Hemorrhoids. About the treatment of hemorrhoids, anal fissure and tears at the rectum. When is surgery?

Hemorrhoids (tumores haemorrhoidalis) is a kind of blood-filled veins, located in and around the anus. Hemorrhoids can be internal, external or both internal and external. It is a common condition that is benign (not become cancerous), but may cause some discomfort. Over half of the population will at some point in their lives get symptoms from hemorrhoids - it is quite common and completely harmless. Hemorrhoids may occur in connection with eg constipation and hard stools, obesity and pregnancy, but there is also a hereditary tendency. The cause of hemorrhoids is often unknown. Increased pressure in the arteries that carries blood back to the heart, veins, however, can cause hemorrhoids. The example problem in pregnancy. Pregnant women with hemorrhoids thus experience mostly that hemorrhoids disappear again once the baby is born. Hemorrhoids can be treated with suppositories, creams, but also require treatment by a doctor.

What can be done about hemorrhoids?

Mild cases: It is important to avoid hard stomach, and one should therefore drink plenty, and possibly make use of mild stool specimens. Another advice is to eat such as magnesia to get a more steady stool - and eat as otherwise the fiber-rich. In mild cases, hemorrhoids treated with laxatives, suppositories eg PROCTOSEDYL, cream or ointment such as mild juniper ointment also may help by hemorrhoids. The same is Xylocaine skin ointment for local anesthesia by itching, scratches and insect bites. At the pharmacy, you can also buy Hemorex ointment that just an ointment for use in hemorrhoids, cuts, itching and other discomfort around the anus. The piles ointment that is antipruritic, antiseptic and without fragrance, dyes and preservatives.

Severe cases: Allows
the Doctor, shoot a tight rubber elastic over the piles to its roots and close to the blood or hemorrhoids can be treated by surgery. Hemorrhoids precursor benign. There is thus no risk of developing cancer, and usually goes hemorrhoids itself again, if one eliminates the risk factors. That is, keep your stools soft and avoid sitting too long on the toilet and push to get the stools out. Learn about Surgical treatment of hemorrhoids further down the page.

Symptoms of haemorrhoids (Hemorrhoids)

Symptoms of hemorrhoids may involve pain, burning, itching, mucus discharge and especially weak or heavier bleeding from the rectum, which makes it difficult to keep the skin around the anus clean. The bleeding is frequently little fresh blood in the stool or on toilet paper. From time to time seen heavier bleeding (bowl splash). It looks dramatic, but the case of relatively modest amounts of blood. Larger hemorrhoids may by feces squeezed out through the anus and again slip up after bowel movements. In severe cases seen constant prolapse of piles. A prolapsed hemorrhoids can be pinched, resulting in significant swelling and severe pain (sandwiched hemorrhoids). Constant pain for several hours or days required examination as soon as possible.

About anal fissure (tear in the rectum)

Tears in the rectum (anal fissures) are as hemorrhoids frequent problems among many people. The symptoms and treatment of these two problems are similar. Anal fissure is a crack or tear in the rectum, which breaks up in the stool. The crack gets deeper and deeper, if there continues to be an over-stretching of the tissue, and there comes a chronic wound. Some have a too tight sphincter, which will also lead to the emergence of a fissure in the rectum. The crack is typically just inside the anus and just posterior to the coccyx and is 5-10 mm long. Fissures are less frequent than hemorrhoids. Cracks in the rectum is often seen in children and adolescents. Anal fissures be prevented and treated as hemorrhoids. That is, avoid hard stomach, hard stools and treat with hæmoridecreme eg Xylocaine local anesthetic skin ointment for anal tears or ointment for anal irritation and itching, and anal lacerations. - Click here to read about constipation >>

Blood in stool

Blood in the stool caused by bleeding from the rectum. Haemorrhoids, lacerations, chronic intestinal inflammation and tumors in the intestine are the major causes of blood in the stool. The first time you notice blood in your stool, you should contact your doctor. Have you both abdominal pain and blood in the stool, call your doctor immediately. Blood in the stools may be signs of serious illness such as cancer or chronic inflammation of the intestine. In most cases, a chronic inflammation of the rectum treated with prescription medication. But in most cases, blood in the stool, however, be signs of something less serious as haemorrhoids or tears in the rectum.

Examination for hemorrhoids in severe cases

Basically hemorrhoids benign, yet annoying. Examination for hemorrhoids is done by the doctor feels up in the rectum and then make a anorekto spectroscopy, that is, a keyhole of the lower part of the intestine. Have there been bleeding, is typically also keyhole higher up in the gut (sigmoidoscopy) as bleeding may be indicative of a polyp, or diseases of the gut. Hemorrhoids are divided into four levels of difficulty:

  • Grade 1: hemorrhoids are sitting inside, and allows bleeding.
  • Grade 2: hemorrhoids fall out of stools and slides back by itself again.
  • Grade 3: hemorrhoids does not slide back after bowel movements, but can be pushed into place.
  • Grade 4: hemorrhoids are always outside the anus, which can get sore.

Treatment of hemorrhoids grade 1 & 2: done frequently outpatient by a specialist using the so-called 'elastic' approach (thd), which shot a tight rubber band over the hemorrhoids to their roots. This stops blood fullness of hemorrhoids, which wither and fall off after two to four days. Often a treatment to be repeated a few weeks apart. Treatment of grade 3 & 4: Piles of this severity can only be treated by surgery.

Surgical treatment of hemorrhoids. Thd or Stapler?

The newest form of surgical treatment of hemorrhoids is called THD, Trans Anal Haemorrhoid Dearterialisation. The new THD with treatment is

  • the healing process is painless
  • that it is carried out-patient
  • that it can be carried out without or with anesthetic cream
  • that as a patient is back in full vigor after 1-2 days

Briefly, THD is explained by the surgeon locates hemorrhoids, and string the arteries as surgical thread. This prevents blood flow and sac pulled together and disappear. Ie the inner blood vessels down to hemorrhoids closed off, and blood flow to the hemorrhoids stopped. In a short time shrinks hemorrhoids in, and in this way avoids cutting the hemorrhoids away. The operation is minimal intervention and leave no ulcers, and therefore are usually very little pain following surgery THD. Half of the patients describe no pain at any time on the day following surgery, while 5% in need of facilitating the analgesic tablets after the operation. In rare cases, pain can last several weeks. The method is tested on a larger number of patients from 2000 to 2004, and has proven to be effective in about 90% of cases, which is higher than the so-called Stapler method where hemorrhoids are cut away. In the remaining 10% will further hemorrhoids surgery sometimes be necessary. In the case of large hemorrhoids that may also involve the skin around the anus, is most often chosen a surgical treatment of hemorrhoids in anesthesia.

The healing after surgery

If you have been operated with the classical method, there will be open wounds in the rectum in four to six weeks after surgery. In the first part of the period you will normally need painkillers, and the wounds must be kept clean with water (shower). By Stapler method can usually go home the same day as the surgery is performed. It is recommended that you take pain medications (arthritis medications) in the first five days in order to avoid pain during defecation. In addition, it is important to avoid the slow stomach. To do this exercise, drink plenty, eat lots of fruits and vegetables and possibly supplementing with a fiber product. After surgery, rinse the wound a few times a day with hand shower. It is important to keep the stool steady until the wound has healed, and therefore often offered a laxative (lactulose magnesia clay). After discharge can eat ordinary food. A tendency to hard stools, this should henceforth be governed by such purgative and plenty of liquid. In both types of surgery can bleed a little from the rectum during the first days. If bleeding increases, you should consult a physician. Whether you have been operated with one or the other method the result can only be definitively resolved three months after surgery.


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