Hemorrhoids are popularly known as hemorrhoids. It is found in and around the anal canal. It consists of bubble-shaped swellings formed by dilated capillary blood vessels. It does not cause many symptoms in the early period. Many patients may not even realize they have hemorrhoids. As the disease progresses, symptoms appear.
HOW CAN HEMORRHOIDS BE DONE?
-Anal bleeding; Usually, a few drops of bright red color are seen in the toilet.
-Itching in the anus; The itching is mild, it does not bother much.
–Swelling in the anus; It hangs out of the anus after going to the toilet and can be inserted by pushing it manually.
–Mucus discharge with the toilet.
–Tenderness, redness and swelling around the anus.
Hemorrhoids cause serious pain when blood flow slows down and stops and blood clots inside (thrombosed hemorrhoids), but at other times there is no significant pain.
When symptoms are observed, a proctologist should be examined and the diagnosis confirmed, otherwise hemorrhoids are symptoms of other diseases. Because of its similar symptoms, diagnosis of many serious diseases, including anal cancer, is delayed. Valuable time is lost in the treatment of such serious diseases. Some patients with hemorrhoids hesitate to have an anal examination, but there is nothing to be ashamed of. Since the proctologist constantly performs these examinations, this situation is normal for him.
How are hemorrhoids diagnosed?
Hemorrhoids are diagnosed by examination. This examination is done in 3 stages. First, the area around the anal canal is checked visually, then an examination called finger touch is performed. In the third stage, the inside of the anal canal is seen with an anoscope and the diagnosis and degree of hemorrhoids are determined.
How is hemorrhoids examined?
First, by looking, it is determined if there is a breast outside the anal canal. Then, the finger is inserted into the anal canal and the changes in the anal canal are determined by an examination called rectal touch. Then, a device called an anoscope is inserted into the anal canal and internal hemorrhoids in the anal canal are visually evaluated. After these examinations, it is clear what type of hemorrhoid you have and its degree. Hemorrhoids in the upper 2/3 of the anal canal are internal hemorrhoids Hemorrhoids in the lower 1/3 of d are called external hemorrhoids.
Hemorrhoid disease is evaluated over 4 degrees;
-First degree; Hemorrhoids are small, invisible swellings inside the anal canal.
-Second degree; Hemorrhoids are swellings that are only noticed when straining in the toilet and then disappear.
-Third degree; Hemorrhoids are swellings that constantly appear around the anus but can be pushed in with the finger.
-Fourth degree; Hemorrhoids are very prominent around the anus and are in the form of swellings that cannot be pushed in with a finger.
The treatment of hemorrhoids varies depending on the degree of hemorrhoids, this degree must be known in order to choose the right treatment method.
HOW DO HEMORRHOIDS FORM?
Although it is not possible to say the exact cause of hemorrhoids, many factors related to hemorrhoids can be said.
-High blood vessel pressure around and inside the anus causes the capillary networks in the anus to expand, swell and become inflamed.
-Excessive straining due to constipation increases the pressure of the capillary networks in the anus and causes them to expand and swell.
-Chronic diarrhea also occurs. It facilitates the formation of hemorrhoids.
-Obesity increases the tendency to have hemorrhoids.
-As age progresses, the supporting tissue weakens and the risk of hemorrhoids increases.
-Pregnancy increases the blood pressure in the anal area by putting pressure on the pelvic veins, and pregnancy hormones also increase the risk of hemorrhoids. It also causes the smooth muscles in the vascular walls to relax and expand.
-A family history of hemorrhoids
-Continuous heavy lifting
-Very persistent cough and vomiting.
-Sitting for too long;< Factors such as br /> increase the risk of hemorrhoids.
HOW CAN WE PREVENT HEMORROS?
By changing our lifestyle, the pressure on the veins around the anus should be reduced as much as possible, for this;
-We should increase the number of fiber foods, ensure regular functioning of the intestines and avoid constipation.
-We should consume plenty of fluids.
-We should avoid alcohol and caffeine.
-Do not go to the toilet. We should not postpone and sit on the toilet for a long time and strain too much.
-We should avoid medications that cause constipation.
If we are overweight, we should lose weight.
-We should exercise regularly, which prevents constipation, lowers blood pressure and helps lose weight.
Early hemorrhoid complaints can often resolve spontaneously or with some simple medications, but the breasts remain and the risk of progression continues.
Hemorrhoids during pregnancy often resolve spontaneously after birth.
HOW ARE HEMORRHOIDS TREATED?
Hemorrhoid treatment is done according to the type (internal-external) and degree of hemorrhoids. Conservative treatment can be performed for the treatment of first degree hemorrhoids. By meticulously applying the protection methods mentioned above, the complaints are alleviated with some creams and pills, but as we mentioned above, the breasts remain and the tendency to progress continues.
Non-surgical interventional treatments should be preferred for second and third degree hemorrhoids.
WHAT ARE THE NON-SURGICAL TREATMENT METHODS OF HEMORRHOIDS?
–Rubber band method; Without the need for anesthesia, the anal canal is entered with an anoscope, the hemorrhoid nozzle is vacuumed and a rubber band is placed to compress the bottom. The blood flow to the breast is cut off. The hemorrhoids rot and fall off in about 1 week. It has advantages such as being easy to apply while standing and not requiring rest.
–Infrared photocoagulation; With infrared light applied to the root of the hemorrhoids, the veins coming to the hemorrhoids are destroyed and shed within 1 week. It is popularly known as laser, but this is a different treatment. Like rubber tape, it can be applied standing and without the need for anesthesia. There is no need to rest after the application.
–Sclerotherapy; Necrosis is caused by injecting a chemical substance under the hemorrhoid breast, and when it heals, the breast is fixed. However, it is not preferred due to serious complications.
–Electrotherapy; It is the burning of hemorrhoids with electric current. It is not widely used due to its difficulty in application and complications.
–Cryotherapy;Cryotherapy of hemorrhoids has been tried, but its application difficulties and complications are high.
HEMOROIDS' WHAT ARE THE SURGICAL TREATMENT METHODS?
–Linking the hemorrhoidal arteries (THD): Actually, it may not be called surgery. Under general anesthesia, a small ultrasound device is inserted into the anal canal and all arteries coming to the hemorrhoids are determined 5-6 cm above the anal canal and tied with sutures. As the pressurized blood coming to the hemorrhoid is stopped, the hemorrhoid nozzles shrink over time and return to their natural state. It is the most suitable treatment method for the anatomical structure. Rest is usually not required and complications are very few.
–Stapler hemorrhoidopexy (longo surgery); It consists of cutting and stitching the large intestine mucosa all around with a stapler device, where the anal canal meets the rectum. Although its results are good, it is not performed as much as it used to be because it is a very serious operation, its complications lead to serious consequences, and its high cost.
-Classical surgery; It is the surgical excision of hemorrhoids under general anesthesia. Although its success rate is good, it has very serious complications such as abscess hematoma, severe postoperative pain and delayed recovery due to infection, anal stenosis and insufficiency. It should not be preferred unless its indication is necessary.
–Laser treatment; Under general anesthesia, a laser probe is inserted into the hemorrhoid nozzles through a small incision, and the entrance points of the vessels to the package are dried by laser ablation. It has no superiority over other methods and is not widely used because it is extremely expensive.
Complications seen after hemorrhoid surgery:
-Bleeding: It is most commonly seen after classical surgery.
-Inflammation: It is common because the operation site comes into contact with the toilet. It is not seen in THD and laser treatments.
-For a temporary period due to pain. difficulty urinating
-Abscess; It is most commonly seen after surgery.
-Incontinence: It is most commonly seen after surgery.
-Anal fistula
-Anal stenosis
When these serious complications are evaluated, it seems that aggressive interventions in the treatment of hemorrhoids should be avoided as much as possible unless necessary.
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