Hemorrhoids are enlarged cushions in the upper part of the anal canal. Also known as piles or anal fissures, hemorrhoids have two types: internal and external. Due to various reasons, the venous cushions in the anal canal can protrude outside the anus over time, forming hemorrhoid disease.
Causes of Hemorrhoids?
- Changes in bowel habits such as chronic constipation and prolonged diarrhea
- Pregnancy and childbirth
- Working while sitting for extended periods (such as driving)
- Working while standing for extended periods
- Sedentary lifestyle, laziness
- Horse riding, cycling
- Alcohol
- Tumors in the pelvic region
Symptoms of Hemorrhoids
- Palpitated swelling in the anus
- Anal pain
- Painful or painless bleeding during defecation
- Discharge, feeling of wetness
- Itching
The symptoms listed above may also be indicative of other diseases. Diseases such as cancer, tumors, colitis, anal fissures, and fistulas can also cause these complaints. Therefore, a person who suspects hemorrhoids should not act on their own or on the advice of others, but should definitely consult a doctor. When a doctor is consulted, hemorrhoid treatment can be provided in a short time, another underlying disease can be diagnosed, and treatment can be followed accordingly. On the other hand, if there are internal hemorrhoids, the symptoms may appear later. Pain is a symptom that appears later in internal hemorrhoids.
We divide hemorrhoids into 4 degrees. In the first degree, the cushions are less prominent. In the second degree, the hemorrhoid lumps protrude outside during defecation and can spontaneously return inside. Itching and bleeding in the anus may occur. In third-degree hemorrhoids, the lumps that protrude outside during defecation can only be pushed back inside by hand. In the fourth degree, they cannot be pushed back inside even by hand.
Hemorrhoid Treatment
Hemorrhoid treatment can be done with surgical and non-surgical methods. The treatment method is determined according to the degree of the disease. In first-degree hemorrhoids, dietary and toilet habits are usually sufficient. In second and third-degree hemorrhoids, medication is recommended in addition to these. In fourth-degree hemorrhoids, surgical methods may be necessary. Among non-surgical hemorrhoid treatments, we can mention band ligation, sclerotherapy, and infrared coagulation methods. In the band ligation method, the hemorrhoid nodules are compressed with rubber bands. In this way, the vascular supply is disrupted, and the nodule dries up and falls off. It is suitable for internal hemorrhoids. In external hemorrhoids, pain may be felt around the anus. In the sclerotherapy method, a substance called a sclerosant is injected into the hemorrhoid nodules. In this way, the nodule dries up. Its place in treatment is limited and insufficient. In the infrared coagulation method, the hemorrhoid nodule is dried up by applying infrared light to its vascular root. Suitable for second-degree hemorrhoids. May require several sessions, recurrence rate is high.
Hemorrhoid Surgery
Classic Hemorrhoid Surgery: Hemorrhoid nodules are surgically removed. During the removal process, a knot is tied in the blood vessel supplying the nodules, which reduces the recurrence rate. In addition, if the internal sphincter muscle around the anus, which works uncontrollably, is partially cut and relaxed, both postoperative comfort is increased and the chance of recurrence is slightly reduced.
Longo (Stapler) Hemorrhoidopexy: Hemorrhoid nodules that form 4-5 cm above the anal canal are compressed with a special stapler for 1-2 cm and removed with an automatic stapler device. This method allows for less pain after the procedure and an earlier return to normal life. However, its cost is slightly higher than classic surgery and its recurrence rate is also slightly higher.
Things to Pay Attention to After Hemorrhoid Surgery
- You can be discharged the day after the surgery.
- After discharge, you should use the medications prescribed by your doctor regularly.
- There may be some spotting and leakage from the anus for 1-2 weeks; this is normal.
- We recommend using stool softeners for about 1 month. This will improve your post-operative bowel comfort.
- We recommend taking sitz baths for 15-20 days. You can do this morning and evening, and after bowel movements, by filling a bathtub or basin with water at a temperature that will not burn the anus. This process will both act as a wound dressing, alleviate possible pain, and contribute to your healing. Remember that applying hot water or a hot water bottle to this area will not have the same effect.
- Don’t forget to consume plenty of fiber-rich foods and drink at least 2 liters of water a day. This recommendation applies not only to our patients who have had hemorrhoid surgery, but to everyone.
Eat plenty of fruits and vegetables, don’t delay going to the toilet, and don’t sit on the toilet for a long time.
