Modern medicine can explain the Donguibogam concept of internal heat more specifically through the lens of inflammatory response and vascular health. When we experience stress or consume irritating foods, the autonomic nervous system undergoes hyperactivation and the dominance of the sympathetic nerve persists. This induces vasoconstriction, impedes blood circulation, affects intestinal motility, and can worsen constipation. Gut dysbiosis is also an important factor. When beneficial gut bacteria decrease and harmful bacteria increase due to Westernized dietary habits or antibiotic use, intestinal mucosal permeability increases and inflammatory substances are easily absorbed, which can trigger a systemic inflammatory response. This chronic inflammation weakens the vascular tissue in the perianal region and exerts pressure especially on the venous plexus in the perianal region, promoting the onset and worsening of hemorrhoids.
Hemorrhoids fundamentally involve abnormal swelling or prolapse of the anal cushions, which are composed of blood vessels, connective tissue, and smooth muscle. Chronic constipation or excessive straining during defecation rapidly raises the pressure in the perianal veins, causing the vascular wall to stretch and the anal cushions to gradually slip out of place. In addition, excessive tension in the sphincter encircling the interior and exterior of the anus also plays a role. Stress, anxiety, and even the use of certain medications cause abnormal tension in the sphincter, making defecation even more difficult, which in turn can lead to damage to the anal mucosa and an anal fissure. An anal fissure is a tear in the skin or mucosa of the anal canal, accompanied by severe pain and hemorrhage, and it increases the risk of chronic inflammation and infection.
Furthermore, recent studies suggest that pelvic floor dysfunction and neurological elements also exert significant effects on anorectal diseases. Poor defecation posture or excessive straining causes an imbalance in the pelvic floor muscle, which can lead to abnormal changes in anal canal pressure and impaired defecation function. Because numerous sensory nerves are distributed in the perianal region, it reacts sensitively to even minor stimuli; when inflammation or injury persists, nerve endings become hypersensitive, the pain threshold decreases, and one ultimately experiences chronic dyschezia and discomfort. Just as Donguibogam viewed stagnant heat in the body as the cause of trouble, modern medicine also explains that complex physiological mechanisms, such as inflammation, vascular damage, and nerve hypersensitivity, trigger and worsen anorectal diseases. This is why overall health management, including dietary habits, lifestyle habits, and stress management, is important beyond mere symptom relief. It is essential to pay attention to these small signals from our body.
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