Shaik,
"severe inflammatory reaction involving the vascular wall and surrounding connective tissue has been demonstrated in hemorrhoidal specimens" therefore, anti inflammatory treatments would be expected to be efficacious.
doi:10.3748/wjg.v18.i17.2009 Hemorrhoids: From basic pathophysiology to clinical management WJG| www.wjgnet.com 2009
the inflammation of the hemorrhoidal plexus can be supported by an altered intestinal microbiota with a loss of lactobacilli and bifidobacteria that lead to butyric acid production. .the absence of butyrate leads to an alteration of the tissue control system (PPAR alpha and Gamma able to block NfKB transcription) resulting in an inflammatory status that cause sensitization of afferent fibers due to prostaglandins. acidic pH also causes afferent fibers sensitization but makes available opioid receptors normally inactive, capable of responding to opiate drugs.
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