In every healthy person, there are pads in the anus area, just above the dentate line, and they contain vessels, connective tissue and smooth muscle. However, due to constant constipation or diarrhea, excessive straining, wrong toilet habits or pregnancy, these cushions turn into hemorrhoids. Hemorrhoids are determined in one in every two people around the age of 50.
What are the types of hemorrhoids?
External hemorrhoids: They are located in the most sensitive and pain-sensitive area of the anus. If the vein here clots, it creates an extremely painful swelling (thrombosed hemorrhoid).
Internal hemorrhoid: The most common symptom is a painless swelling protruding from the anus. They are mostly noticed by patients accidentally during the cleaning process after defecation. This can cause severe pain if the hemorrhoid or hemorrhoid protrudes completely or becomes herniated and cannot be pushed in.
What causes hemorrhoids?
According to the widely accepted view today, hemorrhoids are caused by the disruption of the integrity of the cushions that provide protection around the anus. It is formed with . In people with hemorrhoids or hemorrhoid problems, the veins dilate, clots form in the veins, and sagging occurs in the muscle and connective tissues, compared to healthy people. In some patients, in addition to these changes, ulcers, clotting and malnutrition occur on the intestinal surface located within the anal canal.
What are the factors that facilitate the formation of hemorrhoids or hemorrhoids?
• Professions that require sitting for long periods of time: secretary, architecture, engineering, banking, etc.
•Some sports: bodybuilding, cycling, motorcycle riding, horseback riding
•Advanced age
• Chronic constipation
•Chronic Diarrhea
•Difficulty defecating
•Pregnancy
• Postpartum
• Heredity
• Excessive straining during defecation
• Too much laxative or use of enema
• Habit of sitting on the toilet for long periods of time, reading a book on the toilet
Do hemorrhoids occur because of inadequate anal cleaning?
Hemorrhoid g It has been determined that personal hygiene, defecation or cleaning of the anal area has nothing to do with the occurrence of bleeding.
Can hemorrhoids be a preliminary symptom of a disease?
Yes, hemorrhoids may be a preliminary symptom of some diseases. Hemorrhoids may appear as the first symptom of diseases such as liver cirrhosis or portal hypertension, which can occur with heavy alcohol consumption, liver diseases and Hepatitis B.
How is hemorrhoid diagnosed?
Hemorrhoids are diagnosed by anoscopy, rectoscopy, sigmoidoscopy or colonoscopy as well as clinical examination.
What are the symptoms of hemorrhoids?
• Blood coming from the anus during straining
• Prolapse from the anus during straining
• Itching in the anal area
• Pain in the anus (often due to hemorrhoid clotting)
• Painful swelling in the anal area
What diseases can hemorrhoids be confused with?
When there is bleeding from the anus, the patient must be examined by a specialist surgeon.
(anal fissure)
• (anal fistula, perianal fistula, anorectal fistula)
• (anal abscess, perianal abscess, anorectal abscess)
• Anal condyloma< br /> • Anal cancer
• Rectal cancer
• Rectal polyp
• Anal prolapse
• Ulcerative colitis
• Crohn's Disease
• Anal fungal disease
br /> • Itching in the anus
• Anal area infections (gonococcus, syphilis, chlamydia, etc.)
What is the course of hemorrhoid disease?
While there is only anal bleeding in the initial stages of the disease, in later stages the bleeding is accompanied by swelling in the anus during defecation. As hemorrhoids progress, these swellings no longer fit inside. Especially in advanced stages, the anus becomes constantly wet due to the protrusion of the hemorrhoid nozzles. Itching due to anal wetness is another is added to the complaints.
What are the stages of hemorrhoid disease?
I. Stage II hemorrhoids: internal hemorrhoids that cause bleeding and do not come out of the anus
Stage II hemorrhoids: internal hemorrhoids that come out of the anus but go back in on their own
Stage III hemorrhoids: internal hemorrhoids that come out of the anus and the person can push them in manually
IV: Stage hemorrhoids: internal hemorrhoids that come out of the anus and the person cannot push them in manually
What should be done to protect?
1 Adopting a diet rich in fiber (fruits, vegetables,
legumes, corn flakes, etc.)
2 Abandoning habits such as spending long periods of time in the toilet, reading newspapers or solving puzzles in the toilet, and excessive straining. Teaching children that they should go to the toilet as soon as they need it and not spend a long time there
3 Doing sports and regular exercise
4 Knowing that riding a horse, motorcycle or bicycle has negative
effects on hemorrhoids
5 Knowing that heavy sports such as weightlifting and wrestling have negative effects due to strain
How is hemorrhoid disease treated?
Hemorrhoid disease (hemorrhoids, hemorrhoids, hemorrhoids) is treated without or with surgery. Non-surgical methods include: sitz baths (sitting in hot water for 10-15 minutes), applying some pomades, or taking oral hemorrhoid pills. There are also some types of treatment that can be done in the doctor's office.
1 Bipolar coagulation: With this method, the blood vessels that cause hemorrhoids or hemorrhoids are burned.
2 Infrared coagulation: Called infrared (red light). With the laser beam of different wave lengths, the veins are reduced and it is based on extinguishing the hemorrhoids.
3 Sclerotherapy: A lime-forming chemical substance is injected into the anal area.
By ensuring the formation of lime in the veins that feed the hemorrhoid (piles) breast, a new vein swelling, cracking and widening is prevented there.
4 Taping attempt: An elastic band like a buckle that these ladies wear on their hair, called an anoscope, is inserted into the anus. It is the process of sliding the rubber buckle and placing it there with an illuminated tool. Thus, that hemorrhoid (hemorrhoid) vein is strangled. The results and success of painless methods in the treatment of hemorrhoids are mostly the same, but tape application can cause severe pain, especially if it is not done with the appropriate technique. That's why it should be done by experienced hands.
HEMORRHOID SURGERY
What kind of preparation should be done before hemorrhoid surgery?
Before hemorrhoid surgery, patients should take blood thinners (Aspirin®). , Coraspin®, Ecoprin®, Dispril®, Coumadin®, Heparin®, Plavix®, Pradaxa® etc.) are stopped 7-10 days before surgery. At midnight before the surgery, water and food intake is stopped. While some surgeons do not recommend any medication for bowel preparation before the surgery, others prescribe a laxative (powder or liquid containing substances such as sodium phosphate, senna alkaloids, polyethylene glycol, etc. taken orally) or an enema, which is taken orally one day before the surgery. /p>
What are the surgical methods for hemorrhoids (piles) disease?
If hemorrhoids or hemorrhoids disease is advanced, surgical methods come to the fore. These are:
1 Classical surgical techniques: Milligan & Morgan (open technique defined in 1937), Ferguson (closed technique), Parks (submucosal hemorrhoidectomy) and Whitehead surgeries: in principle, hemorrhoid breasts; They aim to remove the veins by cutting them with scissors, knives, monopolar electrocautery, bipolar cautery (BICAP), "Ligasure" or "Ultracision -harmonic scalpel" types, which can disable veins up to 7 mm in diameter, or by laser. This technique is called "hemorrhoidectomy". Expanding the anus or 'anal dilation' during the procedure provides significant relief, especially in third-degree hemorrhoids.
2 Longo method: One of the surgical methods in the treatment of hemorrhoids is the Longo technique. Hemorrhoids are generally located in three places in the anus and their alignment is 3, 7 and 11 on the clock dial, and in the classical surgical method, it is necessary to create a wound in at least three places. Whether this is done with normal stitching or laser application, serious wounds occur in the anus. Palermo University in Italy by Antonio Longo In the method developed in 1997, no wound occurs outside the anus; the surgery is performed entirely inside the anus, which is a region poorer in nerve network compared to the anal skin (anoderm), which reduces the feeling of pain after the surgery. Additionally, in cases of anal prolapse (rectal mucosal prolapse) and advanced hemorrhoids (third and fourth degree hemorrhoids), the Longo technique is the technique reported to give the most successful results. Longo surgery has been performed in our country since 1999.
Advantages of Longo hemorrhoid surgery:
- Less painful: This method, defined as stapled hemorrhoidopexy, is less painful and allows the patient to recover in a short time. In the Longo method, no intervention is made in the mouth of the anus. Because the last 3-4 centimeters of the anus are sensitive to pain and in this technique, it is worked from above. 80 percent of patients treated with the Longo method need much less painkillers. The patient can defecate easily even the next day. Shao et al. In 29 separate studies comparing Longo surgery with classical hemorrhoid surgery, they examined the results of a total of 2,056 surgeries and determined that there was much less pain in the Longo method compared to classical hemorrhoid surgery. He pulls it up and they all go in. Thus, the internal hemorrhoids (piles) are prevented from sagging outwards. - Cutting and stitching the veins: This tool cuts and stitches these veins. Thus, since the veins will be fixed, the hemorrhoid nozzles will not come out of the anus during subsequent straining. - Ensuring earlier return to work: The duration of the surgery varies between 20-30 minutes. Most patients can return to their active lives and work after 3-4 days.
Surgery methods should be chosen according to the patient. The surgical technique called the Milligan Morgan method is frequently used. The feature of this method is that the hemorrhoids are cut and removed from the head to the end with the help of a tool. In the presence of first-degree hemorrhoids (piles), surgical treatment is not recommended and instead treatment is planned with sitz bath, some ointments and oral pills. At what stage was your disease found?
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