What is the role of decreased venous return in the pathophysiology of hemorrhoids?

Updated: Sep 24, 2019
  • Author: Kyle R Perry, MD; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

Most authors agree that low-fiber diets cause small-caliber stools, which result in straining during defecation. This increased pressure causes engorgement of the hemorrhoids, possibly by interfering with venous return. Pregnancy and abnormally high tension of the internal sphincter muscle can also cause hemorrhoidal problems, presumably by means of the same mechanism, which is thought to be decreased venous return. Prolonged sitting on a toilet (eg, while reading) is believed to cause a relative venous return problem in the perianal area (a tourniquet effect), resulting in enlarged hemorrhoids. Aging causes weakening of the support structures, which facilitates prolapse. Weakening of support structures can occur as early as the third decade of life.


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