What is Hemorrhoid?
The word hemorrhoid means “bleeding out” in Greek. Pads, rich in veins reside inside the anus. These pads hang down and expand over time due to various reasons. Later, these dilated veins bleed during defecation as a result of irritation. Hemorrhoid (pile) bleeding is painless and blood usually observed dropwise after defecation. Hemorrhoids are divided into 4 stages depending on the size and the amount of exit from the anus. These are;
- Stage 1, it is always inside the anus. It is small but can bleed.
- Stage 2, it comes out of the anus due to straining during the toilet, enters back after defecation.
- Stage 3, it protrudes during defecation, but is too large to come in again spontaneously. It can be pushed back in by hand.
- Stage4, it is constantly outside, it will not enter if it is pushed in manually.
What are the symptoms of hemorrhoid (pile)?
The most common symptom is bleeding.After defecation, light red bleeding that drips into the toilet is observed. It does not mix with feces. Rarely tiny arteries may be involved and the bleeding may be more gushing. Another symptom observed is the protrusion and palpation of the hemorrhoid pads from the anus.
How hemorrhoid (pile) is diagnosed?
The diagnosis can sometimes even be made by eye and is confirmed by examining inside the anus with the help of a special illuminating instrument called anoscopy or by a finger to detect enlarged pads. More rarely, protruding hemorrhoid pads occasionally bleed into themselves, causing edema and swelling. This very painful condition is called thrombosed hemorrhoid.
How is hemorrhoid treated?
The treatment includes various steps from the regulation of diet to surgery. To summarize these briefly;
- Regulation of the diet: In stage 1 hemorrhoids that occasionally bleed, increasing the amount of water consumed or even eating more fiber, vegetables, legumes is enough to prevent constipation from time to time.
- Creams:Painkillers and cortisone creams can be used to reduce complaints in painful and edematous hemorrhoids. They do not have therapeutic properties, but they relieve the patient until the thrombosed hemorrhoid pads heal.
- Drug treatments: The effects of oral drugs are also limited. They reduce edema and complaints, providing temporary relief.
- Bandligation method:This approach can be applied in stage 1 and 2 hemorrhoids. The aim is to place rubber bands around the neck of the pads with the help of a special tool and to suffocate the hemorrhoids. This method can be applied in a polyclinic setting, and high success rates are achieved which can be increased when bandligation is performed together with sclerotherapy, drug injection under the hemorrhoid pads. However, the risk of recurrence is high after treatment.
- Photocoagulation:This method involves burning the hemorrhoid pads with the help of a special device. Pain is relatively low. It is often used in combination with other methods. The success rate is high in suitable patients.
- Surgical resection of hemorrhoids: This process defines the removal of the hemorrhoid pads by surgically cutting them with conventionally (by stitching) or with lasers or other special devices that seal the vessels. Surgical methods are a little more painful than other methods and the recovery process may take several weeks, but the hemorrhoids is least likely to recur after surgical resection.
- Removal of hemorrhoids with a stapler: In this method, which was preferred in the past, a special device that cuts the vessels bringing blood to the hemorrhoid pads is used. However, in the technique, which was the subject of my specialty thesis, the possibility of hemorrhoid recurrence in the middle and advanced stages was found to be higher than other surgical methods. For this reason, it is not preferred as often as before.
What should I do to prevent the disease from recurring after hemorrhoid surgery?
Changing the diet and lifestyle after a successful surgery is usually the first goal at this stage. Avoiding standing for long timesas well as constipation are generally helpful for preventing the recurrence of the disease. Regularly checking pads that start to protrude after the surgery allows detecting the disease at an early stage and enables treatment with non-surgical methods.