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Almost all of us have been there. It’s itching. It hurts. It can even bleed and it’s in the anus

This which you can see here is a cross-section of the anus this would be an internal hemorrhoid and this over here an external hemorrhoid actually, everybody has hemorrhoids and

And why am I saying this? Well, because hemorrhoids are normal anatomical vascular structures that everyone has

They can be found over here and they are small

Cushions that help control the stool. These

Hemorrhoids can become swollen and then we refer to them as internal hemorrhoids. Here we see the perineal vessels and

They can become thrombosed and we refer to that as external hemorrhoids

The external hemorrhoids are not hemorrhoids at all.

Those are perianal vessels that became thrombosed.

Luckily, not all of us experience hemorrhoids that are swollen or thrombosed perianal vessels.

But two out of three individuals of general population actually do have this disease.

It’s rather common.

How and why exactly they happen, we don’t know.

What we do know, however, is that constipation, diarrhea, pregnancy and sitting on the toilet for too long does increase the risk of having hemorrhoids.

So what can be done about this condition and what are our options?

Another successful treatment for hemorrhoids is a treatment with a success rate of up to 70% and it is called sclerotherapy.

It involves an injection of a sclerosing agent.

There are also cauterization methods and this is what evidence-based medicine suggests and recommends.

This doesn’t mean that we immediately treat every patient surgically.

There are specific indications when to attempt a surgical treatment of hemorrhoids.

Now, I already explained how long term use of proton pump inhibitors might cause gastric cancer.

This can happen through atrophy of gastric mucosa and autoimmune gastritis. But Helicobacter pylori can do this as well. And as a result of these changes, even ulcers might develop and treating Helicobacter pylori at this stage might not reduce your risk of developing gastric cancer. And last but not least, the fourth thing that can and should be done in this case is to recognize some early signs and symptoms of gastric cancer. Weight loss, bleeding, indigestion and so on.

The first thing is a proper clinical examination that is performed in order to identify if a possible instability of the joint is present. Additionally, during the clinical examination, we might find that the patient experiences spasms of the surrounding muscles because of the pain in the joint or along the ligament. These muscles also can experience a spasm because they help stabilize the injured joint. A skilled clinician could be able to palpate ligaments from their origin all the way to the insertion and the patient might experience pain upon this palpation. Now, not every ligament can be palpated, but if it can, it takes skills and knowledge to be able to do this.