What is Hemorrhoidal Disease?
Hemorrhoids are natural anatomical structures that are present in every human being. The condition in which these structures become deformed over time due to various reasons and cause problems in the anal area is called hemorrhoidal disease. Hemorrhoidal disease is a condition that needs to be treated. It may cause problems such as anal swelling, pain and bleeding that impair the quality of life.
Hemorrhoidal Disease Symptoms
In hemorrhoidal disease, symptoms may vary depending on the stage of the disease. In stage 1-2 disease, the first symptom is rectal bleeding, while in stage 3-4 disease, there may be anal swelling and pain. In thrombosed hemorrhoidal disease, there is a hard and painful swelling in the anal area.
Diagnosis of Hemorrhoidal Disease
Patients with hemorrhoidal disease generally hesitate to go to the doctor. He tries to do his treatment by hearsay. However, there are many diseases that cause similar complaints in the anal area. A differential diagnosis must be made. Approximately 60% of people with rectal cancer think that their complaints are caused by hemorrhoidal disease. For this reason, their treatment is delayed.
The diagnosis of hemorrhoidal disease is made by proctological examination. The problem is usually understood with the examination of an experienced surgeon. However, further tests may sometimes be required for differential diagnosis. The most important of these is colonoscopy. etk
Hemorrhoidal Disease Treatment
Hemorrhoidal disease is usually caused by changes in lifestyle, diet, defecation, which is 90%. It can be treated without the need for surgery with training and some medications. Chronic constipation or diarrhea attacks can trigger hemorrhoidal disease. Staying on the toilet for a long time poses a risk for hemorrhoidal disease. Familial influence has an important place in the development of the disease in many patients.
Hemorrhoidal Disease Surgery
It can be performed in office conditions in the treatment of early stage hemorrhoidal disease; It can be treated with techniques such as radiofrequency treatment, sclerotherapy, hemorrhoidal band ligation and, in appropriate cases, laser treatment.
The method of ligating the hemorrhoidal arteries with Doubleler is also used in the treatment.
Frequently asked questions from you to Prof. Dr. Bah adır EGE answers…
What Causes Hemorrhoidal Disease?
Many factors are effective in the development of hemorrhoidal disease. If we list the most important factors; We can summarize it as familial, occupation, constipation, diarrhea, defecation habits, pregnancy, stress...
Does Hemorrhoidal Disease Go Away on Its Own?
Hemorrhoidal disease is in the early stages. It may go away on its own. In other words, if the constipation attack, diarrhea attack has passed, and the pregnancy has ended, hemorrhoidal disease may regress. However, treatment is required in advanced hemorrhoidal disease. Professional help should be sought for faster recovery and to prevent the disease from progressing.
Hemorrhoidal Disease: Important Information
More than 50% of individuals over the age of fifty have hemorrhoidal problems.
An estimated 10 million people in the United States have been diagnosed with hemorrhoidal disease, which corresponds to a prevalence of 4.4%.
If this rate is applied to our country, 3.7 deaths occur every year. It means that million people are treated for hemorrhoidal problems.
Epidemiological studies conducted in Korea, England and Austria found hemorrhoidal disease in 14 to 39 percent of the population. However, most of them were asymptomatic.
There is cuboidal mucosa in the proximal part of the dentate line and cushions rich in arteries, veins, lymphatics and connective tissue under the keratinized squamous epithelium in the distal part.
This concentration is concentrated in the 3,7,11 o'clock dial. structure
It is called corpus cavernosum hemorrhoidalis.
Treitz ligament (hemorrhoidal sling).
Parks ligaments.
The normal structure of physiological hemorrhoid cushions. As a result of the degeneration of the connective tissue (fibroelastic stroma) involved in the venous function, the hemorrhoid cushions protrude distally, and as a result, the disease develops.
While the anal canal is at rest, the blood coming through the hemorrhoidal arteries is easily carried back into the venous circulation by the venous plexus. The cavernous system does not swell.
Situations that cause venous stasis, such as straining during difficult defecation, pregnancy, and multiple defecation, may lead to venous distension, mucosal edema-ischemia, thrombus and bleeding.
Progressive anatomical degeneration genetics. It causes hemorrhoidal disease on the basis of predisposition.
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Internal (internal) hemorrhoid disease
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External (external) hemorrhoid disease
The basis of hemorrhoid disease is internal hemorrhoidal disease.
Hemorrhoidal Disease examination should be performed under the following conditions;
An environment that respects personal rights, a proctological table, a suitable light source and necessary infrastructure for differential diagnosis.
Hemorrhoidal Disease main differential diagnosis;
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Anal fissure
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Prolapse
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Rectal cancer (52%)
Sclerotherapy (in Grade I-III Disease)
It is the injection of 3-5 ml of sclerosing material into the apex of internal hemorrhoids.
Internal hemorrhoids targeted for treatment are used using a long intravenous 21 gauge needle or spinal needle. 1-3 cc of sclerosing material is injected into the submucosa plane.
A swelling should be removed with the solution. If the injection is too superficial, the area will become tight and white and the injection should be stopped immediately to minimize the risk of mucosal necrosis.
Infrared Coagulation Method:
Infrared light waves are converted into heat resulting in protein necrosis within the hemorrhoid.
This produces white on the mucosa approximately 3 mm wide and 3 mm deep. , is seen as a bleaching effect.
Compared to rubber band ligation, infrared coagulation is associated with more recurrences but causes fewer complications and less discomfort after the procedure.
One to two weeks Over a period of time, it causes the prolobited hemorrhoidal mucosa to retract, leading to a shrunken or ablated area.
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