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Congestion of Sinusoids

Increased internal anal sphincter activity

Loose and hypertrophied connective tissue

Constipation

Decreased vascular tone

Sliding down of anal cushions

Artarterial hyper perfusion

Strangulation

Vicious cycle

Neovascularisations

Fibrous tissue hypertrophy

Congestion of sinusoids and increased anal pressure

Congestion of sinusoids and the already loose and hypertrophied connective tissue

The Key Problem, We need to address