Hemorrhoids

Hemorrhoids are normal vascular anatomic structures in the rectal canal. Hemorrhoidal disease is an enlargement of the hemorrhoidal veins beneath the mucous tissue, the final part of the colon that is the anal canal, which are covered with more or less damaged mucosa. All conditions that lead to increased pressure in the veins of the final part of the large intestine contribute to the development of hemorrhoidal disease.

Besides genetics, the reason for developing this disease is excessive obesity. Infrequent and inadequate nutrition, digestive problems, extreme efforts at defecation may also lead to more frequent occurrence of this disease. It is believed that about 70% of the population in industrially developed countries, age over 50 years, have experienced problems with hemorrhoids.

Depending on disease progress, hemorrhoids can be of different sizes and morphologies, and are classified from first to fourth degree.

Grade I – bleeding hemorrhoids without external visibility

Grade II – hemorrhoids fall out during defecation, but return alone

Grade III – hemorrhoids fall out during defecation, but the patient must bring them back inside manually

Grade IV – hemorrhoids are always outside, and cannot go back, and they can also become thrombosed hemorrhoids

CLINICAL PHOTO

Symptoms of hemorrhoid existence can be various. Hemorrhoids can:

– bleed
– sting
– itch
– hurt
– trombose and
– compress.

DIAGNOSIS

Surgical examination with a proctoscope is sufficient for the diagnosis of hemorrhoidal disease.

TREATEMENT

Depending on the stage and symptoms, treatment can be surgical and non-surgical.

Non-surgical treatment is performed with:

– systemic therapy (vasoactive substances),
– topographical agents (creams, ointments, suppositories)
– sclerosant therapy (injection of appropriate solutions that sclerose (close the vessel), and / or by placing elastic rubber ligatures around the hemorrhoids).

Surgical treatment can be classic or contemporary.

In conventional methods, there is a certain risk of complications such as prolonged and difficult recovery, a strong degree of postoperative pain that can last for days, even weeks, sphincter damage, narrowing of the anus and so on.

Classical surgical method for solving hemorrhoids are done under general anesthesia and the modern method is performed in short-term intravenous analgo-sedation, combined with local infiltration anesthesia.

Modern methods of treatment are minimally painful, and therefore the recovery is quick and most patients return to their daily activities after 24 – 48 h. Modern methods of treatments are:

– LIGASURE method is a treatment method that is performed with radiofrequent coagulation on enhanced blood vessels using Ligasure appliances.
– THD method is based on ultrasonic verification of the hemorrhoidal artery that nourishes hemorrhoids, its ligation, and then the rest of the ligation of hemorrhoids.
– LASER treatment is the latest form of treatment of this disease, which involves laser sclerosation of varicose hemorrhoidal veins.

All these modern procedures have become the standard therapy in developed countries, and have almost completely replaced conventional surgical methods for treating hemorrhoids.