Much like the perspective found in Donguibogam, modern medicine does not view defecation disorders solely as localized anal problems. Discomfort and hematochezia associated with hemorrhoids or anal fissures are common, but their origins are often systemic and complex.
The most direct cause is excessive straining during defecation due to chronic constipation or diarrhea. This increases pressure on the venous plexus in the perianal region, causing blood vessels to swell into hemorrhoids or tearing the delicate anal mucosa into an anal fissure. Repeated mechanical pressure also weakens the supportive muscles and connective tissue of the anal canal, causing hemorrhoids to progress.
From a neurological perspective, the gut-brain axis explains how emotional states and stress influence intestinal function. Stress, anxiety, and depression affect the autonomic nervous system, either overstimulating or suppressing intestinal peristalsis, which can trigger constipation or diarrhea. This mechanism mirrors the concept of qi stagnation in Korean medicine.
Endocrinologically, hormonal shifts also influence bowel motility. During pregnancy, elevated progesterone slows intestinal transit, making constipation common. In individuals with diabetes, autonomic neuropathy can cause intestinal motility disorders, leading to irregular bowel movements.
Because hematochezia or sudden changes in bowel habits can also indicate conditions such as inflammatory bowel disease, including Crohn's disease and ulcerative colitis, colorectal cancer, or diverticulitis, a precise diagnosis is essential. Furthermore, dysbiosis of the gut microbiome impairs the intestinal barrier, promotes inflammation, and reduces digestive efficiency. Daily lifestyle factors, such as low fiber intake, inadequate hydration, and sedentary routines, also play substantial roles. Modern medicine thus views defecation disorders as systemic issues involving the complex interaction of the nervous, endocrine, digestive, and immune systems.
