Hemorrhoids

Hemorrhoids are enlarged, swollen, and painful venous nodes in the anus or rectum. They can occur inside the rectum (internal hemorrhoids) or around the anus (external hemorrhoids). Symptoms include pain, itching, bleeding, or a feeling of heaviness in the anus. Hemorrhoids are a common problem and can occur in people of all age groups. Causes of hemorrhoids include a sedentary lifestyle, excessive consumption of animal fats and proteins, chronic constipation, pregnancy, genetic predispositions, and other causes.

WHAT ARE THE CAUSES OF HEMORRHOIDS?

Hemorrhoids are veins located in the anus and rectum. There are two types: internal and external. The causes of hemorrhoids are:

1. Increased pressure on the rectum: This can occur during childbirth, in individuals with chronic constipation or diarrhea, and in those who often strain when urinating or defecating.
2. Increased venous stasis: Hemorrhoids can occur when blood vessels in the anus and rectum swell and fill with blood. This can happen in people with a sedentary lifestyle or those who have problems with their blood vessels.
3. Genetic predisposition: Hemorrhoids can be hereditary and can occur in individuals with a family history of the condition.
4. Excess weight: Overweight individuals are more likely to suffer from hemorrhoids.
5. Age: Hemorrhoids are more common in older individuals.
6. Diet: A lack of fiber in the diet and excessive consumption of alcohol or caffeine can contribute to the development of hemorrhoids.
7. Injuries or trauma: Injuries or trauma to the rectum or anus can lead to the development of hemorrhoids.
8. Medications: Certain medications, such as anticoagulants, can increase the risk of developing hemorrhoids.

WHEN IS SURGERY INDICATED?

Hemorrhoids can be treated conservatively or surgically. Conservative treatment includes dietary changes, the use of topical medications, and the use of special sitz baths. Surgical treatment of hemorrhoids may be indicated in the following cases:

• If conservative treatment has failed to relieve symptoms or eliminate hemorrhoids
• If there is significant bleeding from the anus
• If thrombosed internal hemorrhoids occur
• If prolapsed internal hemorrhoids occur
• If anal fissures or anal stenosis (narrowing) occur
• If fistulas or abscesses related to hemorrhoids occur

Surgical treatment of hemorrhoids can be minimally invasive or classical (prolapse resection) depending on the severity of the condition and the personal preferences of the patient and physician.
In any case, it is necessary to consult with a proctologist who will assess your condition and recommend the best treatment method.

WHAT ARE THE FORMS OF SURGICAL TREATMENT?

There are different forms of surgical treatment for hemorrhoids, including:

1. Hemorrhoid ligation: This method is used to treat internal hemorrhoids. The doctor places a small elastic band around the base of the hemorrhoid to cut it off from the blood supply.
2. Sclerotherapy: This method is used to treat internal hemorrhoids. The doctor injects a special substance into the hemorrhoid to "thicken" and reduce its size.
3. Cryodestruction: This method is used to treat external hemorrhoids. The doctor uses liquid nitrogen to freeze the hemorrhoid and reduce its size.
4. Hemorrhoidectomy: This method is used to treat severe or chronic hemorrhoids. The doctor surgically removes the hemorrhoids, usually under general anesthesia.
5. Stapler hemorrhoidectomy: This method is used to treat severe or chronic hemorrhoids. The doctor surgically removes the hemorrhoids, usually under general anesthesia, using a stapler to connect the remaining rectum.
6. LASER: Laser is used to cauterize the venous node.
7. Doppler guided hemorrhoidal artery ligation with recto-anal repair (HAL-RAR): Using an ultrasound device, the blood vessels forming the hemorrhoid are detected and tied off. The stitches are placed in a part of the bowel with very few sensory nerves, so the pain is less.

HOW TO PREPARE FOR SURGERY?

Preparation for surgical treatment of hemorrhoids can vary depending on the type of surgery the patient will undergo. In any case, it is important to provide the patient with detailed instructions on what to do before the surgery.

1. Preoperative examination: The patient will need to undergo a preoperative examination to confirm the diagnosis and establish the severity of the condition. This may include physical examination, laboratory tests, and endoscopic examinations.
2. Dietary recommendations: The patient may need to change their diet before surgery. This may include restricting food and fluid intake a few days before the operation.
3. Medications: The patient may need to stop taking certain medications before surgery. This may include blood-thinning medications.
4. Hygiene: The patient may need to enhance hygiene before the operation. This may include washing the anal area and using special soaps.
5. Exclusion of certain activities: The patient may need to refrain from certain activities before surgery, such as smoking and consuming alcohol.
6. Information about the operation: The patient will need to be informed about the details of the operation, including duration, possible risks and complications, and how to cope with them.

All these recommendations will be provided by your doctor. They will also give you detailed instructions on how to prepare for surgery, so follow them strictly and feel free to ask if anything is unclear.

WHAT TO EXPECT AFTER THE SURGICAL PROCEDURE?

Postoperative measures after surgical treatment of hemorrhoids can vary depending on the type of surgery and the severity of the condition. In any case, it is important to follow the doctor's instructions to achieve the best possible results.

1. Pain: The patient may experience pain after the surgery. The doctor will prescribe analgesics to reduce pain.
2. Bleeding control: The patient may have bleeding from the rectum after surgery. The doctor will prescribe appropriate medications to control bleeding.
3. Diet: The patient may need to change their diet after surgery as per the doctor's recommendation.
4. Physical activities: The patient will need to limit physical activities after surgery.
5. Follow-ups: The patient will need to go for regular follow-ups to monitor their condition after surgery.
6. Instructions: The patient will need to follow the doctor's instructions on how to cope with pain, bleeding, and other symptoms after surgery.
7. Watch for infections: The patient will need to be cautious to prevent infections after surgery.

HOW TO PREVENT HEMORRHOIDS?

To prevent the recurrence of hemorrhoids, the following is recommended:

1. Proper diet: Eat fiber-rich foods and drink enough fluids to keep the stool soft and easily passable.
2. Regular movement: Engage in regular physical activity and exercise to maintain normal bowel movements.
3. Hygiene: Maintain good hygiene of the anal area to prevent infections.
4. Avoid sitting: Avoid prolonged sitting or standing, especially on hard surfaces.
5. Weight control: Maintain a healthy weight to reduce the risk of hemorrhoids.
6. Avoid excessive lifting of weights.
7. Avoid using laxatives and other stool-regulating medications unless necessary.
8. Regularly visit a doctor for check-ups and monitoring of the condition.
9. If hemorrhoids occur, contact a doctor immediately.
10. Include abdominal exercises in your daily routine, which will help maintain the health of your colon and anal area.
11. Avoid alcohol, smoking, and excessive caffeine consumption.
12. Maintain regular bowel movements to avoid constipation.