Anus and rectum are the exit gates of the excretory system and is a region where approximately twenty diseases can be seen and the symptoms of some diseases can be observed. Diseases of this region are called proctological diseases.
Hemorrhoids are a disease in which the veins in the anus expand abnormally over time and protrude in the form of red and purple bags. In some patients, prolapse of the anal mucosa occurs with hemorrhoid disease. Hemorrhoids do not turn into cancer. However, in order to distinguish it from cancer and to avoid delaying diagnosis in a cancer patient, every patient with rectal bleeding must be evaluated with at least a rectoscopic examination.
It should not be forgotten that 50 percent of all rectal bleeding consists of diseases other than hemorrhoids.
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Hemorrhoids are divided into internal and external hemorrhoids. They are also divided into subclasses as simple and complicated, thrombosed, acute and chronic. External hemorrhoids occur due to the expansion of the veins located under the skin at the edge of the anus. Patients usually consult a doctor due to a painful mass that appears at the edge of the anus following constipation. Internal hemorrhoid patients constitute the majority of chronic hemorrhoid patients. Internal hemorrhoid patients often come to the doctor complaining of constipation and painless, bright red rectal bleeding that occurs following excessive straining. Depending on the degree of the disease, complaints such as palpable anal swelling, wetness, discharge, and itching may be observed. Pain is a late finding in internal hemorrhoids. If there is pain in the initial period of the disease, diseases such as thrombosed, strangulated hemorrhoids, perianal abscess, anal fissure should be brought to mind and investigated.
The most common cause of hemorrhoids is irregular bowel habits (constipation, diarrhea). Sitting on the toilet for a long time, excessive straining, pregnancy and birth, some sports activities (horse riding, cycling), excessive alcohol and spicy food habits, sitting or standing for a long time (long-term driving), obesity, chronic cough, pelvic area Causes such as tumors, prostate cancer, cirrhosis, and colon cancer are less common causes of hemorrhoidal disease.
Rectal bleeding and defecation. Changes in n habits should definitely warn patients and remind them that they need to be examined by a general surgeon.
Diagnosis of hemorrhoid disease is made by physical examination and anoscopic and rectoscopic examination. Rectoscopic examination is essential to grade internal hemorrhoids and apply the appropriate treatment. Internal hemorrhoids are classified into four degrees, and the treatment to be recommended and applied varies depending on the degree of hemorrhoids.
Degree hemorrhoids present with the complaint of painless, fresh red bleeding that remains in the anus and usually develops after defecation. They cannot be detected by finger examination. On anoscopic examination, they appear as tense, thin-walled vascular bags that are smaller than 1 centimeter in size and are ready to bleed. Methods such as injection of sclerosing material and ligation with rubber bands can be applied in the treatment. These treatments do not require hospitalization and can be administered on an outpatient basis. Patients do not feel pain during the procedure, or a slight pain may be felt. Sometimes, creams, stool softeners and diet may be sufficient in the treatment of first-degree hemorrhoid patients.
Degree hemorrhoids come out of the anus with straining during defecation, and they go in spontaneously when you stand up after completing the toilet. They are hemorrhoidal structures, 1-3 cm in size, that present with the complaint of painless, palpable, eruptive fresh red bleeding. Bleeding sometimes continues for months at every toilet exit, causing the patient to develop anemia. Second degree hemorrhoids also do not require surgery. Rubber band, sclerosing injection, infrared photocoagulation are the preferred treatment methods. Appropriate diet, stool softeners, local creams and venous tone enhancing drugs, and painkillers if necessary should be added to the treatment.
Degree hemorrhoids are the advanced form of internal hemorrhoids that easily come out of the anus and require manual pushing back. . They often complain of pain, complicated by clot formation. Ulcers may form on them due to drying and suffocation, in which case a sudden and inflammatory discharge occurs. Treatment begins with medical methods. In patients who do not respond to medical treatment and conservative treatment methods, Rahi treatment is required.
Degree hemorrhoids, internal hemorrhoids collectively protruding outside the anus due to years of chronic constipation, breasts remaining outside the anus as large, often painless wet masses along with the anal mucosa.
In high-degree hemorrhoids, there are complaints of not being cleaned well, constant mucous inflammatory discharge, itching and frequent bleeding. Sitting has become uncomfortable and causes pain. Many patients require surgical treatment. If there is a condition that prevents surgery, lifelong medical treatment, plenty of water, a diet rich in fiber and plenty of fruit consumption are required. Consumption of tea, coffee, cola, refined foods, spices, bitters and especially alcohol should be restricted.
Hemorrhoids can cause anemia as a result of prolonged bleeding. Inflammation that develops as a result of local injuries in hemorrhoids leads to the formation of abscesses and fever. . Sometimes protruding hemorrhoid nozzles may be compressed by the anus and may become thrombosed or gangrene. The patient has severe pain. Hemorrhoids cannot be pushed back, even touching them causes severe pain. It is not possible for the patient to continue his daily life and requires urgent treatment. The essence of surgical treatment is the excision and removal of hemorrhoids. The anal mucosa may be sutured or left open following bleeding. In advanced cases, it may take approximately 2-3 weeks to return to daily life and work after surgical treatment.
Nowadays, a preferred and increasingly applied treatment method in advanced cases with mucosal sagging is LONGO performed with anal circular steps. It is a hemorrhoidectomy technique.
In this technique, since the procedure is applied to the anal mucosa approximately 4-6 cm inside the anal canal, the technique is quite painless compared to other surgical methods and patients can return to work in a short time. The application of circular steps allows the vessels that feed and fill the hemorrhoids to be completely ligated and the prolapsed and extended mucosa to be removed. Recurrence is less compared to classical methods. The biggest advantages of the LONGO hemorrhoidectomy technique are that protruding hemorrhoids return to the anal canal, the procedure is painless, recurrence rates are lower than other methods, and patients can return to work in a short time. Process Due to the fact that the procedure is performed with disposable steps, its high cost is a partial disadvantage.
The hemorrhoidectomy technique is seen with the application of LONGO circular steps in the video shooting.
Frequently asked questions by Hemorrhoid Patients:
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Do hemorrhoids turn into cancer?
Hemorrhoids do not turn into cancer, but every case of rectal bleeding must be examined by rectoscopy in order for bleeding due to cancer not to be considered as hemorrhoids.
Is hemorrhoid a disease of a certain age or gender?
Hemorrhoid disease is a disease of all ages and genders, although it is very rare in children. Although it is said to be more common in women due to pregnancy and birth, there is no significant difference between the genders when the number of surgeries is considered. The frequency of hemorrhoid disease increases with age. One in every 3 people in society will complain about hemorrhoids at least once in their lifetime.
What are the causes of hemorrhoids:
Although there is no single reason for the development of hemorrhoids, there are some There are facilitating reasons. Familial predisposition, constipation, long-lasting diarrhea, drinking less water, delaying the time of defecation, sitting on the toilet for a long time, straining a lot, irregular defecation, long travels, sitting and standing for long periods of time, pregnancy, intra-abdominal pelvic tumors, cirrhosis, extremely hot spicy Food consumption, excessive alcohol consumption, old age are the reasons that increase the frequency of hemorrhoid disease.
What are the recommendations that hemorrhoid patients should follow.
Paying attention to anal cleanliness, avoiding constipation. Regular toilet habits, not sitting for long periods of time, not standing, maintaining the ideal weight, consuming pulp-fibrous food, increasing the consumption of grains, vegetables and fruits, drinking a lot of water, doing exercises such as walking and swimming, and not lifting heavy loads are the recommended recommendations. Cycling and horse riding are not recommended for hemorrhoid patients.
Are hemorrhoids contagious?
No, it is definitely not contagious.
Hemorrhoid disease is hereditary. Is it?
No. It is not possible to talk about the existence of a clear genetic transition. Life and nutrition styles of family members Since they are similar to each other, it can be said that hemorrhoidal disease is common in some families.
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