The pathogenesis of hemorrhoids requires 2 factors ; A) Weakness of the walls of the rectal veins which is the predisposing factor and this is genetically determined, and B) Increased pressure inside the rectal veins which is the precipitating factor, and this is acquired. As the first factor is genetically determined, it is the least controllable, but it can be managed by some herbal remedies. The second factor is the mainstay of hemorrhoids treatment, and is controlled by dietary and behavioral modifications with the aim of avoiding straining especially constipation.
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