure diet will also be described.
http://www.what-is-hypertension.com
Mesothelioma Information. Are You At Risk?
http://mesotheliomastraight.net/asbestos
Sarasota Interventional Radiology Technologies a Cancer Hospital
Radiation therapy is successful way to treat many kinds of cancer in different part of the body without surgery and stitches and with less pain at affordable cost.
http://www.sivr.net
Great knowledge portal of cancer
The website provides general knowledge of cancer for self-study. There are also information about how to give the treatment to patients, fundamental treatment as well as stories and experience from specialist in this filed.
http://www.cancerdelete.com
Sciatica
A plethora of free sciatica information, including anatomy, causes, symptoms, diagnosis and treatment of sciatic nerve pain, written by an actual recovered patient.
http://www.sciatica-pain.org
Herniated Disc
Comprehensive herniated disc resource written by a recovered disc pain patient. Learn all about disc herniations, degenerative disc disease and treatment options.
http://www.herniated-disc-pain.org
Find Herniated Disc Treatment
Are you looking for herniated disc treatment? Check out this website with complete information on herniated disc.
http://www.herniated-disc-treatment.net
Sleeping Medicine New and Information
Offering Sleeping Medicine News and Information. Zolpidem, Lunesta, Sleep Prescription Information. Sleep better with out Sleeping problems, sleep natural and without addiction to sleep aids.
http://www.sleeping-medicine.com
Tips for Disease Treatments
Offers insightful information to help identify treatments of some diseases and conditions, including rheumatoid arthritis, menopause, high blood pressure, female herpes, diabetes and many others to assist you and your loved ones address various ailments.
http://www.diseasetreatmenttips.com
Chronic Bronchitis – What Exactly Is It?
Chronic Bronchitis Information – Chronic Bronchitis Signs and Symptoms, Treatment Options, and More. Articles, News, Pictures, and Videos related to Chronic Bronchitis.
http://www.chronicbronchitishelp.com
Colon health – About Colon Health.
If you think that you may have a problem with your health You owe it to yourself and your family to read these articles.
http://www.ahealthycolonnow.com/
Intestine Cancer Information
Small-intestine-cancer.com is an informational resource on Intestine cancer. It is useful for patients and the public. The site describes what is Intestine, Intestine Cancer, what are its diagnosis and tests, what is its treatment.
http://small-intestine-cancer.com/
Stomach Cancer
Stomachcancersite.com provides excellent information on stomach cancer for patients and others. It has sections on what is stomach cancer, what are its stages, its symptoms and signs. It also has section about gastric cancer.
http://www.stomachcancersite.com/
Testicular Cancer Information
Testicularcancersite.com provides a detailed resource for Testicular Cancer to the patients and general public. The site has sections on how Testicular Cancer happens, what are its signs and symptoms, what are its stages, what is its treatment.
http://www.testicularcancersite.com/
Diagnosed with mesothelioma
If you are diagnosed with mesothelioma, a deadly cancer caused by asbestos exposure, the experienced mesothelioma attorneys of the Johnson Law Group can help you seek financial compensation. The Johnson Law Group offers free mesothelioma case evaluation…
http://www.nickjohnsonlaw.com
Top Acne Product Reviews
Acne Relief Guide for Top Acne Products and Treatment Reviews. Acne products to make you look and feel better and raise your self esteem.
http://www.acnereliefguide.com
Pinched Nerve Treatment with Neck Traction
Neck traction device relieves the pressure on the neck by stretch the cervical disc. Neck traction is used to treat neck spasm and compressed disc causing neck and shoulder pain.
http://www.chisoftnecktraction.com
Headache Symptoms
What is headache pain? It’s one of the most common complaints and may be frequent for some people. Learn about different types of headaches and migraines.
http://www.headachesymptoms.org
Chronic Back Pain
We provide resources and proven ways to help in preventing and combating all kinds of back pains for all back pain patients…
http://www.backpainclub.com
Symptoms of Diseases
Offering insightful information to help recognize symptoms of diseases, including Attention Deficit Disorder, teenage depression, stages of Herpes, about Alzheimer Symptoms and many others to assist you and your loved ones to spot early warning signs.
http://www.diseasesymptomtips.com
Fungal Skin Infections
Footessentials provide a range of natural alternative products. Essential Oils have many therapopertiproperties; most are anti-bacterial and naturally effective to optimise health and wellbeing without any side effects.
http://www.footessentials.co.uk
Plateltex: Gel for fast lesion recovery
The autologous Platelet-Rich Plasma (PRP) is a blood derivative containing the patient own platelets concentrated up to tenfold the original blood concentration. It is the blood component necessary to prepare the platelet gel.
http://www.plateltex.com
Fungal Skin Infection
Fungal Skin Infections are caused by bacteria called Staphylococcus. These Bacteria live harmlessly on the skin, especially around the mouth and nose.
http://www.improveskinhealth.com
Spinal Stenosis Surgery
If conservative treatments for spinal stenosis have failed you, is it time to consider spinal stenosis surgery?
http://www.stenosis-spinal.com/spinal_stenosis_surgery
Foot pain treatment with docpods orthotic innersoles
Foot aches and pains are often caused by misalignment of the foot and lower limb. This is usually due to over pronation. Docpods orthotics correct lower limb missalignment and help to relieve foot and lower limb pains…
http://www.docpods.com.au
Genital Herpes, Information, Best Natural Treatment
Genital herpes may be easily controlled, eliminated and healed with masterfully combined essential oils. They go to the heart of the problem and eliminates it.
http://www.naturalskinrepair.com/genital-herpes.html
Symptoms of asthma
Asthma is one of the diseases that can be kept in strict control if it is diagnosed early enough. The trouble is that early symptoms of asthma seem to be just fatigue, and is usually interpreted as such.
http://athomeasthmacare.info/
Nasal Spray Addiction: Serious Business
This page examines the possible dangers of becoming addicted to nasal sprays and decongestants.
http://www.nasalspraycraving.com
My Cancer Fund
http://www.mycancerfund.net
Lupus Symptoms and Treatment
Symptoms of lupus concentrates on the difficulty in diagnosing the different types of lupus, the symptoms often present and the treatment of this disease. Symptoms of Lupus also concentrates on the lifestyle changes necessary for living a normal life…
http://www.symptomsoflupus.info
Hair Loss Product Reviews – Hair Loss Product
Read hair loss product reviews for the latest and most popular hair loss treatments and products and find out which ones actually works.
http://www.hairlossproductreviews.net
HELPPNEUMONIA.COM
Find out about pneumonia.
http://www.helppneumonia.com/
Kidney Disease
Kidney disease and other related information.
http://www.helpkidneydisease.com/
Testicular Cancer
Testicular Cancer
http://www.helptesticularcancer.com/
Eczema
Find the solution to your skins needs.
http://www.helpeczema.com/
Ear Ache
Ear Ache help. Find some of the causes and solutions to ear aches.
http://www.helpearache.com/
Treat Cancer
Cancer treatments. Find the right cancer treatment for you.
http://www.helptreatcancer.com/
Ailment Control Articles
There are some easy yet highly valuable tips regarding Ailment Control that can make a world of difference in the condition of a patient.
http://ailmentcontrol.com
The Senior Alliance, Help for Alzheimers, Chronic Pain, Parkinsons Disease and more
An alliance of over 50s working together to find good health information based on sharing our experiences, join us to help yourself and others.
http://www.senioralliance.co.uk
Infertility, Fertility & IVF Clinic for Male & Female: Malpani Infertility Clinic.
Dr Malpani Clinic: Infertility, Fertility & IVF (In Vitro Fertilisation) Clinic for Male & Female in India. Also offers Ovulation Calculator & Ovulation Calendar facilities. India based Infertility & Fertility Clinic offers Information.
http://www.drmalpani.com
How To Get Rid Of Stuff
Learn how to get rid of anything: get rid of stretch marks, sunburn, dandelions, the flu, telemarketers. Our database of articles will help you get rid of anything you need.
http://www.howtogetridofstuff.com
Laser Eye Surgery
Health lasik eye surgery to improve your vision to better than 20/20 Large Description: Lasik eye surgery most advanced FDA approved technology to improve your vision to better than 20/20 lasik eye surgery.
http://www.lalasik.com/
Fibromyalgia
Fibromyalgia information and articles
http://www.fibronews.com
Sun Protection, Sun Protective Clothing.
If I Knew the Benefits That I Know Now Sun protection is a fact of life. It must be done daily in order to prevent or delay skin cancers such as melanoma. Your eyesight might be in danger too.
http://www.sun-protection-and-you.com
Cures and Self Help for Generalized Anxiety Disorder and Depression
Site includes studies into child depression, hierarchy of needs, TV viewing effects and patterns of thinking. Anxiety in education and the workplace, office stress management and confident public speaking are also addressed.
http://www.anxietymadewell.com/
End Your Chronic Low Back Pain For Good?
If you’ve been suffering from chronic pain in your lower back, leg, or neck and shoulders, you know how frustrating it can be to get the help you need to end your pain and suffering.
http://www.arizonabackinstitute.com/
Cancer Assistance Information
Offers insightful information about cancers, symptoms and treatments that include chemotherapy effects, breast cancer signs, brain tumor symptoms, pancreatic cancer symptoms, ovarian cancer warning signs and many others to assist you or your loved ones.
http://www.cancerinfotips.com
Is Steam Good For Acne
Learn how to steam your face correctly so that it can help your acne. Does steaming your face help acne, Yes, if done correctly.
http://www.acnetreatmentspecialist.com/Does-Steaming-Your-Face-Help-Acne.html
Hair Loss, Thinning Hair, Hair Thickener, Hair Baldness, Hair Camouflage, Hair Loss Woman, Hair Bald
We are offering hair care products of hair loss, thinning hair, hair thickener, hair baldness, hair loss woman, hair balding, hair camouflage, hair loss product, hair transplant, hair treatment, hair replacement system, non surgical hair replacement.
http://www.nanogenindia.com/
Your Guide to Obesity
If you’re looking for informations on Obesity, you can find it all here.
http://www.onlineobesityguide.com
Is There A Genital Wart Cure?
Learn what you can do about resolving your genital warts. There are more medical options available than you might think. Find out the real skinny about those irritating warts.
http://www.genital-wart.org
Wellness for Mind, Body and Spirit
A compilation of articles relating to wellness and unwellness. Health as well as diseases are included.
http://www.mesowellness.co.cc
Hemroids treatment
Hemroids.info is an online resource for getting useful information on hemroids, types of hemroids- internal hemroids, external hemroids, bleeding hemroids, hemroids cure, treatment, medicine and more interesting
information on hemroids.
http://www.hemroids.info
Mesothelioma Help
Offering news and stories and help about mesothelioma, it’s causes, symptoms and treatments.The website has a directory of treatment centres both in the UK and USA
http://www.beatmesothelioma.com
Autophagy
Abgent has the most extensive collection Abgent has the most extensive collection of autophagy antibodies.of autophagy antibodies.
http://www.abgent.com/doc/autophagy
Safe, Local, Fast STD Testing – SafeLabCentre.com
SAFE, LOCAL, FAST STD TESTING! Confidential STD Testing Centers For Chlamydia, Gonorrhea, HIV, Herpes, Hepatitis, and Syphilis.
http://safelabcentre.com
Heel Pain Information and Treatment
Information about heel pain, heel spurs and Plantar Fasciitis. Effective, affordable relief with heel pain orthotics and exercises.
http://www.heelpain.net.au
Autism in the UK
Autistic children find it extremely hard to communicate verbally.
http://www.elstreemedical.co.uk
Aids-Drugs-Online AIDS Drugs – Save big by switching to generics AIDS Medicines!
Aids Drugs – Save money on AIDS medicine! We offer only generic medicines like Viraday, Duovir, and Abamune. Come see how much you can save today!
http://www.aids-drugs-online.com/index.php
Acne Scar Natural Treatment
Your Guide On How To Prevent Acne And Reomve Acne Scars – Acne Scar.
http://www.acnescarnaturaltreatment.org
Sleep Advice – Our experts will help you and your family sleep better
Sleep Advice is written by sleep experts to help readers find solutions for sleep, rest and relaxation. Our experts frequently review sleep products and recommend solutions to help you and your family sleep better.
http://sleepadvice.blogspot.com/
What is Diabetes?
Informative web site diabetes mellitus, with information on the various types of diabetes, new on diabetic research and the assorted treatment and medication options commonly used. Website also offers a cookbook of recipes for diabetes.
http://www.informationaboutdiabetes.com
Its All About Cancer
Its all about Cancer, Cancer, Types of Cancer, Causes of Cancer, Symptoms of Cancer, What is Cancer?, Breast Cancer, Causes of Breast Cancer, Types of Breast Cancer, Symptoms of Breast Cancer, What is Breast Cancer?, What is Brain Tumor, cause and …
http://its-all-about-cancer.blogspot.com/
Mesothelioma Orange
All the things you need to know about mesothelioma. Causes, treatments, symptoms, lawsuits, lawyers, attorneys…
http://mesothelioma-orange.blogspot.com
Acne Products Guide
Research many methods of acne treatment and removal, realizing surgical intervention may be of some use, allowing a laser to help remove the first dead layer of skin leaving the healthy and vital skin behind, having many different great opinions on…
http://www.acnecentre.com/
Health The Greatest Gift of God
Important information related to health, healthy lifestyle, healthy food, disaese, treatment, medicine, recent updates, alerts on recent outbreaks.
http://healththegreatestgiftofgod.blogspot.com/
TMJ Treatment – Dr. Martha Cortes – Mnahattan, NY
Dr. Martha Cortes is a dentist in Manhattan, NY and provides a safe and fast way to treat TMJ Disorders and headaches.
http://www.tmjdentistny.com/
Cancer plus about cancer and healthy
http://cancerplus.co.cc
Nutrition and Diabetes
This page within the site talks about eating properly with diabetes. There are tips and many recipe suggestions throughout the site.
http://www.diabetesandrelatedhealthissues.com
Smoking Cessation Lasers
Los Angeles clinic offering therapies including weight loss, sleep apnea, smoking cessation, and insomnia.
http://www.alpsmedicalcenter.com/
Cancer Information, Cancer Facts, Cancer Cure
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http://www.diabeticconnect.com
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http://knowingbipolardisorder.com/
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http://www.clevelandclinic.org/cancer/scottcares/gift/
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http://www.snorelesssleepmore.com
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http://www.imtypefree.com
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http://www.EcstasyAbuse.net/
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http://simplewebsurf.com/best-time-to-get-pregnant/
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Living with nightmare headaches is hard; learning to manage your pain, interpret your symptoms could change your life! We hope that you will find these articles at nightmare headaches.com useful.
http://www.nightmareheadaches.com
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Free online resource to learn more about male and female infertility natural treatments and find out the real cause of infertility.
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Heart attack Recovery & Heart Disease Prevention
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http://heart-attack-and-heart-disease.com
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http://www.hemorrhoidshemroids.com
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http://www.sinusirrigation.org
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Health related message boards offering discussions of numerous health topics including allergies, cancer, diabetes, heart disease, exercise, attention deficit disorder, diet, and nutrition.
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Free tips to lower your blood pressure and unbiased reviews on several proven high blood pressure medications.
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Hair Loss Treatments for men and women: effective treatments and products for hair loss from the UK’s leading hair clinic – The Belgravia Centre.
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Welcome to Candida Albicans Infection, your source for candida info.
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www.kidneykars.comidaho car donation
The National Kidney Foundation, Inc., a major voluntary health organization, seeks to prevent kidney and urinary tract diseases, improve the health and well-being of individuals and families affected by these diseases, and increase the availability…
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Learn how to control your Diabetes today. Free info, articles, advice on diabetes symptoms & treatments, plus a quiz. Or purchase the Ultimate Diabetes Health Care Kit today.
http://www.diabeteshelpkit.info
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Consumer hair loss guide for men and women with hair loss. Unbiased information on hair replacement and hair transplant techniques. Reviews on the latest hair loss treatments. Worldwide hair transplant doctors directory.
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Mesothelioma Attorney
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LASIK Surgery Dallas, TX | Kleiman Evangelista Eye Center, Arlington, TX
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Post Nasal Drip
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All About Diabetes
Online resource for information about diabetes and diabetics. Includes articles about symptoms, treatment options, diets, meals, and tips for managing the disease.
http://www.thewisediabetic.com
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You guide online to help you provide with the right knowledge to help you prevent sweating. Natural treatment and helpful tips to reduce sweating and get your life back on track.
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Help keep your heart in optimal health. Articles on healthy heart, how to keep your heart healthy and prevent heart diseases. Includes reviews on the available heart disease treatments and how to choose them wisely.
http://www.heartdiseasepreventionguide.com
Coronary Heart Disease Cure
Find out more about various types of heart disease cure for coronary and congenital heart disease. Learn the symptoms and how you can prevent it.
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Treatment for head lice and their eggs, known as nits, which doesn’t use toxic chemicals or pesticides. Stop head lice coming back with an all natural headlice prevention treatment that lasts for months.
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Information on Leukemia
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http://www.sleepsense.net/
Comprehensive Kidney Facts
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http://www.comprehensive-kidney-facts.com/
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http://www.aftermesothelioma.com
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http://www.about-hypothyroid.com
Diabetic Gift Baskets
Resource website for continuing education on diabetes cures and treatments, diets, menus, diabetes awareness bracelets and diabetic supplies. Learn about the different types of diabetes.
http://www.learn-about-diabetes.com/
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http://www.yourtipsabout.com/
www.allaboutbackpains
Information about how to treat, prevent and causes of back pains.
http://www.allaboutbackpains.com
Spinal Stenosis and Disc Center
A world famous Southern California clinic specializing in the treatment of low back pain problems such as sciatica, spinal stenosis and disc herniation.
http://www.wevegotyourback.org
Stop snoring
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Acne Treatments | Acne Control | Acne Treatment
The Acne Treatment Control website offers acne sufferers information, help and advice on the prevention, control, medicine options and treatment of acne. The site is also an invaluable resource for the friends and family of acne sufferers.
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The Blood Pressure Reduction Guide
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http://www.natural-blood-pressure-reduction.com
Demystify Cancer
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http://www.demystifycancer.com/
Say Goodbye To Hemorrhoids, 100% Naturally.
The symptoms, causes, treatment, and prevention of very commonly occurring swollen veins in the rectum. Natural Remedies for Digestive System Diseases, Anorectal Disease, Hemorrhoids. Home Patient Care Management.
http://www.nohemorrhoids.net
Health Directory, Diseases and Conditions, Medical, Beauty & Weight Loss Information
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http://www.sicknessdirectory.com/
Sitagliptin Phosphate Drug for Diabetes by Merck – Januvia Metformin
Get the latest and most updated information about Sitagliptin.
http://www.sitagliptin.org.uk
Muscular Dystrophy
Muscular dystrophy treatment, diagnosis, symptoms and causes with detailed articles from professionals.
http://dystrophy.com
Citalopram and bipolar depression
While most people have heard about manic depression, which is also known as bipolar disorder, you may be wondering what is bipolar disorder.
http://www.bipolarsickness.com
Psoriasis Treatment Reviews, Cures & News | PsoriasisToday.com
PsoriasisToday.com – Psoriasis Treatment Reviews, Cures & News.
http://www.psoriasistoday.com
Normal Cholesterol Level
Learn about high cholesterol cure and how you can design your own diet to lower your cholesterol level back to normal.
http://www.highcholesterolcure.net
Social anxiety disorder
Is anxiety crippling your ability to live a normal life? Find what new treatments are available to those suffering from this debilitating disease.
http://www.anxietyinamerica.com
Asthma Cure
Find out the best asthma cure, understand asthma symptoms and the cause of asthma.
http://www.asthmasymptomcure.com
Acid Reflux Relief Explained
Premium resource discussing acid reflux disease symptoms and relief methods. It also covers the cause of acid reflux and other alternative treatment methods.
http://www.acidrefluxexplained.net
Sleep Apnea Symptoms
Offers general information, including symptoms, risks and treatments. Includes lists of professionals and health centers.
http://www.sleep-apnea-explained.com
Depression Information – Online Depression Help
Information about depression its symptoms, causes, types and treatments.
http://www.onlinedepressionhelp.com
Rosacea
Provide information about rosacea, it causes, symptoms and many more things.
http://www.allaboutrosacea.com
Acid Reflux Symptoms
Get the right food plans for acid reflux diet and understand what foods that cause acid reflux symptoms.
http://www.acidrefluxdiets.net
Homeopathic Remedy For Acid Reflux
Free resource on acid reflux remedy, including homeopathic remedy and other natural remedies for acid reflux.
http://www.myacidrefluxremedy.com
Natural Cure For Heartburn
One stop resource on herbal heartburn remedies, learn about the cause for heartburn and natural cure for heartburn.
http://www.herbalheartburnremedies.com
Sleep Apnea Cures
The site is a resource site for sufferers of sleep apnea. We provide information on sleep apnea symptoms and sleep apnea treatments. However, it is always best to consult a Doctor as we are not physicians. Sleep apnea is a chronic disorder that can be…
http://www.mysleepapneacures.com/
Acne Scars Causes, Types, Treatments and Medication – Acne Marks
Offers information on acne scars its causes, types , treatments and medication.
http://www.acnemarks.com/
Best Acne Skin Care Product to Cure Acne Without Side Effects
The best acne skin care Product to cure acne without any side effects.
http://www.acneless.com/
Symptoms Of Cancer
In this cancer resource blog, you will find sign and symptoms of different types of cancer, causes of cancer, and cancer treatments.
http://www.symptomofcancer.com
Health Diseases and Disorders Treatment
Guide to provide information on all common diseases and health conditions with symptoms, causes, diagnosis, and treatment methods as how to overcome them.
http://www.diseasescure.com/
Rare Skin Diseases and Disorders
Get complete cure for various skin diseases and disorders types, problems and common conditions including treatment options for many rare skin disorders and diseases.
http://www.theskindiseases.com/
Drug Rehab – Narconon Arrowhead
Highly successful drug rehab program where 76% of graduates stay drug free. Call 1-800-468-6933.
http://www.stopaddiction.com/
The Anxiety Help
Provides information about anxiety management its symptoms,causes and treatment.
http://www.theanxietyhelp.com
Bird Flu Questions
You do not even need to look very far to find some information on birdflu. No need to look even very much further, past the recent and numerous headlines, WHO (World Health Organization), mainstream media, press, news-releases and warnings etc…
http://www.birdfluquestions.net/
Longwood Chiropractic
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http://www.lakemarychiropractic.com
FindaChiropodist.co.uk | Find a Chiropodist UK | Find a Podiatrist | Foot Problems
Find a Chiropodist lists over 4500 qualified chiropodists and podiatrists in the UK, all registered with the Health Professions Council. Also offers advice on common foot problems, painful feet and footwear.
http://www.findachiropodist.co.uk
Cholesterol Facts: Helpful Cholesterol Facts To Make Life Easier
Cholesterol Facts: Helpful Cholesterol Facts To Make Life Easier.
http://www.cholesterolfactsonline.com/
Dermatoscopes.com – the advantages of dermatoscopy
Reviewing the advantages of dermatoscope use.
http://www.dermatoscopes.com/advantages-of-a-dermatoscope.shtml
Drug Rehab
Locating drug rehab and alcohol rehab programs anywhere in the U.S.
http://www.drug-rehab-locator.com
Free Symptoms of Diabetes Alert
Our mission is to help improve the quality of diabetes care, increase the understanding of the disease, and motivate people to request for help, change life style and engage in self-care for without patient participation, disease management will be…
http://www.free-symptoms-of-diabetes-alert.com
Colon Cleansing: Natural Health for your intestines
The secret to great health can be described in three words: Cleanse Your Body. Natural Colon Therapy offers free, expert advice on colon cleansing, how to do a colon cleanse, product reviews, and why we need cleansing.
http://naturalcolontherapy.com
Diabetes Mellitus Information and Diabetes Treatment
Diabetes Information and Diabetes Treatment Guide. Diabetes Types, Symptoms, Foods, Diet, Vitamins, Herbs, Exercise, Books and more.
http://www.diabetesmellitus-information.com/
Addiction Rescue
information about addiction its causes, symptoms, types and treatments.
http://www.addictionrescue.com
Diabetics Aid
Information about diabetes its causes,symptoms and treatment.
http://www.diabeticsaid.com
Cancer Information – Real Cancer Information
Information about cancer its causes,symptoms,types and treatments.
http://www.realcancerinfo.com
Acai Berry an extraordinary antioxidant-rich palm fruit
AcaÃ berry has a unique tropical fruit flavor and provides a high level nutritional benefits.The acaÃ berry contains high levels of antioxidants also known as anthocyanins.
http://www.acaiberryjuice.org
Verteran Mesotheliom Cancer
Veterans Helping Veterans provides information Veterans With Mesothelioma, Cancer Information Mesothelioma, Veteran Mesothelioma Cancer,Asbestos Cancer Mesothelioma, Mesothelioma Cancer Treatment, Cancer Health Mesothelioma.
http://www.mesothelioma-veteran.com
Mesothelioma Cancer
Find The Facts About Mesothelioma Cancer, Peritoneal Mesothelioma, Pleural Mesothelioma, Pericardial Mesothelioma, Asbestos Lawyer and Treatment for Mesothelioma.
http://www.peritonealmesotheliomacancer.org
Amazingly Simple Secret of weight loss
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http://www.thetotalbodytransformation.com/
Women and Pregnancy Care
Your Ultimate source for women health care, providing information on pregnancy, baby care, women health and pragnancy & women complication with symptom and treatment.
http://www.women-health-guide.com/
Health Doctor – Diseases Information
Information on many diseases like heart diseases, respiratory diseases, and many common ailments, showing cause, symptoms, and treatment with explanation as to how to overcome them, without resorting to medicines.
http://www.health-doctor.org/
Metabolism Diet
If you want to improve metabolism as well as increase metabolism and boost metabolism please review our website for more information.
http://www.maximizeyourmetabolism.com/
Essential Tremor – The Essential Facts
Essential Tremor is a condition which causes uncontrollable shaking.
http://www.essentialtremorinfo.com
Lower cholesterol
Cholesterol guru is free online cholesterol web site with best tips to lower your cholesterol in body ,health care and much more.
http://cholesterolguru.com/
Health Problems Articles
Authorative and comprehensive guide to health care, including articles on health problems and health and nutrition related topics.
http://www.health-care-articles.info/
Natural Cure for Genital Warts
Curing Genital Warts Naturally Guides. Includes genital warts symptoms, genital warts pictures, genital herpes etc.
http://www.genitalwartsonline.info
Blood Pressure Manual
Blood pressure manual with complete information on high blood pressure and low blood pressure there symptoms,monitoring ,controling pressure and much more.
http://bloodpressuremanual.com/
What is Sleep Apnea
What is Sleep Apnea. Online guide to symptoms of sleep apnea. Diagnosing and treatment. Informative tips for sleep apnea sufferers and family members.
http://www.sleepapneaanswers.com
Diabetes Diet
Dabetic Diet is the diet for diabetic patients in order to maintain ideal body weight, by providing adequate nutrition along with the normal blood sugar levels in blood. The diet plan is based on height, weight, age, sex and nature of diabetes.
http://diabetesinformationhub.com/DiabetesDiet.php
Online Medical Clinic
Information on diseases and conditions, home remedies, cancer prevention and more related health topics. Information on health topics, including news, discussion and health care services.
http://www.online-medical-clinic.com/
Skin Disorders and Diseases
Get information on skin disorders and skin diseases. Find detailed information on various common skin disorders including its causes, symptoms and effective treatment methods.
http://www.theskindisorders.com/
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Find treatment methods for treating various health diseases and disorders. There are a number of diseases, some serious, others not so serious, which are either incurable or can be cured only with great difficulty.
http://www.diseasestreatment.com/
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Diabetes causes
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http://www.diabetescauses.org/
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http://www.arthritissymptom.org/
Asthma attack
A blog for asthma information relating to asthma symptoms, asthma treatment, medications, types, asthma in children and adults, causes of asthma attacks.
http://www.asthma-attack.org/
Sweat-Stop stops sweating!
Sweat-Stop is an antiperspirant developed for people who suffer from excessive sweating or… hyperhidrosis.
http://www.sweat-stop.com/en
Diabetes Blog, Diabetes Symptoms, Diabetes Treatment and Diet Care
Latest information, news and tips on diabetes diet care.
http://www.thediabetesblog.net
Understanding Heartburn
Heartburn affects millions of people around the world, but there are cures for heartburn for those that suffer from this condition. To learn more visit Learn About Heartburn for more information.
http://www.learnaboutheartburn.com
Infant eczema
Infants eczema is a resource for factual information about infant eczema, how to deal with infants eczema and what products to use to avoid irritating skin.
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Effects of Diabetes
What is diabetes exactly? Diabetes is an incurable metabolic disorder characterized by abnormally high urine production and excessive thirst. Although diabetes is incurable, there are several ways an individual may manage effects of diabetes.
http://www.effectsofdiabetes.com
Diseases & Conditions – A to Z Health Solutions
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http://www.healthatoz.info/
Skin Disorders Treatment Solution
Skin-Disorders-Guide.com helps you to get complete cure for various skin diseases and disorders types, problems and common conditions including treatment options for your complete skin care.
http://www.skin-disorders-guide.com/
Aids Directory, Treatment and Therapies, Clinics and Practices
Provides the useful service in finding acquired immune deficiency syndrome (AIDS), organization, disease, treatments, medications, sexuality, treatment guidelines, vaccines for patients and more.
http://www.aidsindex.com/
Health Disorders and Health Diseases
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http://www.health-disease.org/
The Cure For Heart Disease
Heart Disease….Will it kill you? Or, Will you cure it. Heart Diseases because of fat content, cholesterol etc..
http://thecureforheartdisease.net
Diabetes Facts
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http://www.diabetesdiscussion.net/
Pneumatic Compression Device
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http://www.remarxservices.com/
Remove Cellulite
Looking for information on cellulite, its causes and tips to prevent it. Are you one of the 90% of the females who suffer from cellulite aka fat gone wrong and want information to get rid of it.
http://www.combat-cellulite.com
Alcoholism Search Engine
Information on Alcoholism, alcohol abuse, and alcoholism treatment alternatives can be found by using this specialty search engine.,
http://www.Search4Alcoholism.com
Cancer survival
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http://www.michaelgan.net
Irritable Bowel Syndrome.
Control Irritable Bowel Syndrome by using positive mental attitude. Experts agree this is the best way fowards. Positive thoughts attract positive results.
http://www.healingibs.com
Yeast Infection Symptoms In Man, Woman And Infant
Premium online resource on all you need to know about yeast infection condition.
http://www.yeast-infection-bible.com
Overcoming My Insomnia – knowledge for a restful sleep
Information to overcome insomnia and get a good night sleep. Website provides information on disorders pertaining to insomnia, articles and solutions.
http://www.overcomingmyinsomnia.info/
The Acne Treatment System – Derma Cleanse
Acne can’t be cured, but it can be managed. With our Derma Cleanse System you can treat the acne you have and prevent future acne from forming. Our experts have developed the system to manage your complexion and keep the clear skin you want.
http://dermacleanse.com
Triggers for migraine
Getting to know what triggers migraine and how to identify them. A collection of migraine related resources for the public, volunteers, health professionals & schools.
http://www.migrainewatch.info
Realistic Doctors Excuse Note Sample You Customize for work, school, etc.
Print Your Own Doctor s Excuse Note Now and Learn How to Use Them Without Getting Fired.
http://www.mycaloriescount.com/doctors-excuse-note.html
Acid Reflux Treatment
Resource site for sufferers of acid reflux. Our site will help you whether you are looking for acid reflux treatment or just information on the types of foods that cause acid reflux. We will also provide surfers with the proper diet to avoid acid reflux.
http://www.acidcurereflux.com/
Thick toenail and fingernail fungal infection
A guide to identify symptoms
http://www.treatnailfungus.org/treatment/thicktoenail8.html
Mesothelioma Cancer Tips
Free information and useful tips about mesothelioma cancer. Articles, news, resources and all the information that you need to know about mesothelioma cancer.
http://www.cancer-and-mesothelioma.info
Addiction Treatment and Recovery Resources
Find addiction treatment and drug rehab resources. Addiction treatment and drug rehab professionals, community, and forums available.
http://www.addicted.com
Acne And Rosacea Help
Information on diet, nutrition, and treatments to alleviate acne and rosacea.
http://www.acnetohealth.com
Mesothelioma Cancer Resources Portal
Non-laywer sponsored, hand-picked resources for those facing mesothelioma cancer including support groups, forums, and alternative treatment options.
http://mesotheliomacancerportal.org
Alopecia Areata Information
Alopecia Areata questions and answers. A disorder which causes patches of bald spots to appear on the scalp.
http://www.alopecia-info.org
Thyromine Review
Why your depression is not the end of the world.
http://www.thyromine-reviewed.com
Male Breast Cancer Advice
The breast cancer condition has many symptoms ranging from swelling of the skin to lumps in the breast. It is the aim of the breast cancer advice site to give advice on coping with this condition. Information is available on how the various cancer.
http://www.breastcanceradvice.net
Acne free in 1 night "gauranteed"
Louise Griffin (Naturopath) for the past 8 years has extensively researched powerful techniques for stopping acne and other skin conditions. Acne free in 1 night!
http://www.overnight-acne-cures.com
Acne treatments from zenmed
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http://zenmed.com/
Migraineheadachesymptoms Net
http://www.migraineheadachesymptoms.net
Natural Acne Treatments | ClearPores (Clear Pores)
Top quality improved acne treatments including herbal supplements, based on selectively mixed herbs which reduces sebum, clears pores and deep skin washes to unclog pores and gets rid of acne bacteria.
http://www.wefightacne.com
Acne Treatments | Clear Your Pores
Acne Treatment – Clear Pores, Acnezine, Zenmed, Vilantae – Leaders in natural acne treatments for clear and healthy skin. Get back your confidence and natural beauty!
http://www.clear-your-pores.com
Alopecia Can Be Beaten
Alopecia Can Be Beaten – Treatment , Areata, Totalis, Barbae, Universalis, and Childrens Alopecia. Visit our website and view our case studies, find out more about our products and visit our forum – Calosol.com.
http://www.calosol.com
Living with Arthritis
Free resource site for Rheumatoid Arthritis. Includes information on arthritis symptoms & causes, arthritis treatment, arthritis drugs etc
http://www.living-with-arthritis.biz/
The various ways of lowering high blood pressure
The various ways of lowering high blood pressure.
http://www.reducinghighbloodpressure.net
Diabetes Treatment Tips And Guide
Diabetes treatment and diabetes control is very important in both type 1 and type 2 diabetes mellitus. Diabetes diets, diabetes medications, and tests to diagnose diabetes are discussed. Also get tips on preventing long term health problems of diabetes.
http://www.thediabetesguide.com
Mr Clear s Acne Treatment Reviews and Articles
Mr. Clears complete acne treatment reviews and researched acne articles covering natural products, scarring, medication, surgery, and home remedies.
http://www.mrclear-acne-reviews.com
American Diabetes Services – Diabetic Supplies for Diabetes Testing
American Diabetes Services offers diabetic supplies for diabetes testing. Our diabetic supply company carries glucose meters, diabetic testing strips, and more. Find out if you qualify for free diabetic supplies today! Diabetic medical supplier offers.
http://www.americandiabetes.com
Tips For Insomnia | Fact About Insomnia
The inability to sleep can leave a person feeling unrested, irritable and in some cases unable to think clearly. Visit Tips For Insomnia to learn about insomnia cures and more.
http://www.tipsforinsomnia.com
Avatrol Review
A review of Avatrol and its place in hemorrhoid management.
http://avatrolreview.com
Pain Relief
Power Over Your Pain has stories about people who have overcome pain as well as information about pain support organizations.
http://www.poweroveryourpain.com
Arthritis Cure
If you are looking for information on Arthritis, its symptoms, cure, treatments or diet this site is for you.
http://www.arthritiscure.info
Asthma tips
Find tips and advice to beat your asthma. This site give you full information about asthma like diets, facts cause, Asthma Inhalers etc.
http://www.asthmadoctor.org
Speech Language Pathology Jobs, Products, Speech Therapy Courses
Professional speech pathology resources, including Jobs , discussion areas, message forum, product listings, continuing education courses, and other free resources.
http://Speech-LanguagePathologist.org
Diabetes Type 1
People with diabetes type 1 need insulin in order to stay alive. This disease is often referred to as insulin dependent diabetes. We provide facts on Sugar Diabetes, Diabetes Type 1, Diabetes Type 2, Diabetes Symptoms, Diabetes Supplies and diets…
http://www.sugardiabetes.net
LowerCholesterol30
http://www.lowercholesterol30.com/
Depression Treatment
Find information & help on depression useful for you in treating your depression. Also learn about symptoms, natural treatments to overcome depression.
http://www.treatingdepression.org
Eczemo
provide Information about eczema, its causes, types, treatment and as well as articles about this skin disease.
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How To Get A Good Night’s Sleep

admin — Tue, 27 Apr 2010 13:21:21 +0000

Potions, Teas, Vitamins, Drinks, Massages And Herbal Baths Helpful In Inducing A Good Night’s Sleep

A herbal bath can soothe your nerves andrelieve insomnia. Boil 2 ounces of Balm leaves in water for a few minutes, then let steep for 20 minutes. Strain and add to your bath water. Your bath water should be warm, but not hot, as the latter could stimulate rather than soothe.
Make a tea out of one or several of the following herbs: Catnip, Cowslip, German Chamomile, Hops, Passion flower,Valerian, Balm, Linden and Melissa. Drink several times a day if possible.
Inositol, one of the B vitamins, as well as pantothenic acid, both help induce sleep. Try one or even both together. Inositol: 1 to 3 grams an hour before bedtime. Pantothenic Acid: 1/2 to 2 grams an hour before bedtime.
Tryptophan is a natural amino acid which induces sleep. Combined with calcium it can be even more effective.

Try the following program :

(a) 3 trypthophan tablets half an hour before bedtime.
(b) 1 chelated calcium and magnesium tablet 3 times a day and 3 tablets half an hour before bedtime.

Turkey is an excellent source of tryptophan and milk of calcium; therefore, a turkey sandwich with a cup of warm milk at bedtime might cure your sleeplessness. A cheese sandwich would also help, as cheese (as well as milk) contains both tryptophan and calcium.
Make an effective sleeping potion :

(a) Combine 1 tbsp. tincture of Valerian (from a pharmacy), 1-1/2 tsp. of apple cider vinegar, 3 tbsp. of honey and 2 tbsp. of gin or vodka in a cup. Stir.

(b) Add 2 tbsp. or more of hot milk and stir again. Drink this mixture warm or hot half an hour before bedtime.

If you are not asleep within an hour, repeat the dose. Do not drink more than 2 doses in an evening.
Massage the soles of your feet with mustard oil at bedtime.

Nervous Habit – You Can Break It In A Few Days

admin — Thu, 01 Apr 2010 05:38:52 +0000

If you have a nervous habit you’d like to break, don’t pull your hair out.

You can put an end to fingernail-biting or hair-twisting in a matter of several days and you can do it on your own.

The following 4-step plan will help you put an end to your nervous habit for once and for all.

Recognize your bad habit
Increase your awareness of it by acting it out in front of a mirror. Try to keep track of how many times during the day you fall into your habit.
Devise a replacement action
If you’re a hair-puller, start carrying a brush and brush your hair each time you get the pulling or twisting urge. A nail-biter should learn to substitute filing his or her nails rather than biting.
Bring your habit out of the closet
Advise your work cohorts and family that you are attempting to break your nervous habit. Ask them to remind you when they catch you falling into your habit.
Learn to take it easy
Relaxation will help you put an end to a nervous habit. When you are too keyed up, your nervous habit takes over, so learn to do some deep breathing when you begin to feel uptight about something.

Your biggest hurdle in overcoming your nervous habit is in recognizing it. Once you do this and really decide you want to break it, you have done the hardest part.

Good luck.!!

Fifty Useful Tips For Better Sleep

admin — Thu, 01 Apr 2010 05:34:55 +0000

You can sleep without pills and still beat insomnia.

The fifty following tips will help you to have a better night’s sleep.

Try to relax before bedtime; take a walk or read a newspaper; just do something which is not stressful.
Do your paperwork or other work-related activities early in the evening.
Make sure your bedroom is not noisy.
If your bedroom is noisy and you can’t correct it, wear earplugs.
Think of places you fell asleep easily and try to copy those places; set your room up the same way.
Check the medicines you are taking to see that they aren’t nervous system stimulants.
Make sure your bedroom is well-ventilated but not too cold.
Don’t use too many or too few blankets.
Don’t tuck your sheets in too tight at the bottom of the bed; your feet should feel free and unrestricted.
Your mattress should not sag.
Have a big enough bed for yourself; if you’re 6’8″, don’t try sleeping in a single bed.
Your pyjamas or nightgown should be comfortable, not too tight.
Use a pillow that suits you, soft or firm, whichever you prefer; or not at all, if that’s what you prefer.
If you like a soft light on while you sleep, have one on.
If you prefer to sleep in darkness make sure your blinds are thick.
Rise at the same time seven days a week, no matter what.
Do not linger in bed when you wake up; instead, get up right away and start moving on with your morning routine.
Avoid napping in the afternoon.
Do some sort of physical exercise each day which will tire you out.
Cut down on smoking and drinking alcohol at least two hours before bedtime.
Don’t drink coffee or soft drinks containing caffeine after dinner.
If you like to watch TV before going to bed, keep it light; watch a comedy instead of a drama.
If you like to read before going to bed, keep it light. Read to a logical stopping point, so you won’t lie awake wondering what’s going to happen.
Don’t socialize with friends with whom you are likely to argue in the evening. Nighttime arguments are like poison to an insomniac.
Establish a regular bed-time.
Avoid eating too much salt with your dinner and in any after-dinner snacks.
Try eating snacks high in calcium and protein before retiring; small amounts of cheese and nuts contain Tryptophan, an amino acid which promotes sleep.
Take bone meal tablets or some other form of calcium regularly after dinner.
Herbal teas such as camomile and valerian induce sleep.
Try a teaspoon of brewer’s yeast and a tablespoon of molasses in a glass of milk.
Don’t forget about a glass of warm milk before bed; it does work.
A teaspoon of honey in a cup of hot water is said to induce sleep.
Another old-fashioned remedy is to take two teaspoons of cider vinegar with two teaspoons honey in a glass of warm water.
Ask your spouse which sleeping position you sleep most soundly in; try to assume that position upon retiring.
Don’t go for 8 hours of sleep; you may only need 4 to 6 hours.
Spend no more than 3 minutes thinking about the day’s problems when you are in bed.
If you find it difficult to sleep with your spouse, try getting twin beds or separate bedrooms.
The optimum temperature for sleep is 60 to 64 degrees F.
Relax before bed in a warm bath.
Buy a humidifier to keep your room warm in the winter without drying out the air too much.
Add a tablespoon of dry mustard powder to your before-bed bath.
Add baking soda to the bath water.
Footbaths before bed help.
Before bed, listen to relaxing music.
When you are in bed, recall the happiest experiences of your life.
Ask someone to read aloud to you in bed before you go to sleep.
Lie on your back in bed and relax each muscle in your body.
Visualize various parts of your body relaxing.
Concentrate on doing some deep breathing as you lie in bed.
If all else fails, try counting sheep; it’s an age-old cure and has helped many an insomniac get a good night’s sleep.

The Family Guide To Drugs And Drug Abuse

admin — Wed, 24 Mar 2010 22:36:01 +0000

If you’re a parent or young adult, you know there’s a drug problem on this planet. Whether it’s alcohol; the most abused drug, or crack cocaine; one of the most psychologically addictive and dangerous drugs, the problem affects us all.

Federal studies show that over 70 million people in U.S. households have used illegal drugs!

Drugs are responsible for a great number of the crimes committed today! Thefts, burglaries, robberies and murders a recommitted for the sole purpose of financing drug habits!

This report is presented only as a source of general information. Nothing in this report is to be considered as legal or medical advice!

Consult with legal and medical professionals for the best advice on topics covered in this report.

Parents are encouraged to add their own views and suggestions to each topic.

This report is not intended to replace a parent’s instructions to their children.

Alcohol is the most abused of all drugs! It is believed that almost three quarters of the U.S. population uses alcohol to some extent.

Alcohol enters the bloodstream quickly and affects the judgement and behavior of the user. It affects coordination and response time.

Thousands of teenagers are killed each year in alcohol-related traffic accidents!

Marijuana is the most abused of all the illegal drugs. It is normally smoked in hand-rolled cigarettes, pipes, and other suitable devices. It is also ingested by mixing in food and drink.

Marijuana is a mind-altering drug that causes a state of intoxication. It can affect thinking and judgement and can cause anxiety attacks.

Marijuana use can cause tissue damage, panic attacks, bronchitis, and changes in male hormones. It has more cancer causing chemicals than tobacco!

Marijuana is made from the leaves and flowering tops of the canabis sativa plant, which are harvested and dried. The mind-altering component of Marijuana is called THC, for short. The higher the THC content, the more potent the Marijuana.

Hashish is a resin that is extracted from the marijuana plant, and is normally smoked.

Cocaine is a white powder that is snorted, sniffed, swallowed, smoked, and injected. The most common method is sniffing or snorting.

Cocaine may be found packaged in baggies, vials, and similar containers. It is frequently layed out in “lines” on a smooth surface to be inhaled into the nose with a small tube or straw.

Cocaine use may cause runny nose, paranoia, depression, irritability, violent behavior, headaches, and trouble sleeping.

Crack is a dangerous and deadly form of cocaine. It appears on the street as small white, brown, or tan pellets, rocks, or chips. It is inhaled through a pipe or similar device and is 5 to 10 times more potent than cocaine that is snorted through the nose.

Crack provides a quick, intense, but short-lived “high”, and then results in a need for more of the drug.

Some of the effects of crack use are weight loss, hyperactivity, hoarseness and heart attack. Crack can addict the user faster than any other drug!

Inhalants such as gasoline, glue, spray paints, rubber cement, and other chemicals can cause a “high” when inhaled. They can also cause permanent damage to the nervous system, liver, kidneys, and can lead to various psychological problems.

Some athletes inject anabolic steroids in order to improve their physical ability and appearance. Steroid use can cause liver damage, testicle atrophy, aggressive behavior, high cholesterol, high risk for heart attack, enlarged prostate, baldness, depression, and other problems.

Appears intoxicated or drunk

Wears sunglasses to hide red eyes

Starts using incense or other deodorizers

The smell of Marijuana (some say it smells like burnt rope)

Presence of drug paraphernalia

Mood swings

Failing or dropping grades in school

Reports of skipping or dropping classes

Missing complete days in school

Pays less attention to responsibilities

Always needing money

Arrests or tickets for vehicle incidents

Selling personal items

Valuables missing from the home

Spending more time away from home

Wants more privacy

There are many things that could be considered signs of drug use and abuse. Some could indicate medical or other problems. Get all the facts. Consult a professional.

Aids is a disease that attacks the body’s immune system. As the disease progresses, the body becomes unable to fight off diseases such as cancer, pneumonia, and tuberculosis the way a healthy body can. The major avenues of infection with the AIDS virus are sharing needles used to inject drugs, intimate sexual relations, and receiving AIDS contaminated blood, or allowing AIDS contaminated blood or body fluids to enter your bloodstream.

There have been no reported cases of the AIDS virus being transmitted by shaking hands, hugging, or from toilet seats.

However, using alcohol or other drugs can ruin your judgement about activities that lead to AIDS!

The number of street gangs and the incidence of violence involving them is definitely on the rise. If you live in a large city, you know this already. If you live in a smaller or medium size city, you have probably read about it or are beginning to experience the problem locally.

Gangs probably formed out of the feeling for a need to band together for protection against other groups with conflicting interests or intentions.

It is generally believed that gangs are made up of members of society who fit a certain mold. People who join gangs are usually “followers” who are not able to get respect without their “gang identity”. They probably had no one in their lives to provide a positive influence on them. They were probably left home alone a lot due to various circumstances. They may have been involved in minor crimes and possibly drug use. They lack any feeling of importance or power. They have no real self-esteem. They feel there is no excitement in their lives.

Gang-related graffiti is one sure sign of the presence of or the impending emergence of gang activity in your area. Gangs mark their turf with gang symbols which can be found on building walls, fences, sidewalks, and on just about anything else in the neighborhood. These gang symbols and other markings can contain very complicated codes.

Some gangs and/or members are very well armed.

Change in attitude about society, authority, etc.

Riding around in cars filled with people.

School work suffering and class attendance dropping.

Gang graffiti near or at your home.

Use of alcohol or drugs.

Being secretive about their activities.

Wearing a different style of clothing and hanging out with others who dress the same.

Strange or threatening phone calls, possibly from rival gang members, to your home.

Tips

Drugs do absolutely NOTHING for you! Those who use or sell drugs will end up with nothing but a sick, broken body, a police record, no real job, or DEAD! You can do better than that!
Graduating from high school can make it possible for you to earn several hundred thousand dollars MORE during your working life than someone who only finished the eighth grade or dropped out of high school.
Are you thinking of being a teacher, airline pilot, nurse, doctor, lawyer, psychologist, dentist, veterinarian, optometrist, or fighter pilot? Don’t even think about dropping out. These are all college graduates.
Many jobs that only required a high school diploma a few years ago are now going to people with a college background. With so many people looking for work, employers can now pick from only the best.
Don’t pick up hypodermic needles or syringes you see on the ground or in the trash. They can carry viruses that cause diseases including hepatitis and AIDS.
Check with your police agency about Law Enforcement Exploring. You’ll have a great time and you’ll learn a lot, too. If your agency doesn’t have a post ask them to start one.
Some drugs can kill you the first time you try them!
Be very alert around strangers. The sad truth is that there are people in the world who will hurt you for no reason. Be aware of where you are and who is around you at all times.
Your mom and dad said it. Your teacher said it. Now here it is again: NEVER GET INTO A CAR WITH A STRANGER! You may never be seen again! Run away from anyone who tries to get you into a car. Scream, yell, and RUN!
You come home from school and find the door to your house open. No one is supposed to be at home. STOP right there and go to a responsible neighbor’s house, the nearest pay phone, or other location designated by your parents, and call the police! Do not go into the house! Do not walk around the house to check other windows and doors! If you walk in on a burglar, you could be injured, kidnapped, or killed! Let the police check the house!
Never tell strangers, in person or over the phone, how many people are in your family, when your mom and dad go to work or come home, or anything else that will let someone know when it’s a good time to break into your home.
Always wear a seatbelt when travelling in a car. Many accidents can injure or kill you, and many will make you crack the windshield with your face and make you ugly for the rest of your life! Or paralyzed!
Don’t let your friends talk you into doing something dangerous or against the law. Don’t ruin your day or your life on a dare. Stop and think… then decide.
Don’t play with guns! Don’t hang around someone else who is playing with a gun. Get away as fast as you can and tell your parents! Bullets can travel over a mile, and through walls, and injure or kill you!
Don’t use steroids! You don’t need them. Steroids can’t replace a hard workout!
Don’t drink. When you drink it’s hard to make the right decisions.

Vocabulary

Addictive
The property of a drug that can cause a psychological or physical dependence.
AIDS
Acquired Immune Deficiency Syndrome. A fatal disease that attacks and destroys the body’s immune system. This disease makes the body unable to fight off infections and other disease. As the condition progresses and the body becomes weaker, diseases such as cancer, tuberculosis and pneumonia take hold and cause the death of the victim. AIDS is found frequently in people who have shared needles with other people while injecting intravenous drugs.
Angel Dust
Another name for the hallucinogen PCP.
Atom Bomb
A name for the mixture of heroin and marijuana.
Barbiturates
A class of depressants often prescribed by doctors to help people sleep. Barbiturates are taken orally and are sold on the illegal drug market. Phenobarbital is a widely known barbiturate.
Clandestine (clandestine laboratories)
Describes secret, or hidden, laboratories where illegal drugs are manufactured.
Cocaine
Made from the leaf of the coca plant that is grown in South America. It stimulates the nervous system and has mind-altering effects. Cocaine can constrict the blood vessels which causes the heart to strain in order to do its work. Repeated cocaine use can cause a psychological dependence that becomes the most important thing in the user’s life. Cocaine use during pregnancy can cause miscarriages and even stillbirth.
Colors
The colored insignia, flags, bandanas, or other items that indicate specific gang or club affiliation.
Crack
A very dangerous form of cocaine that is sometimes called "rock" because it resembles small rock or stone chips, rock salt, soapchips or crystals. It is white or tan in color. It is normally smoked. Crack use can cause a very high heart rate and possible heart attack. This can happen even with the first use! It causes a very strong “high” and then a very devastating “crash”!
Crank
A name given to the mixture of cocaine and heroin that is usually injected. Since the arrival of crack, this name also applies to the mixture of crack and the smokable form of heroin. These mixtures are also known as "speedball".
Depressants
Drugs that cause a relaxing, intoxicating effect. Often called tranquilizers. Some common types are Tuinal, Seconal, Miltown, Librium, Valium, and Chloral Hydrate.
DWI
Driving while intoxicated. This is the charge filed against a person arrested for drunk driving. In many states a driver is presumed to be intoxicated to a degree where he is a danger to himself or others when his blood alcohol level is 0.10% or more. Some states call the offense DUI, or “driving under the influence”. Some states have a separate charge for driving under the influence of drugs, or DUID. Some states make no distinction.
Dusted
Under the influence of PCP. Dusting Adding PCP or other drugs to marijuana.
Ecstasy
The most popular of the "designer drugs". It is sometimes taken as an aphrodisiac, but its effects can be the opposite of what the user intended or expected. This drug can cause blurred vision, blood pressure changes, and even brain damage.
Euphoria
A feeling of well-being. In this presentation it is used to describe an effect of a particular drug.
Freebasing
A term used to describe the smoking of cocaine after its active ingredient has been separated from its salt base. It is usually smoked in water-filled pipes. Heat applied to the bowl causes the "freebase" to vaporize. There is a risk of fire during this process due to the dangerous chemicals that must be used.
Goofball
A term for the mixture of cocaine and heroin.
Hallucination
An imagined seeing of visions or hearing of sounds.
Hallucinogens PCP LSD
As the name implies, hallucinogens cause the user to experience hallucinations. All the person’s senses may become distorted and totally unreliable and unpredictable. They may lose all sense of reality.
Hashish
A dark brown, but sometimes green or black, resin that is derived from the marijuana plant. Hashish is smoked in pipes or similar devices. Hashish oil is usually smoked by putting it on regular cigarettes or marijuana cigarettes.
Herb and Al
A name for marijuana and alcohol.
Hyperactivity
Abnormally high level of activity.
Hypodermic Needle/Syringe
The syringe is a hollow barrel containing a plunger inside. It is tipped with a hollow needle. It is used to inject drugs under the skin. Hypodermic means “under the skin”.
Ice
A very dangerous, crystallized form of methamphetamine. It is believed that ICE originated in Hawaii. It looks like rock candy or rock salt. ICE is made into its solid or crystallized form by cooking it. ICE can be even more dangerous and addictive than cocaine or crack. ICE is virtually odorless when smoked.
Illicit (illicit drug use – illicit drugs)
Used in this presentation to describe the illegal use of prescription drugs or the use of illegal drugs.
Inhalants
Chemicals that are introduced into the body by breathing or inhaling them. Common inhalants are spray paints, glue, felt markers, polishes, and gasoline. These are legal, easily obtained items, but contains poisons that cause a “high” when purposely inhaled in concentrated amounts. Spray paints (gold and silver are popular) are sprayed into paper or plastic sacks. The sack is then placed over the mouth and nose and the concentrated fumes inhaled. The chemicals can also be poured or sprayed onto rags and held against the face. The effects range from lightheadedness to intoxication to coma. "Sniffing" ("huffing") causes brain damage (usually irreversible)! It also damages other vital organs such asthe liver, kidneys, and lungs.
Intoxication
Being under the influence of alcohol, drugs, or other chemical. Being drunk.
Intravenous
Injected or introduced directly into the vein.
Junkie
A person who is addicted to drugs.
Mescaline
A white, crystalline substance derived from the tops of a species of cactus. It can cause hallucinations.
Methamphetamines
The most popular stimulant. Sometimes called "speed", "uppers", "crank", or "crystal". Methamphetamines are taken due to their effect of causing increased alertness and euphoria. An overdose can cause a stroke or heart attack.
Nicotine
A very poisonous chemical found in tobacco.
Opium
A poisonous and addictive chemical derived from the poppy plant. Morphine and codeine are derived from it.
Paraphernalia (drug)
Equipment or apparatus used to assist in the smoking or injection of drugs. Syringes, needles, roach clips, spoons, etc.
Paranoia
A mental condition describing a feeling of persecution. This condition is brought on by the use of certain drugs.
PCP (Phencyclidine)
Considered to be the most dangerous of the hallucinogens. PCP has many different street names including, angel dust and supergrass. PCP was first produced as an anesthetic, but is now made only in clandestine labs.
Roach Clip
Any device used to hold the short butt (roach) of a marijuana cigarette. Small “alligator” clips are very common.
Speed
See "Methamphetamine".
Speedball
A term used for the mixture of cocaine and heroin. Since the arrival of crack, the term now more frequently applies to the mixture of crack and heroin in its smokable form.
Steroids
Drugs used to enhance physical ability, strength, and appearance of the user. It is generally thought that the hazards associated with steroid use far outweigh any possible benefit.
Stimulants
A class of drugs that causes an increase in energy, alertness, and possibly activity. Some examples are Benzedrine, Preludin, Fastin, Ritlan and amphetamines. Continued use of stimulants can cause weight loss, mood changes, tremors, and palpitations.
Tragic Magic
A term for the mixture of PCP and crack.
Zoom
A mixture of PCP and marijuana.

If you have a friend who is using drugs of any type, talk to him or her and let them know you care about what may happen to their life because of their actions.

Don’t just point your finger at them and talk down to them. Really show them you care and are willing to help them get the help they need.

But remember not to let yourself be caught in suspicious places or circumstances with someone who may have drugs on them. It is possible that you could be arrested, depending on the situation, if you are with someone who is caught with drugs!

If your friend does not listen to you, ask your parents for advice on how to handle the situation. Your parents can be your best source of guidance if you give them a chance.

Your friend may need medical attention or counselling for the problem. You can also get information and advice from your school, religious, or professional substance abuse counselors.

National Federation of Parents For A Drug-Free Youth 8730 Georgia Ave, Suite 200 Silver Springs,MD 20910

Cocaine Hotline 1-800-262-2463
Referral 1-800-544-5437

Alcoholism & Drug Abuse Help Line
ADCARE Hospital
107 Lincoln
Worcester, MA 01605
1-800-252-6465

National Clearinghouse For Drug/Alcohol Abuse Information
P.O. Box 2345
Rockville, MD 20851
1-800-729-6686

Walking and Weight Loss

admin — Wed, 24 Mar 2010 06:35:43 +0000

Three universal goals most of us share are: to live longer, to live free of illness and to control our weight. Interesting enough, normal walking lets us achieve all three. In fact, walking may be man’s best medicine for slowing the aging process.

First, it works almost every muscle in the body, improving circulation to the joints and massaging the blood vessels (keeping them more elastic).

Walking also helps us maintain both our muscle mass and metabolism as we age. It also keeps us young in spirit.

For anyone out of shape or unathletically inclined, walking is the no-stress, no-sweat answer to lifelong conditioning.

All it takes is a little time, common sense and a few guidelines. Unfortunately, there’s a lot of misinformation floating around regarding fitness walking, weight-loss and dieting.

Walking is one of the best exercise for strengthening bones, controlling weight, toning the leg muscles, maintaining good posture and improving positive self-concept.

People who diet without exercising often get fatter with time. Although your weight may initially drop while dieting, such weight loss consists mostly of water and muscle.

When the weight returns, it comes back as fat. To avoid getting fatter over time, increase your metabolism by exercising daily. To lose weight, it’s more important to walk for time than speed. Walking at a moderate pace yields longer workouts with less soreness leading to more miles and more calories spent on a regular basis.

High-intensity walks on alternate days help condition one’s system. But in a waking, weightloss program, it’s better to be active every day. This doesn’t require walking an hour every day. The key is leading an active life-style 365 days a year.

When it comes to good health and weight loss, exercise and diet are interrelated. Exercising without maintaining a balanced diet is no more beneficial than dieting while remaining inactive. The national research council recommends eating five or more servings of fruits and vegetables a day.

Fruits and vegetables are the ideal diet foods for several reasons. They’re relatively low in fat and calories, yet are often high in fiber and rich in essential vitamins and minerals.

Remember that rapid weight-loss consists mostly of water and muscle the wrong kind of weight to lose. To avoid this, set more reasonable goals, such as one pound per week. Carbohydrates are high-octane fuel. They provide energy for movement and help raise internal body metabolism.

They’re also satisfying. The key is not adding high-fat toppings to your carbohydrates. It’s everyday habits which define our weight and body composition. A three-minute walk after each meal is worth four pounds less body fat annually. Two flights of stairs a day burns off half a pound of body fat in a year.

On the other hand, one candy bar eaten daily will cost you 20 pounds annually.

Sensible Diet Tips

admin — Wed, 24 Mar 2010 03:23:51 +0000

Start your diet with a food diary, record everything you eat, what you were doing at the time, and how you felt. That tells you about yourself, your temptation, the emotional states that encourage you to snack and may help you lose once you see how much you eat.

Instead of eating the forbidden piece of candy, brush your teeth.
If you’re about to cheat, allow yourself a treat, then eat only half a bite and throw the other half away.
When hunger hits, wait 10 minutes before eating and see if it passes.
Set attainable goals. Don’t say, “I want to lose 50 pounds.” Say, “I want to lose 5 pounds a month.”
Get enough sleep but not too much.
Try to avoid sugar.
Highly sweetened foods tend to make you crave more.
Drink six to eight glasses of water a day
Water itself helps cut down on water retention because it acts as a diuretic. Taken before meals, it dulls the appetite by giving you that “full feeling.” Diet with a buddy. Support groups are important, and caring people can help one another succeed. Start your own, even with just one other person.
Substitute activity for eating.
When the cravings hit, go to the “Y” or health club if possible; or dust, or walk around the block. This is especially helpful if you eat out of anger.

If the pie on the counter is just too great a temptation and you don’t want to throw it away, freeze it. If you’re a late-night eater, have a carbohydrate, such as a slice of bread of a cracker, before bedtime to cut down on cravings. Keep an orange slice or a glass of water by your bed to quiet the hunger pangs that wake you up.
If you use food as a reward, establish a new reward system.
Buy yourself a non-edible reward. Write down everything you eat everything – including what you taste when you cook. If you monitor what you eat, you can’t go off your diet.
Weigh yourself once a week at the same time.
Your weight fluctuates constantly and you can weigh more at night than you did in the morning, a downer if you stuck to your diet all day. Make dining an event. East from your own special plate, on your own special placemat, and borrow the Japanese art of food arranging to make your meal, no matter how meager, look lovely. This is a trick that helps chronic over-eaters and bingers pay attention to their food instead of consuming it unconsciously.
Don’t shop when you’re hungry. You’ll only buy more fattening food.
Avoid finger foods that are easy to eat in large amounts.
Avoid consuming large quantities of fattening liquids, which are so easy to overdo. And this includes alcoholic beverages.
Keep plenty of crunchy foods like raw vegetables and air-popped fat-free popcorn on hand. They’re high in fiber, satisfying and filling.
Leave something on your plate, even if you are a charter member of the Clean The Plate Club. It’s a good sign that you can stop eating when you want to, not just when your plate is empty.
Lose weight for yourself, not to please your husband, your parents or your friends.
Make the kitchen off-limits at any time other than mealtime.
Always eat at the table, never in front of the TV set or with the radio on.
Concentrate on eating every mouthful slowly and savoring each morsel.
Chew everything from 10 to 20 times and count! Never skip meals.

Leukoplakia of the Anal Verge with Bleeding Hemorrhoids – A Case Report

admin — Thu, 07 Jan 2010 17:16:05 +0000

Pravin J Gupta
Clinical Head
Nagpur, India

Case Report

On 14^th August 2002, a 46-year- old male, an office clerk, reported with bleeding and prolapse per rectum for since 6 months, however without any complaint of any pain, pruritus or discharge per anus.

Upon anal and intra anal examination a circumferential area of thickening and whitish discoloration of the anal verge, which was extending up to the dentate line, was found. Perianal skin was macerated, excoriated and thickened, suggestive of leukoplakia.

The patient gave no history of previous anal surgery, homosexual contact or exposure to radiation. He had been using various hemorrhoids ointments in and around the anus for the last four months. The test for HIV virus was negative.

The hemorrhoids were ablated using a Ellman radiowave generator [Ellman International Inc., Oceanside, NY, USA] under local anesthesia with the patient in a lithotomy position. A biopsy was taken from the anal verge and the patient was discharged after 2 hours. He was asked to return after 4 weeks.

The microscopic picture of the biopsied anal skin showed pronounced cornification of the anoderm. Acanthosis was prominent, but rete cells were orderly and the basal layer was well defined. The dermis showed profuse chronic inflammation, with lymphocytes, plasma cells and large mononuclear cells in the papillary layer.

At the 4 week follow-up, the patient was asymptomatic, the biopsy wound was healed and the hemorrhoids were not visible. The patient was asked to report each year or earlier if symptoms appeared. At the last follow-up in October 2007, the patient had no specific anal symptoms except occasional Dyschezia. The leukoplakic area remained unchanged.

Discussion

Leukoplakic lesions are most commonly seen in the oral cavity, more frequently in men than in women at that site. They are somewhat less common on the vulva. The bladder, kidney pelvis, ureters, larynx, esophagus, cervix and glans penis are occasionally involved.

Extensions of primary vulvar leukoplakic lesions with involvement of the perineum and perianal skin have been described in literature.

Primary leukoplakia on the anoderm of the anal canal has been occasionally reported. The lesions developed on the so-called “mucosa” or anoderm of the anal canal, with some extension to the adjacent rectal mucosa.

Leukoplakia is considered to be a precancerous dermatosis of mucous membranes analogous to senile keratosis of exposed skin surfaces.

Several patients with carcinoma in situ had a discrete area of leukoplakia in the anal canal or a pigmented plaque of the anus and anal canal.

However, in this case, leukoplakia was absolutely innocuous with no change in the color, texture or extension of the lesion noticed over a period of five years.

The cause of leukoplakia is still controversial. Earlier investigators indicated syphilis as a prominent factor in oral lesions. Deficiencies of vitamin A, hydrochloric acid, vitamin C and estrogens have been mentioned as causative factors in vulvar leukoplakia. Excessive excretion of irritating organic urinary acids has also been considered.

Other investigators consider that prolonged local irritation from any cause, acting on a deficient, aging epithelium is a fundamental cause of this lesion.

The author considers that, probably, continuous use of hemorrhoids cream was the cause of leukoplakia in this patient. A correctly interpreted preliminary biopsy serves as a guide for a proper therapeutic approach.

Follow-up of our case shows little evidence that leukoplakia of the anal canal is premalignant, but patients should be followed carefully, since the natural history of this rare lesion remains unknown.

References

Bender MD, Lechago J. Leukoplakia of the anal canal. Am J Dig Dis. 1976;21:867-72.
Templeton JL, Brennen MD. Anal leukoplakia: management using a staged plastic procedure. J R Coll Surg Edinb. 1991;36:333-4.
Jongen J, Reh M, Bock JU, Rabenhorst G. Perianal precancerous conditions (Bowen disease, Paget disease, Carcinoma in situ, Buschke-Lowenstein tumor) Kongressbd Dtsch Ges Chir Kongr. 2001;118:79-86.
Riedler L. “Bowenoid” leukoplakia in the anal region. Klin Wochenschr. 1988;66:271-3.
Foust RL, Dean PJ, Stoler MH, Moinuddin SM. Intraepithelial neoplasia of the anal canal in hemorrhoidal tissue: a study of 19 cases. Hum Pathol. 1991;22:528-34.
Del Río M, Maturi RH, Maturi HV. Postoperative anus stricture and leukoplakia lesions. Acta Gastroenterol Latinoam. 1987;17:337-42.

Imagem em Medicina – 382 Rev Assoc Med Bras 2009; 55(4): 382-3

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Hemorrhoids – Patient Education Series

admin — Thu, 07 Jan 2010 17:09:25 +0000

What are hemorrhoids?

Hemorrhoids are enlarged veins in the area around the anus. Sometimes called “piles,” hemorrhoids may occur outside the anus and be visible (external hemorrhoids) or may occur inside the rectum (internal hemorrhoids). Sometimes, an internal hemorrhoid may protrude through the rectal opening.

Hemorrhoids can become inflamed and swollen or can develop a localized blood clot. The result is itching, pain or bleeding. These flare-ups can be caused by constipation, straining to have a bowel movement, heavy lifting or pregnancy. In most cases inflammation, swelling or blood clots resolve spontaneously in a few days.

The following suggestions will ease your discomfort and speed recovery. You’ll also find guidelines for preventing hemorrhoidal flare-up.

How do I relieve discomfort?

Avoid straining during a bowel movement
To achieve a soft stool that is easy to pass, increase the amount of fiber in your diet and drink plenty of liquids.
See the list of foods on the bottom of this post. Whole-grain cereals and bran are the richest sources of fiber, but a variety of other foods also contain it.
In addition, your medical provider may prescribe a bulk-type laxative to take once or twice a day until your discomfort is gone.
A bulk laxative draws water into the stool and forms a thick solution to soften and give volume to the stool.
Important : neither a diet with high-fiber content nor a bulk laxative will produce a soft, bulky stool unless you drink plenty of fluids preferably 2 quarts (8 glasses) a day.
Take frequent sitz baths
Soaking for 10 to 15 minutes in a hot bath about 110 degrees Fahrenheit 2 to 3 times a day provides some relief of pain and itching.
Apply compresses soaked in witch hazel
Many people find witch hazel soothing.
Avoid commercial products such as Preparation H or Anusol,
because they are of no additional benefit beyond being a lubricant for easier passing of stool.
Avoid any remedy with the suffix “caine” as these may irritate the anal area.
Hydrocortisone 1% cream can help reduce the local inflammation.
Avoid sitting or standing for long periods.
Lie down frequently until the pain, itching and/or bleeding is gone.

How do I prevent future discomfort?

Eat at regular hours and establish a regular time for bowel movements
Go to the toilet when you have the urge, never delay.
Avoid prolonging time spent on the toilet
Sitting on the toilet for long periods, or straining to produce a stool can aggravate hemorrhoids or produce fissures (cracks in the skin) surrounding the anus.
Clean the anal area after each bowel movement by washing with a warm, soapy cloth or cotton, and then rinsing the area. Avoid using toilet paper. Tucks pads are gentle and a convenient method for wiping.
Eat a diet high in fiber content to achieve soft, bulky stools that do not irritate the rectum or necessitate straining. The list of foods will help you modify your present diet as necessary. Remember to drink plenty of fluids.
Avoid heavy lifting.
Exercise daily to help relieve some of the pressure on the hemorrhoidal veins caused by prolonged standing or sitting.
Schedule 2 to 3 periods of relaxation daily, lying down for 5 to 10 minutes.

Foods to include on a high-fiber diet:

Vegetables :
- Asparagus
- Beans and lentils, all varieties
- Beets
- Broccoli
- Brussel sprouts
- Cabbage
- Carrots*
- Cauliflower*
- Celery*
- Corn
- Cucumber, with skin
- Eggplant
- Endive
- Greens, all varieties
- Kohlrabi
- Lettuce
- Mushrooms
- Okra
- Onions
- Parsnips
- Peas, all varieties
- Peppers*
- Potatoes, all varieties with skin
- Radishes
- Rhubarb
- Sauerkraut
- Spinach*
- Squash
- Tomatoes*
- Turnips
- Watercress
(*eat raw or undercooked)

Bread :
- Buckwheat bread
- Corn bread made with coarse ground meal
- Cracked wheat bread
- 100% Whole wheat
- Rye bread

Cereal :
- All high bran cereals: Kashi Good Friends, Fiber One
- Oat Bran (2 Tbsp daily)
- Brown rice
- Puffed wheat
- Oatmeal
- Shredded wheat
- Whole-grain cereals
- Ground flaxseed

Protein :
- Crunchy peanut butter
- Nuts
- Pumpkin seeds
- Sunflower seeds
- Include for balance, no fiber: Bacon, Ham, Beef, Chicken, Eggs, Fish, Lamb, Pork, Turkey, Veal.

Soups :
- Hearty varieties, such as: vegetable, minestrone, chowder, bean, chili.

Fruit :
- Apples*
- Apricots*
- Bananas
- Berries
- Cantaloupe
- Cherries
- Dried fruits
- Grapefruit
- Oranges
- Peaches*
- Pears*
- Pineapple
- Plums*
- Strawberries
(*eat unpeeled)

Desserts :
- Fruits, (fresh, frozen, canned)
- Fruit whips
- Ices and sherbets

Beverages :
- Fruit juices with pulp
- Include for balance, no fiber: Milk (3 to 4 cups), Water.

Source : Brown University Health Services – www.brown.edu/health

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Botanical Treatments for Hemorrhoids

admin — Thu, 07 Jan 2010 17:01:35 +0000

Botanical Treatments for Hemorrhoids
Kathy Abascal, B.S., J.D., R.H. (A.H.G.) and Eric Yarnell, N.D., R.H. (A.H.G.)

Abstract

Hemorrhoids are a very common condition. Hospitalbased proctoscopy studies show prevalence rates of hemorrhoids in up to 86 percent of patients studied with many in an asymptomatic state.

Botanicals used internally and topically can treat early stages of hemorrhoids effectively and can be used as adjuncts in more advanced stages when surgical treatments may be necessary.

The roles of butcher’s broom (Ruscus aculeatus), horse chestnut (Aesculus hippocastanum), stone root (Collinsonia canadensis), witch hazel (Hammamelis virginiana), arnica (Arnica spp.), oak (Quercus spp.), chamomile (Matricaria recutita), gotu kola (Centella asiatica), calendula(Calendula officinalis), and psyllium (Plantago ovata) in hemorrhoid treatment are discussed.

Introduction

Hemorrhoids are understudied and most likely undertreated. It is estimated that about one half of all Americans have some discomfort from hemorrhoids by the time they are 50 but only a much smaller percentage (approximately 4 percent) seek medical treatment for the condition.

Hospital-based proctoscopy studies show prevalence rates of up to 86 percent with many patients in an asymptomatic state.

Clinical experience suggests that botanical treatments and lifestyle changes can relieve hemorrhoid symptoms in the early stages and can provide significant benefit as adjunct treatment in the later stages of the ailment.

Unfortunately, science has barely begun investigating these fairly ancient treatments. Hemorrhoidal tissues, cushions of tissue within the anal canal that contain blood vessels and supporting tissue made up of muscle and elastic tissue, are present in all individuals.

There are usually three major hemorrhoidal cushions oriented to the right posterior, right anterior, and left lateral positions. There is a rich network of arteries around the anal canal, providing a ready supply of arterial blood to hemorrhoidal blood vessels. It is only when these cushions enlarge causing negative symptoms that “hemorrhoids” in the vernacular sense are present.

Negative symptoms typically include the passage of bright red blood that can occasionally be severe and result in anemia. If the hemorrhoid originates at the top of the anal canal, it is referred to as an internal hemorrhoid. If it originates at the lower end of the canal, near the anus, it is referred to as an external hemorrhoid.

Internal hemorrhoids are usually painless (because this area of the body lacks pain receptors) but they may bleed when they are irritated and, if large enough, may protrude from the rectum and cause discomfort.

Untreated internal hemorrhoids can lead to prolapse, in which the distended internal hemorrhoids are pushed outside of the anus. If the sphincter spasms, the blood supply to the prolapsed hemorrhoid can be cut off, leading to a strangulated hemorrhoid.

External hemorrhoids occur outside the anal verge. They can be painful, swollen, and irritated. Itching can result from external hemorrhoids although, typically, itching is most commonly caused by skin irritation.

The stages of internal hemorrhoids are shown in Table 1. Obviously, pain, bleeding, and problems with passing stool can be caused by conditions other than hemorrhoids. This article presupposes that such conditions have been ruled out before any treatment for hemorrhoids is undertaken.

The actual cause of hemorrhoids is not known. Genetic predisposition, straining during bowel movements, obesity, a sedentary lifestyle, pressure on the rectal veins caused by poor posture and/or muscle tone, and pregnancy are believed to be causes.

Hemorrhoids are common in patients with spinal-cord injuries. Constipation, chronic diarrhea, poor bathroom habits (such as overzealous cleaning and wiping), postponing bowel movements, and a fiber-poor diet are also considered to be contributing causes. Alcoholic cirrhosis or other causes of portal obstruction can cause severe hemorrhoids.

Internal Botanical Treatments

Botanical treatments for hemorrhoids have been poorly researched. Butcher’s broom and horse chestnut are two herbs that have some scientific validation of benefit in hemorrhoids but have both been better studied in chronic vascular insufficiency (CVI) where they have more substantial evidence of benefit.

Butcher’s Broom

Butcher’s broom is a prickly, small berry producing shrub in the Liliaceae family. Its Latin name (Ruscus) is believed to come from the Anglo Saxon word for holly or box because the plant has a pointed leaf shape similar to holly leaves.

The herb’s common name derives from its use by butchers to clean meat stalls and keep flies away. The whole plant contains steroidal saponins and ruscinogens the compounds deemed to be most active but only the dried rhizomes are used medicinally.

Butcher’s broom is typically administered in capsule form, and is frequently paired with trimethylhesperidin chalcone (a flavonoid complex) and ascorbic acid.* However, the plant is also available as an alcoholic extract and a tea.

There are also numerous topical preparations often combining butcher’s broom with sweet clover (Melilotus spp.). Butcher’s broom has a long history of clinical use as a treatment for hemorrhoids, and its use for treating this condition has been approved by the German Commission E.

In one open-label multicenter study of 124 patients, 69 percent of the patients rated butcher’s broom as having good or excellent efficacy. Seventy-five (75) percent of the treating physicians rated this herb’s efficacy similarly. In addition, 92 percent of the physicians rated butcher’s broom as safe and well-tolerated.

For this study, patients took 6 capsules per day of a product containing 150 mg of butcher’s broom for 3 days and then reduced their dose to 4 capsules per day. Statistically significant improvement in a variety of symptoms (such as pain, local signs, overall severity, etc.) was seen after 7 days of treatment.

While a single study does not prove efficacy, the very favorable observations of treating physicians combined with a long history of clinical use are reasons to recommend that patients consider using butcher’s broom as an internal treatment for hemorrhoids.

Butcher’s broom has been studied for use in pregnancy-related varicosities. Two studies on pregnancy related venous insufficiency both showed improvement in maternal symptoms without any negative effects on the fetus. Two additional European studies, one a multicenter study of 124 patients, showed a similar reduction of symptoms in pregnant women.

These studies do not establish the safety of ruscus in pregnancy conclusively but both animal and human studies indicate that ruscus has a high degree of safety. Based on these studies, we favor butcher’s broom when an internal remedy is needed for treating hemorrhoids in pregnant women (when surgical treatments are often contraindicated).

In most clinical studies using this herb, the researchers gave the subjects 150 mg of butcher’ broom, 3 times per day with meals; the typical alcoholic tincture dose is 30–60 drops (1.5–3.0 mL) 3 times per day.

Table 1. Staging of Internal Hemorrhoids

Stage I
Occasional discomfort and/or bleeding but no obvious external abnormality.

Stage II
Hemorrhoids protrude with defecation but reduce spontaneously.

Stage III
Hemorrhoids protrude and require digital reduction.

Stage IV
Hemorrhoids protrude and cannot be reduced.

Adapted from Anonymous. American Gastroenterological Association medical position statement: Diagnosis and treatment of hemorrhoids. Gastroenterol 2004;126:1461–1462.

Horse Chestnut

Horse chestnut is a beautiful deciduous tree that produces large chestnut-like seeds that are dried for medicinal use. The seeds contain a complex mixture of triterpene saponins collectively referred to as escins (or as aescins). It also contains flavonoids and tannins.

The German Commission E has approved the use of a standardized horse chestnut extract (containing 16–20 percent anhydrous escin) for treating chronic venous insufficiency (CVI).

Horse chestnut is the most widely prescribed oral remedy for venous edema in Germany. Although widely used in Europe, the herb’s popularity as a remedy in the United State is fairly recent.

There are some 20 clinical trials on horse chestnut and CVI, all of which demonstrated a positive effect. In these studies, the herb’s adverse effects were mild and infrequent and it was found to be as effective as rutoside, another common treatment for CVI in Europe.

There are European publications from the late 1800s and early 1900s reporting that horse chestnut benefits patients who have hemorrhoids but there are no recent studies on the use of the whole botanical medicine for treating hemorrhoids.

One doubleblinded placebo-controlled study on 80 patients suffering from acute symptomatic hemorrhoids showed that 40 mg of aescin administered three times per day, for up to 2 months, reduced symptoms in 81 percent of the subjects (compared to 11 percent in the placebo group) and a notable reduction in bleeding (95 percent versus 62 percent) and swelling (87 percent versus 38 percent) as shown via endoscopic examination.

Symptom reduction typically was reported after 6 days of treatment and improvement in the condition was shown via endoscopy after 2 weeks.

Herbalist Michael Moore, director of the Southwest School of Botanical Medicine, considers horse chestnut to be the preferred remedy for hemorrhoids in individuals who are highly active physically (Michael Moore, personal communication).

High levels of physical activity move more blood to the skeletal muscles, reducing the flow of blood to the gastrointestinal tract.

Mr. Moore says that this can lead to malabsorption, constipation, and hemorrhoids, and he has found horse chestnut combined with increased dietary flavonoids to be particularly helpful in these cases. A typical dose of horse chestnut is 250 mg (corresponding to 100 mg of escin) 2 times per day with meals.

Stone Root Many American herbalists favor stone root, a nonaromatic mint family plant, as a treatment for symptomatic hemorrhoids. The Eclectic physicians found this herb particularly useful in patients with signs of congestion (dark red or purple tissue) and hemorrhoids.

Overweight, physically inactive individuals who eat a diet high in fats and sugars and low in fruits, vegetables, and grains tend to develop this state of congestion. In our experience, stone root will often rapidly resolve hemorrhoid symptoms and we favor its use in these types of individuals.

There is virtually no research on stone root, except for constituent studies showing that it contains flavonoids and saponins. Of course, isolated flavonoids have been shown to be of benefit for patients with hemorrhoids, and both butcher’s broom and horse chestnut also contain flavonoids and saponins.

These data lend some very vague support for the use of stone root. The Eclectics used a fairly low dose of stone root (1–30 drops); presently a typical dose of stone root tincture is 2–4 mL, 3 times per day.

Witch Hazel

Witch hazel also has a long history of use as a hemorrhoid treatment. Witch hazel is a shrub or small tree indigenous to North America. The plant’s yellow flowers appear in the Fall, and the leaves and bark are harvested for medicinal use.

Both the leaves and the bark contain tannins, primarily hamamelitannins, and also contain catechins. The leaves contain more flavonoids than the roots, and both contain a small amount of volatile oil.

Today, many people think of witch hazel primarily as a topical treatment (see below). However, both European and American herbalists typically use witch hazel both as an internal and topical remedy for hemorrhoids.

Thus, both the European Scientific Cooperative on Phytotherapy and France have approved the herb’s combined use for treating hemorrhoids.

Witch hazel is frequently prescribed as a decoction or as an alcohol-preserved decoction. This makes sense as tannins are highly soluble in hot water. Witch hazel extract has produced anti-inflammatory, astringent, and vasoconstrictive properties in pharmacologic studies.

Its astringency is of help for patients with bleeding hemorrhoids, and the Eclectics favored it for such hemorrhoids as well as for any type of passive bleeding. The dose for an infusion is 2–3 g of leaf or bark steeped in 150 mL of boiled water, taken 2–3 times per day between meals. The tincture dose is 2–4 mL, 3 times per day.

Topical Treatments

Topical treatments to assist locally in calming inflammation and for stopping bleeding and swelling are highly useful in hemorrhoid treatment. According to the late Rudolf Fritz Weiss, M.D. (a German phytotherapist and medical doctor), acute hemorrhoidal inflammation is best treated with wet compresses.

In addition, ointments can be applied but he did not consider them to be sufficient if used alone. He recommended that the compresses be cool, below room temperature, but not cold because cold compresses can induce rectal spasming. Dr. Weiss recommended that the wet compresses be applied for at least 1 hour, morning and night, or that a sitz bath be used.

A hemorrhoid ointment should then be applied after each treatment and after every bowel movement. As a practical matter, only a client with severe symptoms is likely to dedicate that amount of time to treatment. Milder cases may be dealt with effectively by a shorter time for compress application and an occasional sitz bath with regular applications of ointment. Suppositories also work well.

Dr. Weiss favored arnica (Arnica spp.) compresses, which he considered to be one of the fastest remedies for acute hemorrhoid inflammation. He recommended using 1–2 teaspoons of arnica tincture per half-liter of water for compresses.

Alternatively, he recommended the use of an oak bark decoction or a chamomile infusion. He typically followed the application of compresses with a witch hazel ointment.

Topical application of witch hazel alone will often suffice to soothe minor symptoms of acute inflammation. No doubt its effectiveness explains why witch hazel remains a common ingredient in over-the-counter hemorrhoidal preparations.

Preparation H® Hemorrhoidal Cooling Gel (Wyeth, Madison, New Jersey) for instance, contains 50 percent witch hazel. It is witch hazel’s tannins that provide many aspects of its healing power, and the clear witch hazel distillate so readily available over the counter is not the medicine of choice because it is almost completely devoid of tannins.

Instead, a more colorful tea or tincture should be used. We tend to prefer combining several herbs in the compresses, sitz baths, or ointments to provide a broader range of actions. Any of the herbs used internally (stone root, butcher’s broom, horse chestnut, and witch hazel) can be combined effectively for topical application.

We also like to include herbs that are noted for their wound-healing properties, such as gotu kola, chamomile, or calendula. If needed, tinctures of these herbs can be worked into a cream base for topical application.

The Broader View of Hemorrhoid Treatment

Addressing hemorrhoids should go beyond simply prescribing the botanicals discussed above. Dietary issues, while beyond the scope of this article, are of great importance. Surprisingly little research has been done on the connection between diet and hemorrhoids given the prevalence of the disorder and the fact that isolated flavonoids have shown substantial benefit in the treatment of hemorrhoids.

Studies on fiber and hemorrhoids have focused on the effect of soluble fiber; adding soluble fiber has shown benefit in hemorrhoid treatment, at least when constipation is an aggravating factor.

As a general rule, we consistently recommend that our clients increase their intake of fruits and vegetables, with an emphasis on foods containing soluble fiber. When constipation is an issue, we often recommend psyllium seed husks. Lifestyle changes that include increasing water intake and exercise to increase muscle tone also help effect a long-term reduction of hemorrhoid symptoms.

As mentioned above, using botanicals both internally and topically will speed healing. Botanicals such as gotu kola or ginkgo (Ginkgo biloba), used to increase peripheral circulation, can act synergistically with herbs used specifically for treating hemorrhoids.

For instance, gotu kola and its isolated triterpenic fraction improve microcirculation, decrease capillary permeability, and reduce symptoms of CVI. The herb also has been shown to increase tensile strength, collagen content, and epithelialization in many types of wounds when used internally or topically.

Dr. Weiss commented that it is important to address adequately the constipation and pain that accompanies many hemorrhoids as well. He typically prescribed a tea that combined laxative, anti-inflammatory, and antispasmodic herbs with a bitter herb to tone the plexus hemorrhoidalis and an astringent to relieve bleeding.

One of his tea formulas is in the box entitled Dr. Rudolf Fritz Weiss’ Hemorrhoid Tea. A comprehensive treatment plan will work effectively on hemorrhoids in the early stages. More complicated or advanced hemorrhoids are likely to require allopathic intervention.

Nonetheless, botanicals as an adjunct to ligation and surgery will be helpful for healing and preventing recurrences.

References

Online document at: www.answers.com/main/ntquery?tname=hemorrhoid Accessed September 2005.
Madoff RD, Fleshman JW. American Gastroenterological Association technical review on the diagnosis and treatment of hemorrhoids. Gastroenterol 2004;126:1463–1473.
Yarnell E. Naturopathic Gastroenterology. Wenatchee, WA: Healing Mountain Publishing, 2000.
Abascal K, Yarnell E. Butcher’s broom: Herb’s potential too often swept under the rug. Alt Comp Ther 2002;8:177–186.
Bennani A, Biadillah MC, Cherkaoui A, et al. Acute attack of hemorrhoids: Efficacy of Cyclo 3 Forte® based on results in 124 cases reported by specialists. Phlebologie 1999;52:89–93.
Berg D. First results with Ruscus extract in the treatment of pregnancy related varicose veins. In: Vanhoutte PM, ed. Return Circulation and Norepinephrine. Paris: John Libbey Eurotext, 1991:55–61.
Baudet JH, Collet D, Aubard Y, Renaudie P. Therapeutic test of Ruscus extract in pregnant women: Evaluation of the fetal tolerance applying the pulse Doppler’s method of the cord. In: Vanhoutte PM, ed. Return Circulation and Norepinephrine. Paris: John Libbey Eurotext, 1991:63–71.
Schroder EA. Phlebodril-Creme in pregnancy-related varicose veins [in German]. Extracta Gynaecologica 1985; 9:151–172.
Leutenegger S, Martinaggi P. Cyclo 3 Fort® and pregnancy [in French]. Gazette Medicale 1988;95:33–36.
Moore M. Herbal Materia Medica. Bisbee, AZ, Southwest School of Botanical Medicine, 2004.
Blumenthal M. The ABC Clinical Guide to Herbs. Austin, TX: American Botanical Council, 2003.
Blumenthal M, Goldberg A, Brinckmann J. Herbal Medicine: The Expanded Commission E Monographs. Newton MA: Integrative Medicine Communications, 2000.
Sirtori CR. Aescin: Pharmacology, pharmacokinetics and therapeutic profile. Pharmacol Res 2001;44:183–193.
Felter HW. The Eclectic Materia Medica. Sandy, OR: Eclectic Medical Publications, 1994.
Stevens JF, Ivancic M, Deinzer ML, Wollenweber E. A novel 2-hydroxyflavanone from Collinsonia canadensis. J Nat Prod 1999;62:392–394.
Joshi BS, Moore KM, Pelletier SW, et al. Saponins from Collinsonia canadensis. J Nat Prod 1992;55:1468–1476.
MacKay D. Hemorrhoids and varicose veins: A review of treatment options. Alt Med Rev 2001;6:126–140.
Weiss RF. Weiss’s Herbal Medicine, classic ed. Stuttgart: Thieme, 2001.
Bruhl W, Schmauz R. Injection sclerotherapy and a bulk laxative in the treatment of bleeding grade 1 hemorrhoids. Coloproctology 2000;22:211–217.
Morgan M, Bone K. Professional review: Horse chestnut [review]. Med Herb 1998;65:1–4
Cesarone MR, Incandela L, De Sanctis MT, et al. Evaluation of treatment of diabetic microangiopathy with total triterpenic fraction of Centella asiatica: A clinical prospective randomized trial with a microcirculatory model. Angiology 2001; 52(10[suppl2]):S49–S54.
Cesarone MR, Laurora G, De Sanctis MT, et al. Microcirculatory activity of Centella asiatica in venous insufficiency: A double-blind study [in Italian]. Minerva Cardioangiol 1994;42:299–304.
Bonte F, Dumas M, Chaudagne C, et al. Asiaticoside and madecassoside activity on human fibroblast type I and III collagen secretion [in French]. Ann Pharm Fr 1995;53:38–42.
Maquart FX, Bellon G, Gillery P, et al. Stimulation of collagen synthesis in fibroblast cultures by a triterpene extracted from Centella asiatica. Connect Tissue Res 1990;24:107–120.
Maquart FX, Chastang F, Simeon A, et al. Triterpenes from Centella asiatica stimulate extracellular matrix accumulation in rat experimental wounds. Eur J Dermatol 1999;9:289–296.

Kathy Abascal, B.S., J.D., R.H. (A.H.G.), is executive director of the Botanical Medicine Academy, Vashon, Washington.

Eric Yarnell, N.D., R.H. (A.H.G.), is president of the Botanical Medicine Academy, a specialty board for using medicinal herbs, and is an adjunct faculty member at Bastyr University, Kenmore, Washington.

To order reprints of this article, write to or call: Karen Ballen, ALTERNATIVE & COMPLEMENTARY THERAPIES, Mary Ann Liebert, Inc., 140 Huguenot Street, 3rd Floor, New Rochelle NY 10801, (914) 740-2100.

When to Contact a Physician for Hemorrhoid Symptoms

admin — Tue, 22 Dec 2009 07:00:30 +0000

A variety of problems may be mistaken for hemorrhoids. These include benign tumors called polyps, cancerous tumors, slit-like breaks in the skin (fissures), venereal warts, infection of an anal valve (sphincter), or other infection that leads to abscess.

These problems can produce the same symptoms as hemorrhoids. Therefore, a physician should be contacted when there is any question as to the cause of symptoms.

A physician also should be contacted if hemorrhoidal symptoms are relieved in seven or fewer days with self-care and self-medication, if pain is severe, or if bleeding is noticed. Also consider contacting a physician if any of the following is apparent:

Abscess: painful swelling caused by infection (often produces pus).
Seepage: passing of mucus or fecal material due to inability of the anal sphincter to close completely.
Prolapse with strangulation: an internal hemorrhoid (in rectum) descending through the anal sphincter with blood supply cut off.
Painful defecation: severe or persistent pain occurring with defecation.

Hemorrhoids are composed of masses of blood vessels and other tissues in the area of the anus and rectum. Itching, burning, discomfort, swelling, inflammation, and pain can occur with “piles” the common name for hemorrhoids.

Although these symptoms often can be relieved with self-care and nonprescription medicines, a physician’s advice is needed for some hemorrhoid symptoms and for problems resembling hemorrhoids.

Hemorrhoids are most likely to occur between the ages of 20 to 50, but can appear at other times. Some authorities believe that heredity plays a role in hemorrhoid development. Most experts agree that occupations involving either prolonged sitting or standing can contribute to hemorrhoids, as can a lowfiber diet or a diet with insufficient fluids.

Any activity that increases pressure on the blood vessels in the anorectal area can lead to hemorrhoids (e.g. exertion, constipation, diarrhea, coughing, or sneezing). Pregnancy is a common cause of hemorrhoids and they can be aggravated by labor.

Avoiding circumstances that increase pressure in the blood vessels of the anorectal area could prevent hemorrhoids or reduce the intensity of symptoms. Constipation should be avoided. Consuming a high-fiber diet (vegetables, fruits, and whole grains) and drinking plenty of fluids (several glasses daily) is helpful.

Daily use of a bulk-forming laxative product can add needed fiber to the diet. Try to avoid prolonged sitting or standing and activities that involve excessive exertion and straining.

Keeping the anal area clean can relieve itching and other symptoms. Soap and water are excellent. Commercial wipes (available at pharmacies) are a convenient away from home alternative. Sitz baths (sitting in warm water) can relieve many symptoms.

Several non-prescription products are available for relieving the many symptoms of hemorrhoids. Some authorities recommend ointment-type products (including creams and gels) over suppositories. Pile-pipes are useful to place ointments inside the anorectal opening. A product should be selected based on one’s specific symptoms. Knowledge of various ingredients is a must. Ask your pharmacist to recommend a product that is just right for you.

Itching, burning, and pain: Anesthetics such as benzocaine and pramoxine help relieve these frequently experienced hemorrhoids symptoms. The local anesthetics in some hemorrhoid preparations have not been proven to be effective.

Inflammation: Hydrocortisone cream and ointment in 1% and lesser strength is now available for reducing rectal itching. Such preparations also may relieve some of the inflammation (redness and burning) that often occurs with hemorrhoids.

Swelling: Several hemorrhoid preparations contain vasoconstrictors such as ephedrine, epinephrine, and phenlyephrine. There is some controversy as to whether or not these agents reduce swollen hemorrhoids or provide any special benefit. Although vasoconstrictors may reduce or check bleeding, this symptom requires evaluation by a physician and generally should be treated with non-prescriptive products.

Wound healing: Some hemorrhoid preparations contain a variety of ingredients, which may be promoted as useful in wound healing. These include skin respiratory factor or SRF, a yeast extract, cod liver oil, Peruvian balsam, shark liver oil, vitamin A, and vitamin D. According to an American Pharmaceutical Association publication, there is no evidence that these agents are effective as wound healers.

Miscellaneous ingredients: Most hemorrhoid preparations contain oily materials to protect tissues from fecal materials as well as astringents such as zinc oxide to coagulate protein, reducing irritation and itching. Antiseptics may be included but are of questionable value because of the large number if microorganisms present in the anorectal area.

Mission Statement
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We, the University Health Services Staff of the Pat Walker Health Center, have a commitment to physical, mental, spiritual, social, and emotional health, the highest standards of quality, and appreciation of the value of each individual.

Through these endeavors we support the educational mission of the University of Arkansas and the growth of each individual.

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Relief from Common Discomforts of Pregnancy

admin — Tue, 22 Dec 2009 06:57:20 +0000

This article tells you about changes that may occur during your pregnancy. Tips are given for helping with the discomforts that may come with these changes.

REMEMBER: Contact your health care provider if you think you have a health problem or before taking any prescription drugs, over-the-counter medicines, or a home remedy.

Changes in : Skin, Breasts, Mouth, Back, Swelling and Varicose Veins, Hemorrhoids, Vaginal Discharge.

HEMORRHOIDS
Increasing pressure, poor blood flow and straining to pass bowel movements can cause hemorrhoids (enlarged veins of the rectum), which can be painful. If your hemorrhoids bleed, notify your health care provider.

TIPS

Maintain your regular bowel habits and keep the bowel movements soft by drinking plenty of water, juice and milk.
Eat foods like whole grains, raw fruits and vegetables.
Put your feet on a step stool when having a bowel movement. Breathe out while pushing.
Avoid sitting for long periods of time. Sitting on a small inner tube may help if sitting for long periods cannot be avoided.

VAGINAL DISCHARGE
During pregnancy, it may be normal to have a thick white discharge from the vagina. Contact your health care provider if you find that the discharge has changed to bloody, yellow, green, or dark color; is heavy, foamy, or causes burning and itching.

TIPS

Do not use tampons or douche while you are pregnant.
Avoid using minipads unless absolutely necessary. They may cause irritation to the vulva.
Bathe daily. Avoid perfumed soaps and bubble baths.
Wear cotton panties and loose comfortable clothing.

CHANGES IN YOUR SKIN
As the skin stretches on your belly and breasts, you may notice dark or red lines. You may notice darker skin on your face or below your belly button. You may sweat more.

TIPS

These color changes fade and sweating may lessen after the birth of your baby.

CHANGES IN YOUR BREASTS
Your breasts may become larger, firmer, and more tender. They may feel more lumpy. The nipples and the area around the nipples will be darker and the breast veins will look blue. You may also notice sticky drops of breast milk.

TIPS

When you bathe, clean your nipples with warm water only no soaps.
Dry them well.
Wear a good support bra.

CHANGES IN YOUR MOUTH
Your gums may get red and bleed. Your teeth decay more easily while you are pregnant.

TIPS

Brush and floss your teeth gently, at least twice a day.
See your dentist while you are pregnant be sure to tell him you are pregnant.

CHANGES IN YOUR BACK
During pregnancy, the uterus is growing and pulling on your back muscles. This will change how you stand. Your hip joints loosen and may become sore. This may cause a change in the way you walk and in your balance, which can lead to backaches.

TIPS
Your back may ache less if you:

Wear low-heeled shoes.
Stand or sit with a straight back.
Avoid heavy lifting. (If you have to lift something, bend at the knees rather than the waist.)

SWELLING AND VARICOSE VEINS
As your uterus gets bigger, it will cause pressure and slow down the blood return from your legs. Mild swelling is normal due to the increase of fluids in your bloodstream. Swelling that does not go away overnight or happens suddenly is not normal. If this happens, contact your health care provider.

Sometimes the leg veins get larger (varicose veins). This problem may be worse if you have been pregnant before or have a family history of varicose veins.

TIPS

Exercise – take short walks daily.
Change position frequently
Put your feet up and sit with legs uncrossed.
Avoid tight stockings, especially knee high stockings.
Support hose can be helpful if you are on your feet a lot.

DEPARTMENT OF HEALTH
State (SDCL 20-13) and Federal (Title of Civil Rights Act of 1964, the Rehabilitation Act of 1973 as amended, and the Americans With Disabilities Act of 1990) laws require that the S.D. Department of Health provide services to all persons without regard to race, color, creed, religion, sex, disability, ancestry, or national origin. 3,000 copies of this brochure were printed by the South Dakota Department of Health at a cost of $.17 per copy. 6/99 MCH-037.

Procedures for hemorrhoids

admin — Tue, 22 Dec 2009 06:54:38 +0000

Giving you the edge on healthy living, here’s mayo clinic’s medical edge.

You’ve changed your diet, tried sitz baths and medications, but still the itching, burning and bleeding of hemorrhoids is driving you nuts.

Mark Larson, M.D.
“The most common and probably most effective way to treat the hemorrhoidal tissue would be to place small rubber bands over the veins that are dilated and that causes the tissue to shrink. They’re basically strangulated and they fall off.”

It’s a procedure that mayo clinic dr. Mark Larson says can be done right in a physicians office. But sometimes, even this isn’t enough.

Dr. Larson
“Then a consultation with a colorectal or a general surgeon may be required, to actually surgically remove the hemorrhoidal veins.”

But even that is no guarantee that new hemorrhoids won’t appear. So it’s important to address the factors that are causing them in the first place.

For more information, talk to your doctor or visit mayoclinic.org. I’m Vivien Williams.

Hemorrhoids – Reducing the pain and discomfort

admin — Tue, 22 Dec 2009 06:51:49 +0000

What are hemorrhoids?
Hemorrhoids are swollen veins in your rectum or anus. The type of hemorrhoid you have depends on where it occurs.

Internal hemorrhoids involve the veins inside your rectum. You can’t feel pain on the inside of your rectum, so you may not feel pain from an internal hemorrhoid. You may get bleeding or you may feel a fullness in the rectum, like you need to have a bowel movement.

Sometimes, an internal hemorrhoid may stretch down until it bulges outside your anus. This is called a prolapsed hemorrhoid. If this happens, you may feel a pinching sensation or you may just feel a painless lump when you wipe after a bowel movement. A prolapsed hemorrhoid will go back inside your rectum on its own, or you can gently push it back inside.

Prolapsed hemorrhoids can sometimes be itchy or painful. If a blood clot forms, you may feel a very tender lump on the edge of your anus. Your hemorrhoid may crack and bleed. If your hemorrhoid bleeds, you may see bright red blood on the toilet paper when you wipe or in the toilet after a bowel movement.

Hemorrhoids that involve veins outside your anus in your skin are called external hemorrhoids. They may crack and bleed from straining or rubbing. External hemorrhoids can be itchy and painful, especially if a blood clot forms.

What causes hemorrhoids?
One of the main things that can lead to hemorrhoids is straining when you’re trying to have a bowel movement. This may happen if you’re constipated or if you have diarrhea. It may also happen if you sit on the toilet too long. When you sit on the toilet, your anus relaxes. The veins in your anus then fill with blood, which puts pressure on those veins.

Just about everyone has hemorrhoids at some time. But some things may make you more likely to get them. People whose parents had hemorrhoids may be more likely to get them. Pregnant women often get hemorrhoids because of the weight of carrying the baby and also from giving birth. Being very overweight, or standing or lifting too much can make hemorrhoids worse.

Should I see my doctor?
See your doctor if you notice bleeding to make sure the cause is hemorrhoids and not colitis, cancer or some other disease. Your doctor may be able to diagnose hemorrhoids just by examining you. An anoscopy or other test may also be needed. An anoscopy lets your doctor look into your anus with a thin tube like instrument that has a light at the end.

Preventing constipation

Include more fibre in your diet. Fibre helps soften stools. Fresh fruit, leafy vegetables, and whole-grain breads and cereals are good sources of fibre.
Avoid low-fibre foods, such as ice cream, cheese, white bread and meat.
Drink plenty of fluids (except alcohol). Eight glasses of water a day is ideal.
Exercise regularly.
Bulk-forming laxatives may be helpful. Bulkforming laxatives include bran, psyllium (some examples are Metamucil, Fibrepur, Novo-Mucilax, Prodiem [plain]) and others (an example is Fibyrax).
Avoid laxatives for more than occasional use unless they’re bulk-forming.
If you feel the need to have a bowel movement, don’t wait too long to use the bathroom. Your stool will get drier and harder the longer you wait.

What can I do about hemorrhoids?
Hemorrhoids are most often a short-term problem. Constipation is one of the main things that can lead to hemorrhoids. See the box above for some tips on preventing constipation.

In the meantime, you can follow these tips to reduce the pain caused by hemorrhoids. Although you’ll find many hemorrhoid medicines in the store, some haven’t been proven to work. And some may even be harmful if you use them too much. Talk to your family doctor about which products may be helpful for you.

Relieving the pain

Take warm soaks three or four times a day.
Clean your anus after each bowl movement by patting gently with moist toilet paper or moistened pads, such as Tucks or baby wipes. Rinsing in the shower may also be helpful. Pat, don’t wipe, your anus clean.
Use ice packs to relieve swelling.
Acetaminophen (some examples are Panadol, Tylenol), ibuprofen (some examples are Advil, Medipren, Motrin) or aspirin may help relieve pain.
Apply a cream that contains witch hazel to the area or use a numbing ointment. Creams that contain hydrocortisone can be used for itching or pain.
For very painful flare-ups, stay off your feet and in bed for a full day.
Avoid heavy lifting and straining.

Will I need surgery?
Most hemorrhoids heal on their own in a week or two. Hemorrhoids tend to come back unless you do what you can to prevent them. If yours keep causing problems, talk with your doctor about your options.

Internal hemorrhoids can also be destroyed by injection sclerotherapy infrared coagulation (injecting them with chemicals) or by electrocoagulation (burning them). Rubber band ligation can be used to treat internal hemorrhoids.

It involves placing a small rubber band around the base of the hemorrhoid. This stops the flow of blood to the area. The hemorrhoid then withers away. A hemorrhoidectomy (surgical removal of the hemorrhoids) may be needed if internal hemorrhoids are prolapsed or very large.

Painful external hemorrhoids that contain blood clots can be treated by removing the clot in a simple procedure. This works best when it’s done within the first 24 hours after the clot forms and pain starts.

Notes:
This brochure provides a general overview on this topic and may not apply to everyone. To find out if this brochure applies to you and to get more information on this subject, talk to your family doctor.

This health education material has been favorably reviewed by the Patient Education Review Committee of the College of Family Physicians of Canada.

The College of Family Physicians of Canada, one of the nation’s largest medical specialty groups, is committed to promoting and maintaining high standards for family doctors – the doctors who give ongoing, comprehensive care to people of all ages.

This patient education brochure was developed by The College of Family Physicians of Canada in cooperation with the American Academy of Family Physicians.

Health Notes from Your Family Doctor Hemorrhoids Reducing the pain and discomfort The College of Family Physicians of Canada.

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Hemorrhoid Treatment by Infrared Coagulation (IRC)

admin — Tue, 22 Dec 2009 06:49:20 +0000

It’s True
More than ten million people visit a physician in the U.S. each year with symptoms of hemorrhoids. Three out of four people will develop hemorrhoids at some time in their lives. While many people associate hemorrhoids with painful surgery, only a small percentage of patients actually require surgery. New comfortable office treatments have taken the fear out of hemorrhoids. This pamphlet has been prepared to help you understand them.

What Are Hemorrhoids and Who Gets Them?
Hemorrhoids are swelling in the rectum or anal area that may protrude through the anus on straining. They usually contain enlarged veins and are most common in people over the age of 50.

What Are The Symptoms?
Hemorrhoids can often be felt as a swelling in the area of the anus. There may be soreness, bleeding, discharge, or itching.

What Causes Hemorrhoids?
We do not know for sure, but hemorrhoids are often found in people who either sit or stand a lot or who have low fiber diets or poor bowel habits.

Are Hemorrhoids Preventable?
No one knows for sure. Avoid straining or extensive sitting on the toilet. A diet rich in fluids, fruits, vegetables and fiber is desirable. If symptoms develop, see your doctor without delay.

Are There Different Kinds of Hemorrhoids?
Yes. “Internal” hemorrhoids develop inside the anus. The most common symptoms are bleeding during bowel movements or protrusion through the anus upon straining. “External” hemorrhoids develop around the anus and can be very painful, especially if a blood clot develops within them. They can be felt as firm lump or lumps around the anus.

How Are Hemorrhoids Treated?
When treated early, hemorrhoids usually disappear within a week or two. By increasing fiber and fluids in your diet, your stool will soften thereby promoting bowel movements that are more regular. It also helps to eliminate excessive straining and to take warm baths.

Most painful external hemorrhoids will respond to rest and warm sitz baths. Within a week the pain should subside. The firm lump should completely recede within 4-6 weeks. If pain is severe, the physician may decide to make a small incision under anesthesia and remove the clot to provide immediate relief.

What is Rubber Band Ligation?
Internal hemorrhoids can be treated in the doctor’s office by ligation. A small rubber band is placed around the tissue above the hemorrhoid to cut off its blood supply. The hemorrhoid tissue and band slough off a few days later and the sore that is left will heal. This method produces mild discomfort and slight bleeding.

What is Infrared Coagulation?
Infrared Coagulation (IRC) is the most widely used office treatment for hemorrhoids and is preferred over other methods because it is fast, well tolerated by patients, and virtually pain free. A small probe contacts the area above the hemorrhoid, exposing the tissue to a burst of infrared light for about one second. This coagulates the veins above the hemorrhoid causing it to shrink and recede. The patient may feel a sensation of heat very briefly, but it is generally not painful. Therefore anesthetic is usually not required.

Are There Any After Effects?
Generally not. Most patients return to a normal lifestyle the same day. There may be slight spot bleeding a few days later. Heavy straining or lifting should be avoided and aspirin should not be taken for a few days.

How Many Visits Are Required?
Many patients have more than one hemorrhoid. Therefore, most physicians recommend two or three visits at twoweek intervals, treating a different portion of the hemorrhoid tissue each visit.

Will The Hemorrhoids Come Back?
Millions of patients have been treated with IRC. Experience tells us that hemorrhoids treated with IRC generally do hot recur. A sensible diet, moderate exercise, and proper bowel habits will also help.

Our team of specialists includes:

Board Certified Physician
Board Certified Nurse Practitioner.

Obtaining an Appointment

You may first be seen by one of our providers
at SCIM and be referred.
You may be referred by another physician.
Self-referral is optional.
Call and set up your appointment today!

“I can’t believe we had our procedure yesterday”

South Carolina Internal Medicine 1 Wellness Boulevard, Suite 200 Irmo, SC 29063 803.749.1111 fax 803.749.0050. Carlotta M. Davis, APRN, CDE

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Health Education, Healthy Living Hemorrhoids (Kaiser Permanente)

admin — Tue, 22 Dec 2009 06:46:20 +0000

Hemorrhoids
Hemorrhoids are enlarged and inflamed veins that may develop either inside or outside the anal canal. These veins can become enlarged and inflamed when we strain to pass hard, compacted stools.

Prolonged sitting or standing, or being overweight or pregnant, can also cause hemorrhoids.

The symptoms of hemorrhoids include:

Bright red streaks of blood on stools or spurting from the anus.
Leakage of mucus from the anus.
Irritation or itching around the anus.

Sometimes an internal hemorrhoid will actually stick out of the anus, and it may have to be pushed back into place with a finger. Although they can cause discomfort, hemorrhoids do not usually cause severe pain unless a blood clot forms in a hemorrhoid.

A clotted hemorrhoid can be extremely painful, but is not dangerous. While itching around the anus can be a symptom of hemorrhoids, anal itching is usually caused by other conditions.

If the anus is not kept clean, itching may result. Any fecal seepage that comes with diarrhea can irritate the skin around the anus. Trying to keep the area too clean by rubbing with dry toilet paper or using excess soap can also injure the skin.

While it is important to keep the skin in the anal area clean, it is also important to be gentle when doing so. Although uncomfortable at times, hemorrhoids rarely pose a serious health problem. They generally last several days and often come back (recur).

Nearly everyone, in fact, has hemorrhoids at some time. There are, however, steps you can take to reduce your discomfort from hemorrhoids and help prevent their recurring.

How to prevent hemorrhoids

Try to keep your stools soft
Be sure to include plenty of water, fresh fruits, vegetables, and whole grains in your diet. Add two tablespoons of bran or a commercial fiber product such as Citrucel or Metamucil to your diet each day.
Avoid using laxatives, because they may cause diarrhea which can irritate hemorrhoids
For information about constipation, check your Kaiser Permanente Healthwise Handbook or search online at kp.org.
Try to exercise every day to promote smooth bowel movements.
Avoid sitting or standing too much
This restricts blood flow around the anus. Take short walks to increase blood flow in your pelvic region.
Go to the bathroom as soon as you have the urge
Try not to strain during bowel movements. Remember to take your time and never hold your breath.
If you are pregnant, try sleeping on your side to relieve the pressure on your pelvic area.
Keep your anal area clean
More importantly, be gentle when cleaning yourself.

Home treatment

Taking warm baths can be soothing and cleansing, especially after a bowel movement.
Try using pre-moistened tissues (baby wipes) or moistened toilet paper instead of dry toilet paper.
Wear cotton underwear and loose clothing.
Relieve itching by using cold compresses on the anus four times a day, ten minutes at a time.
Sitz baths (hot baths with just enough water to cover the anal area) can be soothing, but may worsen itching.
Use medicated suppositories to relieve pain and lubricate the anal canal during a bowel movement.
Ease itching and irritation with zinc oxide, petroleum jelly, or hydrocortisone (1 percent) cream.
Ask your physician before using any product that contains a local anesthetic. These products have the suffix “-caine” in the name of the product or in the name of one of the ingredients. Such products can cause allergic reactions in some people.

Call Kaiser Permanente if:

Any bleeding continues for longer than one week despite home treatment.
Pain is severe or lasts longer than one week after home treatment.
Bleeding occurs for no apparent reason and is not associated with straining to pass stools.
A lump on the anus is increasing in size or becoming more painful and you develop a fever.
Fever accompanies bloody stools.
Stools become more narrow than usual (maybe no wider than a pencil).
Any unusual material or tissue seeps or sticks out of the anus.

Other resources:

Connect to our Web site at kp.org. to access health and drug encyclopedias, interactive programs, health classes, and much more.
Check your Kaiser Permanente Healthwise Handbook.
Contact your Kaiser Permanente Health Education Center or Department for health information programs, and other resources.

This information is not intended to diagnose health problems or to take the place of medical advice or care you receive from your physician or other health care professional.

If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse any brand names; any similar products may be used.

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Endoscopic hemorrhoidal sclerotherapy using 50% dextrose water a preliminary report

admin — Tue, 22 Dec 2009 06:41:42 +0000

Absract
Injection sclerotherapy has a prominent role in the treatment of bleeding hemorrhoids. The commonly used sclerosants are not available or very expensive in Nigeria. We prospectively evaluated 50% dextrose water, used as a nonallergenic sclerosant, in the treatment of bleeding internal hemorrhoids.

Forty consenting adult patients (median age 50 years [range 35–67]; 22 women) with bleeding hemorrhoids, seen over a 2-year period, were offered injection sclerotherapy with 50% dextrose water.

They were assessed for response, tolerance and complications. The duration of symptoms before presentation was 3 months to 15 years. The bleeding stopped after the injection in all patients. No patient needed a repeat procedure.

No complication was recorded during follow up which ranged from 2 months to 12 months. We conclude that endoscopic hemorrhoidal sclerotherapy using 50% dextrose water offers a simple, safe and effective modality of treatment if properly utilized.

Introduction
Bleeding from hemorrhoids is the most common anorectal disease. Historically, injection sclerotherapy has had a prominent role in the treatment of bleeding hemorrhoids.

Some of the sclerosants that have been used include Nbutylcyanoacrylate, ethanolamine oleate, 5% phenol in almond oil, sodium tetradecyl phosphate, and sodium morrhuate.

The injected sclerosant obliterates the hemorrhoid vascularity, inducing inflammation and fibrosis which fixes the hemorrhoids to the surrounding tissue and prevents prolapse. This method has, however, become unpopular because of sclerosant related morbidity which includes anorectal abscess, hepatic abscess, necrotizing fascitis, retroperitoneal sepsis, oleogranuloma (with oil-containing solutions), and pulmonary allergic reaction.

Though rare, some of these complications may be fatal. To reduce the morbidity associated with non-physiological agents, Ponsky et al. used hypertonic saline, and found good response, but no complication, in 19 patients with bleeding hemorrhoids. They concluded that non allergenic sclerosing agents may give better results with less complications.

Another physiological solution that has been used as a sclerosant is 50% dextrose water; this agent has not been used as a sclerosant for hemorrhoids.

Rubber band ligation is presently the most preferred outpatient treatment for hemorrhoids. This method of treatment may not be very useful in patient with active bleeding.

Some of the commonly used sclerosing agents are not easily available in most centers in Nigeria; hence we conducted this study to assess the efficacy of 50% dextrose water in patients with bleeding hemorrhoids.

Methods
The study was conducted at the Endoscopy Unit of our hospital which serves as the referral tertiary hospital to the rural and semi-urban agrarian communities in southwestern Nigeria, which has an estimated population of approximately 7.7 million persons.

Forty consenting consecutive patients (22 women) with bleeding hemorrhoids between January 2006 and May 2008 were recruited. Five patients with bleeding hemorrhoids who chose conservative management and one patient who opted for surgical management were excluded. Patients with significant blood loss before presentation were resuscitated.

The diagnosis of hemorrhoids was confirmed by protoscopy in all patients. Hemorrhoids were classified into four grades using the American classification. Patients above 50 years underwent colonoscopy to rule out additional sources of rectal bleeding. Patients with history of diabetes mellitus or with positive urine-reducing substances were excluded from the study.

Premedication consisted of intramuscular pentazocine (30 mg) and prophylactic antibiotic (combination of ampicillin and cloxacillin 1 g intravenous). Patients were placed in modified left lateral decubitus (Sims’ position).

All injections were done by experienced personnel. Approximately 2–5 mL of 50% dextrose water was injected into the submucosa of each hemorrhoidal bundle, at least 1 cm proximal to the dentate line, using a 20-guage spinal needle.

The injection was deep enough so as not to blanch the mucosa, but not deep enough to injure the underlying muscle. Each patient was observed for 30 minutes before being allowed to go home. Patients were asked to follow up at 1 week, 4 week and 3 months to assess for recurrence or complications.

Intraoperatively, pain assessment was done using a 4-point modified visual analogue scale where grade 1 indicated severe pain requiring conversion to general anesthesia, and grade 4 indicated no pain.

Since bleeding was the chief complaint, relief of bleeding was used as an indicator of success of treatment. The grade of the hemorrhoids, duration of symptoms, the modified visual analogue rating and outcome were recorded. Data were analyzed using SPSS version 11.0 (SPSS Institute, Chicago, IL).

Results
The median age of patients was 50 years (range 35–67 years). The median duration of symptoms before presentation was 1 year (range 3 months to 15 years). Nine (22.5%) patients had grade 1 disease, 15 (37.5%) had grade 2, 11 (27.5%) had grade, and 5 (12.5%) had grade 4 disease.

The procedure lasted for approximately 3 to 5 minutes. All patients tolerated the procedure well. Thirty five patients had grade 3 (mild) discomfort and 5 patients had no discomfort during the procedure. Bleeding stopped after the injection in all patients. No patient needed a repeat procedure.

No complication was recorded during the varying period of follow up which ranged from 2 months to 1 year and the median follow up is 10 months. Eighteen of the 31 patients with grade 2 to 4 hemorrhoids had regression of the anal protrusion.

Discussion
Bleeding is the most common complication of hemorrhoids. Occasionally the bleeding may be large in quantity. Because of the absence of social security and fear of surgery, most Nigerian patients prefer an effective procedure that will not involve the use of anesthesia and that will be inexpensive.

Injection sclerotherapy is a simple, safe and effective method for the treatment of bleeding hemorrhoids. The success rate of the procedure is close to 100%. Problems associated with injection sclerotherapy are due to the sclerosing agent used or incorrect placement.

The most common sclerosing agents used include 5% phenol in almond oil, ethanolamine oleate and sodium tetradecyl phosphate. These agents are expensive and not readily available in our environment.

They are also non physiological, toxic and allergenic. Perianal sepsis has been reported following injection sclerotherapy.

We found an impressive response in our patients after a single injection of 50% dextrose water; the bleeding stopped in all patients and no patient had recurrence of bleeding during follow up. Results obtained in the study may be due to the fact that 50% dextrose water is a physiological solution with mild sclerosing effect. This effect may be progressive over time preventing recurrence of the disease.

In addition, the anal tag associated with the disease regresses after the procedure. This may be due to
the fact that the tone of connective tissues that hold the anal cushion improved after the injection. These findings will need further evaluation in larger population and long-term follow up.

One of the major complications of various treatment modalities of hemorrhoids is pain. Pain could be very severe necessitating use of opoid analgesics. None of our patients needed an analgesic after the procedure. No complication was observed during the procedure.

We conclude that endoscopic hemorrhoidal sclerotherapy using 50% dextrose water offers a simple, safe and effective modality of treatment if properly utilized.

References

Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation. An epidemiologic study. Gastroenterology 1990;98:380–6.
Cataldo PA. Hemorrhoids. Clin Colon Rect Surg 2001;14:203–14.
Kann BR, Whitlow CB. Hemorrhoids: Diagnosis and Management. Tech Gastrointest Endosc 2004;6:6–11.
Thomson WH. Banding and injection of piles. Ann R Coll Surg Engl 2001;83:361–2.
Guy RJ, Seow-Choen F. Septic complications after treatment of haemorrhoids. Br J Surg 2003;90:147–56.
Ponsky JL, Mellinger JD, Simon IB. Endoscopic retrograde hemorrhoidal sclerotherapy using 23.4% saline: a preliminary report. Gastrointest Endosc 1991;37:155–8.
Klein RG, Eek BC, DeLong WB, Mooney V. A randomized double-blind trial of dextrose-glycerine-phenol injections for chronic, low back pain. J Spinal Disord 1993;6:23–33.
Davies RJ. Haemorrhoids. Clin Evid 2006;15:711–24.
Faponle AF, Kuti O. Perception of labour pain by pregnant women in Southwestern Nigeria. Trop J Obstet Gynaecol 2004;21:153–5.
Nisar PJ, Scholefi eld JH. Managing haemorrhoids. BMJ 2003;327:847–51.

Olusegun I. Alatise • Olu A. Arigbabu • Oladejo O. Lawal • Abdulrasheed K. Adesunkanmi •
Augustine E Agbakwuru • Denis A. Ndububa • David O. Akinola • Alatise, et al

Department of Anatomy and Cell Biology, Department of Surgery, Department of Medicine, College of Health Sciences, Obafemi Awolowo University Nigeria.
E-mail: segunalatishe@yahoo.co.uk,
Received: 28 July 2008 /
Revised: 8 November 2008 /
Accepted: 9 December 2008.
© Indian Society of Gastroenterology 2009.
Indian J Gastroenterol 2009: 28(Jan–Feb):31–32.

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American Gastroenterological Association Technical Review on the Diagnosis and Treatment of Hemorrhoids (Part 2)

admin — Tue, 22 Dec 2009 06:28:07 +0000

To read the previous post, you can click here.

H. Conclusions
Hemorrhoids are a common condition with symptoms that include bleeding, protrusion, and itching. Because other conditions can lead to identical symptoms, a directed physical examination, including anoscopy and proctosigmoidoscopy, should be performed.

Care depends on the extent of hemorrhoidal disease. First-degree hemorrhoids can be treated with medical management alone or with one of several nonoperative outpatient therapies. Second-degree and relatively small and thirddegree hemorrhoids can be treated with nonoperative therapy.

Surgery is generally reserved for the minority of patients who have large third-degree or fourth-degree hemorrhoids, acutely incarcerated and thrombosed hemorrhoids, hemorrhoids with an extensive and symptomatic external component, or patients who have undergone less aggressive therapy with poor results.

ROBERT D. MADOFF – University of Minnesota – Minneapolis, Minnesota

JAMES W. FLESHMAN – Washington University School of Medicine – St. Louis, Missouri

I. References

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Johanson JF, Sonnenberg A. Temporal changes in the occurrence of hemorrhoids in the United States and England. Dis Colon Rectum 1991;34:585–591; discussion 591–593.
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Address requests for reprints to: Chair, Clinical Practice Committee, AGA National Of.ce, c/o Membership Department, 4930 Del Ray Avenue, Bethesda, Maryland 20814. Fax: (301) 654-5920.

The Clinical Practice Committee acknowledges the following individuals whose critiques of this review paper provided valuable guidance to the authors: Jeffrey L. Barnett, M.D., Peter Carne, M.D., Gary R.Lichtenstein, M.D., and John H. Pemberton, M.D.

The authors thank Pamela Barnard, M.S.L.S., for literature search assistance, Mary E. Knatterud, Ph.D., for editorial help, and Alexandra A. Broek for help with preparation of the manuscript.

Abbreviation used in this paper: MPFF, micronized, puri.ed .avonoid fraction.
© 2004 by the American Gastroenterological Association.

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American Gastroenterological Association Technical Review on the Diagnosis and Treatment of Hemorrhoids (Part 1)

admin — Tue, 22 Dec 2009 06:05:32 +0000

This literature review and the recommendations therein were prepared for the American Gastroenterological Association Clinical Practice Committee. The paper was approved by the Committee on January 8, 2004, and by the AGA Governing Board on February 13, 2004.

Hemorrhoids are a common condition, but their true prevalence is unknown. Most patients and many physicians tend to attribute any anorectal symptom to hemorrhoids. Furthermore, anal cushions are normal structural components of the anal canal that are present from infancy.

Despite their confusing epidemiology, it is important for gastroenterologists, surgeons, and primary care physicians alike to be able to accurately diagnose hemorrhoids and offer a rational, effective treatment plan.

A. Materials and Methods
We performed a literature search for all English language articles dealing with hemorrhoids published from 1990 to 2002. Databases searched included MEDLINE, PreMEDLINE, the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effectiveness, the American College of Physicians Journal Club, and the Cochrane Central Registry of Controlled Trials.

Additional references were obtained from the bibliographies of selected articles. We selected pertinent studies emphasizing randomized controlled trials to formulate this technical review.

B. Etiology and Pathophysiology
Hemorrhoids are found in the subepithelial space of the anal canal. They consist of connective tissue cushions surrounding the direct arteriovenous communications between the terminal branches of the superior rectal arteries and the superior, inferior, and middle rectal veins.

Anal subepithelial smooth muscle arises from the conjoined longitudinal muscle layer, passes through the internal anal sphincter, and inserts into the subepithelial vascular space. There, the smooth muscle suspends and contributes to the bulk of the hemorrhoidal cushions.

The cushions contribute approximately 15%–20% of the resting anal pressure. Perhaps more importantly, they serve as a conformable plug to ensure complete closure of the anal canal. Most people have 3 of these cushions, but cadaver studies have shown that the so-called typical right anterior, right posterior, and left lateral configuration of the cushions occurs only 19% of the time.

Symptoms attributed to hemorrhoids include bleeding, protrusion, itching, and pain. For the most part, external hemorrhoids are asymptomatic unless they become thrombosed, in which case they present as an acutely painful perianal lump. Persisting skin tags after resolution of the thrombosis can lead to problems with hygiene and secondary irritation.

Most hemorrhoidal symptoms arise from enlarged internal hemorrhoids. Abnormal swelling of the anal cushions, stretching of the suspensory muscles, and dilation of the submucosal arteriovenous plexus result in the prolapse of upper anal and lower rectal tissue through the anal canal. This tissue is easily traumatized, leading to bleeding. The blood is typically bright red due to the arterial oxygen tension caused by arteriovenous communications within the anal cushions. Prolapse of the rectal mucosa leads to deposition of mucus on the perianal skin, causing itchiness and discomfort.

The pathogenesis of the enlarged, prolapsing cushions is unknown. Many clinicians believe that inadequate fiber intake, prolonged sitting on the toilet, and chronic straining at stool contribute to the development of symptomatic hemorrhoids, yet rigorous proof of such beliefs is lacking. Other factors have also been proposed, including constipation, diarrhea, pregnancy, and family history.

None of these have been rigorously proven, although 0.2% of pregnant women require urgent hemorrhoidectomy for incarcerated prolapsed hemorrhoids. Multiple studies have shown elevated anal resting pressure in patients with hemorrhoids when compared with controls voluntary contraction pressure is unchanged.

Whether the elevated resting pressure is caused by or due to enlarged hemorrhoids is unknown, but resting tone becomes normal after hemorrhoidectomy. Ultraslow pressure waves are more common in patients with hemorrhoids, but the significance of the waves is uncertain.

C. Epidemiology
The epidemiology of hemorrhoids has been studied using a number of approaches, each of which has shortcomings. Accordingly, the data must be interpreted with caution. Population-based surveys rely on self-reporting of a condition with symptoms that are nonspecific; moreover, a physician observer does not validate these supposed diagnoses.

Hospital discharge data are more reliable in this regard but still remain imperfect; it is likely that most patients with a diagnosis of hemorrhoids at discharge have not in fact undergone a directed anorectal examination. Similar criticism may be leveled at physician visit data; a complete evaluation, including anoscopy, cannot be assumed to have taken place, particularly if the data are from primary care providers.

Hospital-based proctoscopy studies show prevalence rates of up to 86%, even though many of their patients are asymptomatic. Despite these caveats, the community-wide prevalence of hemorrhoids in the United States is reported to be 4.4%, with a peak prevalence occurring between 45 and 65 years of age.

Increased prevalence rates are associated with higher socioeconomic status, but this association may reflect differences in health-seeking behavior rather than true prevalence. Population-based surveys suggest that the prevalence of hemorrhoids decreased in both the United States and United Kingdom during the second half of the 20th century. Hemorrhoids are frequently seen in patients with spinal cord injury.

D. Evaluation and Classification
For many patients, the presence of any anorectal symptom is indicative of hemorrhoids. Physicians should not make the same assumption. Hemorrhoids are, in fact, frequently the cause of common symptoms such as bleeding, a lump, itching, or pain.

However, when hemorrhoids are simply assumed to be the cause, other pathology is too often overlooked. Prolapsing hemorrhoids may cause anal itching, but itching is just as likely to be due to inadequate hygiene, minor incontinence, or perianal dermatitis.

Pain associated with a palpable lump is the hallmark of a thrombosed external hemorrhoid, but anal fissure and perianal abscess are equally common causes of anal pain and, in particular, painful defecation. A precise patient history and a careful physical examination are essential for accurate diagnosis; neither should be omitted when a patient has anorectal symptoms.

Bleeding is the most common presenting symptom of hemorrhoids. The blood is typically bright red and may frequently drip or squirt into the toilet bowl. Darker blood and blood mixed in the stool suggest a more proximal source of bleeding.

However, because physicians predictions are not reliable in the evaluation of hematochezia, exclusive reliance on patients’ descriptions of bleeding is unwise; further investigation is warranted. Current practice guidelines from both the American Society for Gastrointestinal Endoscopy and the Society for Surgery of the Alimentary Tract advocate a minimum of anoscopy and flexible sigmoidoscopy for bright-red rectal bleeding.

Complete colonic evaluation by colonoscopy or air-contrast barium enema is indicated when the bleeding is atypical for hemorrhoids, when no source is evident on anorectal examination, or when the patient has significant risk factors for colonic neoplasia. The decision to pursue further evaluation also depends on the patient’s age and general medical condition.

Hemorrhoids alone do not cause a positive result with a stool guaiac test, so fecal occult blood should not be attributed to hemorrhoids until the colon is adequately evaluated. Anemia due to hemorrhoidal disease is rare (0.5 patients/100,000 population) and responds to hemorrhoidectomy.

Because symptoms caused by other conditions are frequently attributed to hemorrhoids, a careful anorectal evaluation is warranted for any patient who reports hemorrhoids. External examination will enable the discovery of pathology such as perianal abscess or anal fistula.

The cardinal symptom of anal fissure is postdefecatory pain, but anal fissure also frequently causes minor rectal bleeding. Anal fissure is best seen with eversion of the anal canal by opposing traction with the thumbs. Any skin tags, thrombosed external hemorrhoids, mixed hemorrhoids, and incarcerated rectal mucosal prolapse will be evident on external examination. Internal hemorrhoids and associated rectal mucosal prolapse are best evaluated through an anoscope with an adequate light source.

Portal hypertension can cause varices of the anal canal. These varices are distinct from hemorrhoids and should not be considered a cause of hemorrhoids. In fact, patients with portal hypertension and varices do not have an increased incidence of hemorrhoids.

Variceal bleeding should not be considered the same as hemorrhoidal bleeding, so standard hemorrhoidal treatments should not be used. Rectal variceal bleeding is best treated by correction of the underlying portal hypertension; transjugular intrahepatic portosystemic shunts have been successfully used in the treatment of refractory bleeding.

If local therapy is necessary, oversewing of the varices rather than attempted excision is the procedure of choice. There are a few case reports of injection sclerotherapy for bleeding rectal varices, but the overall success rate of this approach is unknown.

The evaluation of patients with hemorrhoids should include an assessment of their symptoms. As mentioned previously, the presence, quantity, and frequency of bleeding are important. The presence, timing, and reducibility of prolapsed tissue help to classify the extent of the hemorrhoids and dictate therapeutic options.

The effect of the hemorrhoids on hygiene is a factor when deciding on operative treatment. Anal pain is generally not associated with hemorrhoids unless thrombosis has occurred. Thus, anal pain suggests other pathology and mandates closer investigation.

As many as 20% of patients with hemorrhoids have concomitant anal fissures. New-onset anal pain in the absence of a visible source suggests the possibility of a small intersphincteric abscess.

Hemorrhoids are defined as internal or external according to their position relative to the dentate line. External hemorrhoids become symptomatic only when thrombosed or when skin tags are so large that hygiene is impossible. Thrombosed external hemorrhoids are common. Such patients present with acute-onset anal pain and a palpable perianal lump.

Thrombosed external hemorrhoids occasionally bleed when local pressure causes erosion through the overlying skin. Thrombosed internal hemorrhoids are far less common; typical symptoms include pain, pressure, bleeding, mucus production, and an inability to reduce spontaneously prolapsing tissue.

Symptoms of internal hemorrhoids include bleeding and protrusion. Prolapsed hemorrhoids are a cause of soiling and mucus discharge, and both lead to secondary pruritus ani. Advanced prolapsed hemorrhoids may become incarcerated and strangulated.

Most colorectal surgeons use the grading system published in 1985 by Banov et al. Internal hemorrhoids that bleed but do not prolapse are designated as firstdegree hemorrhoids. Those that prolapse and reduce spontaneously (with or without bleeding) are seconddegree hemorrhoids. Prolapsed hemorrhoids that require reduction are third-degree hemorrhoids.

Prolapsed internal hemorrhoids that cannot be reduced are fourth-degree hemorrhoids; they usually include both internal and external components and are confluent from skin tag to inner anal canal. Acutely thrombosed, incarcerated internal hemorrhoids and incarcerated, thrombosed hemorrhoids involving circumferential rectal mucosal prolapse are also fourth-degree hemorrhoids.

Accurate classification is important for both assessing the reported efficacy of various hemorrhoidal treatments and selecting the optimal treatment for an individual patient. The American Society of Colon and Rectal Surgeons uses the Banov classification in its practice parameters for the treatment of hemorrhoids.

However, a descriptive system is sometimes more useful than one based on symptoms because of the range in severity within each grade. Large third-degree hemorrhoids may only be treatable with excision, for example, if they extend to the dentate line, if chronic prolapse has caused epithelial changes, or if the volume of tissue is simply too large to be managed nonoperatively. Smaller third-degree hemorrhoids, in contrast, may be readily treatable by nonoperative methods.

E. Medical Treatment
Few recent studies concern either the prevention or the medical management of hemorrhoids. The almostuniversal recommendations are to add dietary fiber and to avoid straining at stool. One double-blind, placebo-controlled trial showed that the use of psyllium reduced hemorrhoidal bleeding and painful defecation, but other studies of fiber have shown less impressive or insignificant results.

Because diarrhea exacerbates hemorrhoidal symptoms, controlling it with fiber, antimotility agents, and specific treatment of any underlying cause will likely be of benefit. Over-the-counter topical agents and suppositories have become equally ubiquitous in the empirical treatment of hemorrhoidal symptoms, but data supporting their use are lacking.

Topical analgesics may bring symptomatic relief of local pain and itching. Corticosteroid creams may ameliorate local perianal inflammation, but no data suggest that they actually reduce hemorrhoidal swelling, bleeding, or protrusion. Long-term use of highpotency corticosteroid creams is deleterious and should be avoided. In one prospective series, nitroglycerin ointment relieved pain due to thrombosed external hemorrhoids, presumably by decreasing anal tone.

Several studies have assessed the use of oral micronized, purified flavonoid fraction (MPFF) (Daflon; Servier Laboratories, Neuilly-Sur-Seine, France). Flavonoids increase venous tone, lymphatic drainage, and capillary resistance and normalize capillary permeability.

Two placebo controlled trials showed symptomatic improvement with use of MPFF, but results were inconsistent when MPFF and fiber were combined. Ho et al. reported that a combination of MPFF and fiber led to faster relief of hemorrhoidal bleeding than either fiber and rubber band ligation or fiber alone.

In contrast, Thanapong-sathorn et al. compared fiber with and without MPFF in a double-blind trial and found similar improvement at 14 days. MPFF has not been approved for use in the United States by the Food and Drug Administration.

F. Nonoperative Treatment
Several methods that do not involve surgical excision are available to treat patients with hemorrhoids. These procedures are usually performed in the office setting and do not require anesthesia. Although nonexcisional, they all function as ablative by thrombosis, sclerosis, or necrosis of the mucosal portion of the hemorrhoidal complex.

1. Sclerotherapy
Sclerotherapy is one of the oldest forms of nonoperative treatment; it was first described in 1869 by Morgan in Dublin. It is reserved for first or seconddegree hemorrhoids. A submucosal injection of 5 mL of 5% phenol in oil, 5% quinine and urea, or hypertonic (23.4%) salt solution at the base of the hemorrhoidal complex causes thrombosis of vessels, sclerosis of connective tissue, and shrinkage and fixation of overlying mucosa.

Sclerotherapy requires no anesthesia and takes only minutes to perform through an anoscope. Khoury et al. performed a prospective trial of patients with first or second-degree hemorrhoids who had initially been treated with medical therapy. In that trial, sclerotherapy improved or cured 89.9% of the patients, with no difference between single or multiple injections.

In contrast, Senapati and Nicholls performed a randomized controlled trial and found no difference in bleeding rates at 6 months following sclerotherapy with bulk laxatives or bulk laxatives alone.

Even though sclerotherapy is minimally invasive, it can cause complications. Pain is variably reported in 12%–70% of patients. Impotence, urinary retention, and abscess have also been reported. In one study, hemorrhoidal symptoms recurred in about 30% of patients 4 years after initially successful sclerotherapy.

2. Cryotherapy
Cryotherapy has been advocated as a technique for destroying enlarged internal hemorrhoids. Initial reports were enthusiastic; however, the technique is relatively time consuming, and subsequent reports have shown disappointing results.

Smith et al. performed a trial comparing cryotherapy with closed hemorrhoidectomy on different hemorrhoids in the same patient. The cryotherapy site was associated with prolonged pain, foul-smelling discharge, and a greater need for additional therapy. Cryotherapy is now only rarely used for the treatment of patients with hemorrhoids.

3. Rubber Band Ligation
Rubber band ligation relies on the tight encirclement of redundant mucosa, connective tissue, and blood vessels in the hemorrhoidal complex. The encirclement must be well proximal (at least 2 cm) to the dentate line.

Placement of the band too far distally leads to immediate, usually severe pain due to the presence of somatic sensory nerve afferents that are absent above the anal transition zone. Internal hemorrhoid ligation can be performed in the office setting with one of several commercially available instruments, including devices that use suction to draw the redundant tissue into the applicator to make the procedure a one-person effort.

No anesthesia is required. The resulting scar fixes the connective tissue to the rectal wall and resolves the prolapse. Endoscopic variceal ligators have also been shown to be effective tools for hemorrhoid ligation.

Rubber band ligation is most commonly used for first-, second-, or third-degree hemorrhoids. Some authorities recommend it for fourth-degree hemorrhoids after operative reduction of the incarcerated prolapse.

Up to 3 hemorrhoids can be banded in a single session, although many authorities prefer to limit treatment to 1 or 2 columns at a time. Like the other nonoperative treatments, rubber band ligation does not address the external hemorrhoid component.

Success rates vary, depending on the degree of hemorrhoids treated, length of follow-up, and criteria for success. Wrobleski et al. reported that 80% of their patients improved and 69% were symptom-free at a mean follow-up of 5 years. Steinberg et al. reported 89% patient satisfaction at a similar follow-up interval, but only 44% of their patients were symptom-free.

The recurrence rate may be as high as 68% at 4 or 5 years of follow-up, but symptoms usually respond to repeat ligation; only 10% of such patients require excisional hemorrhoidectomy.

The most common complication of rubber band ligation is pain, which is reported in 5%–60% of treated patients. Pain following the procedure tends to be relatively minor and almost always can be satisfactorily managed with sitz baths and over-the-counter analgesics.

Other complications, such as abscess, urinary retention, band slippage, prolapse and thrombosis of adjacent hemorrhoids, and minor bleeding from the ulcer, occur in 5% of patients.

Severe bleeding occasionally requires intervention when the eschar from the band sloughs, usually 1–2 weeks after treatment. Necrotizing pelvic sepsis is a rare complication of rubber band ligation.

The clinical triad of severe pain, high fever, and urinary retention suggests the diagnosis. Such patients require emergency examination under anesthesia, with radical debridement of all necrotic tissue. The risk of necrotizing pelvic infection is increased in immunocompromised patients, including those with uncontrolled acquired immunodeficiency syndrome, neutropenia, and severe diabetes mellitus.

4. Bipolar Diathermy. Direct-Current, Electrotherapy, and Infrared. Photocoagulation
These techniques all rely on the coagulation, occlusion, and obliteration or sclerosis of the hemorrhoidalvascular pedicle above the level of the anal transition zone. The area of tissue damage sloughs, leaving an ulcer that eventually forms fibrotic tissue at the treatment site.

Bipolar diathermy or cautery is applied in 1-second pulses of 20 W until the underlying tissue coagulates (often _30 seconds). About 12% of patients experience pain, bleeding, fissure, or spasm of the internal sphincter. Multiple applications to the same site are often required, especially for second- and third-degree hemorrhoids (up to 3 per site).

The depth of injury from bipolar cautery is 2.2 mm and does not increase with multiple applications at the same site. Bipolar cautery has been used to treat first-, second-, and thirddegree internal hemorrhoids; success rates (defined by relief of bleeding) range from 88% to 100% in randomized trials. It does not eliminate prolapsing tissue, and up to 20% of patients will require excisional hemorrhoidectomy.

Direct-current electrotherapy requires the prolonged (up to 14 minutes) application of 110-V direct current (up to 15 mA) to the base of the hemorrhoidal complex well above the anal transition zone.

Current and time requirements increase for higher-grade hemorrhoids. Multiple treatments to the same site are required in up to 30% of patients. Even though multiple sites can be treated in one setting with minimal pain, the technique has not been widely accepted because of the lengthy treatment time and the limited control of prolapse in higher-grade hemorrhoids (only a 44% success rate).

However, in several randomized trials using adequate levels of current (16 mA) and prolonged treatment times (10 minutes), bleeding was controlled in 88% of patients with first-, second-, or third-degree hemorrhoids. Complications included pain (33%), ulcer formation (4%), and bleeding (10%).

Infrared photocoagulation focuses infrared radiation from a tungsten-halogen lamp via a polymer probe tip. The probe tip must touch the hemorrhoidal tissue at its base; 0.5- to 2-second pulses of energy are delivered to the area.

Multiple (2– 6) hemorrhoids can be treated at one time. The depth of tissue injury after one treatment is about 2.5 mm, and the penetration increases with subsequent treatment at the same site. According to 2 randomized studies, hemorrhoidal bleeding was successfully controlled in 67%–96% of patients with first- or second-degree hemorrhoids.

Complications, including pain and bleeding, are uncommon. Each method of nonoperative treatment described has its proponents. Randomized controlled trials have compared each method with one or more of the others, yet no single study has compared all 5 (sclerotherapy, rubber band ligation, bipolar diathermy, direct-current electrotherapy, and infrared photocoagulation).

A meta-analysis by Johanson and Rimm examined 5 trials involving 862 patients with first or second-degree hemorrhoids who underwent infrared photocoagulation, sclerotherapy, or rubber band ligation.

Rubber band ligation was more effective than sclerotherapy, and patients treated with rubber band ligation required fewer additional treatments than those treated with sclerotherapy or infrared photocoagulation.

However, rubber band ligation was associated with a significantly higher incidence of pain than the other 2 treatments. Thus, Johanson and Rimm favored infrared photocoagulation as the nonoperative treatment of choice.

MacRae et al. performed a similar meta-analysis covering 23 studies that compared rubber band ligation, infrared photocoagulation, sclerotherapy, hemorrhoidectomy, and manual dilation of the anus for patients with first-, second-, or third-degree hemorrhoids.Like Johanson and Rimm, they found that rubber band ligation was more effective than sclerotherapy, less likely to require additional therapy than either sclerotherapy or infrared photocoagulation, and more likely to cause pain.

Despite these identical findings, MacRae et al. concluded that rubber band ligation was the initial procedure of choice for first-, second-, and third-degree hemorrhoids because of its higher rate of efficacy.

G. Surgical Treatment
Surgical hemorrhoidectomy is the most effective treatment for hemorrhoids overall and for third-degree hemorrhoids in particular. Recurrence following a properly performed hemorrhoidectomy is uncommon.

However, nonoperative techniques are preferred when feasible in the first instance because surgery is associated with more pain and complications.

Hemorrhoidectomy techniques include excising internal and external components in 1–3 quadrants around the anal canal, suturing or banding the internal hemorrhoids and excising the external component, or performing a circular excision of the internal hemorrhoids and prolapsing rectal mucosa proximal to the dentate line.

Anal dilatation has been advocated as a nonexcisional operation for hemorrhoids and this approach has had some acceptance in European centers. However, anal endosonography has shown sphincter injuries associated with anal dilatation and several clinical series have reported high rates of associated incontinence.

Konsten and Baeten reported long-term follow-up (median, 17 years) results of a randomized prospective trial of hemorrhoidectomy versus anal dilatation; 52% of patients who underwent anal dilatation had impaired continence at the time of follow-up.

Furthermore, anal dilatation has a higher failure rate than operative hemorrhoidectomy in prospective randomized trials. Because of the risk of incontinence, most authorities now advocate abandoning this approach to the treatment of patients with hemorrhoids.

Indications for surgical hemorrhoidectomy include hemorrhoids too extensive for nonoperative management, failure of nonoperative management, patient preference, and concomitant conditions (such as fissure or fistula) that require surgery.

About 5%–10% of patients, usually those with third- or fourth-degree hemorrhoids, need surgical hemorrhoidectomy. Surgical hemorrhoidectomy can be performed with either open or closed techniques.

In the Milligan-Morgan hemorrhoidectomy, widely used in the United Kingdom, the internal and external components of each hemorrhoid are excised and the skin is left open in a 3-leaf clover pattern that heals secondarily for 4–8 weeks.

In the Ferguson hemorrhoidectomy, each hemorrhoid component is excised and the wounds are closed primarily. Four randomized trials have studied open versus closed hemorrhoidectomy. Three of these trials showed no difference in postoperative pain. Differences in healing times were not consistent between trials.

One randomized trial showed decreased pain and a more rapid return to work following submucosal (partially closed) versus Milligan-Morgan hemorrhoidectomy. Postoperative pain remains the major drawback of excisional hemorrhoidectomy. Narcotic analgesics are generally required, and recent studies show that most patients do not return to work for 2–4 weeks following surgery.

Several trials have assessed the effect of excision techniques on postoperative pain. Randomized trials have shown no difference in pain scores between diathermy and scissors hemorrhoidectomy, although the oral pain medication requirement was less in the diathermy groups.

Early reports suggested that laser hemorrhoidectomy was associated with decreased postoperative pain, but a randomized trial of the Nd:YAG laser versus cold scalpel excision for closed hemorrhoidectomy did not detect any difference in postoperative pain or analgesic use.

In fact, the trial found that laser hemorrhoidectomy was associated with impaired wound healing and higher cost. Four randomized controlled trials evaluating the ultrasonically activated scalpel showed conflicting results with respect to postoperative pain. Two small randomized trials suggested a possible minor advantage with a bipolar diathermy device (LigaSure; Valleylab, Boulder, CO), but pain scores themselves did not differ significantly.

Other strategies to reduce pain have included limiting the incision, suturing only the vascular pedicle without an incision, using a lateral internal sphincterotomy in conjunction with an external hemorrhoidectomy, administering metronidazole, injecting local anesthetics at the operative site, and using drugs such as anal sphincter relaxants, anxiolytics, parasympathomimetics (to avoid urinary retention), and topical nitroglycerin.

However, each strategy has had limited or mixed results. The complications of hemorrhoidectomy are usually minor but occur with significant frequency. These complications include urinary retention (2%–36%), bleeding (0.03%–6%), anal stenosis (0%–6%), infection (0.5%–5.5%), and incontinence (2%–12%).

Sphincter defects have been documented (by ultrasonography and anal manometry) in up to 12% of patients after hemorrhoidectomy. The use of excessive retraction with extensive dilation of the anal canal is probably responsible for sphincter injury and incontinence.

Lateral internal sphincterotomy has been suggested as an adjunct to hemorrhoid excision, but randomized studies have not confirmed its usefulness. In fact, these studies have actually shown an increase in incontinence.

Emergency hemorrhoidectomy for incarcerated, gangrenous hemorrhoids can be performed safely, with results comparable to those obtained after elective hemorrhoidectomy. A randomized trial of the Milligan-Morgan hemorrhoidectomy versus incision and rubber band ligation for acute strangulated hemorrhoids showed that both techniques can be performed safely; early recovery was slightly improved after incision and ligation.

In 1998, Longo introduced an alternative approach to conventional hemorrhoidectomy by modifying the circular stapling device commonly used for low rectal anastomoses.

Stapled hemorrhoidectomy (also called, among other names, stapled anopexy, prolapsectomy, or circumferential mucosectomy) removes a ring of redundant rectal mucosa above the anal canal and proximal to the hemorrhoids themselves.

The goal is to resuspend the prolapsing hemorrhoidal tissue back within the anal canal as well as to interrupt the arterial inflow that traverses the excised segment. In contrast to conventional hemorrhoidectomy, skin tags and enlarged external hemorrhoids are not removed using the stapled technique.

Eight randomized controlled trials have now studied stapled versus conventional hemorrhoidectomy. All 8 showed decreased pain in the stapled groups, and 6 also showed a more rapid return to normal activities.

Complication, impaired continence, and recurrence rates were comparable between stapled and conventional groups. The disposable stapler adds cost to the operation, but some of this is recouped by shorter operating times and length of stay in countries in which patients are routinely hospitalized.

A systematic review of stapled hemorrhoidectomy concluded that the procedure was as safe as conventional hemorrhoidectomy and was associated with shorter operating time, convalescence, and postoperative disability. Efficacy of the technique compared with conventional hemorrhoidectomy could not be determined due to a paucity of long-term data.

Despite these promising results, several important caveats regarding stapled hemorrhoidectomy remain. One randomized trial was suspended when 5 of 22 patients developed pain and fecal urgency that persisted for up to 15 months, yet no other group has reported similar findings. Several serious complications have been reported after stapled hemorrhoidectomy, including rectal perforation, retroperitoneal sepsis, and pelvic sepsis.

The true incidence of such complications remains unknown, but their common denominator may be excision of full-thickness rectal wall rather than mucosa and submucosa only. Smooth muscle fibers have been detected in a variable percentage of stapled hemorrhoidectomy specimens, although such fibers have also been detected following conventional hemorrhoidectomy.

One histologic study suggested that at least some of those fibers were from the internal anal sphincter rather than the more proximal rectal wall. Of potentially more functional consequence, fragmentation of the internal sphincter was noted in 14% of patients who underwent stapled hemorrhoidectomy using the standard 37-mm anal dilator.

Patients with other diseases in addition to hemorrhoids pose special risks. Infection with human immunodeficiency virus does not contraindicate hemorrhoidectomy, but patients who are severely immunocompromised because of acquired immunodeficiency syndrome are at high risk for complications. Crohn’s disease of the intestine does not seem to contraindicate hemorrhoidectomy; in a Ferguson Clinic series, only 1 of 17 patients developed anal disease (follow-up, 12 years).

However, patients with anorectal Crohn’s disease or Crohn’s proctitis have a substantial risk of local complications that can be severe enough to require proctectomy.

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