Haemorrhoids
Hemorrhoids are one of the most common ailments known. More than half of people will develop hemorrhoids, usually after age 30.
Today's treatment methods make some types of haemorrhoid removal much less painful.
Haemorrhoids are venous cushions (enlarged, bulging blood vessels) around the anal canal. Haemorrhoids are graded (1-4) according to their position in the anal canal.
Causes of Haemorrhoids
- Chronic constipation or diarrhea
- Pregnancy
- Heredity
- Straining during bowel movements
- Faulty bowel function due to overuse of laxatives or enemas Spending long periods of time (e.g., reading) on the toilet
Symptoms
Common symptoms of haemorrhoids include rectal bleeding (usually bright red), discomfort if the haemorrhoid prolapses, and itch from mucous leakage onto the skin around the anus.
If a blood clot (thrombosis) develops in an external hemorrhoid, it becomes a painful, hard lump. The external hemorrhoid may bleed if it ruptures.
Treatment
Mild symptoms can be relieved frequently by increasing the amount of fiber (e.g., fruits, vegetables, breads and cereals) and fluids in the diet.
Office based procedures
Rubber band Ligation works effectively on internal hemorrhoids that protrude with bowel movements. A small rubber band is placed over the hemorrhoid, cutting off its blood supply. The hemorrhoid and the band fall off in a few days and the wound usually heals in a week or two. This procedure is carried out in the endoscopy unit and sometimes produces mild discomfort and bleeding and may need to be repeated for a full effect.
Injection and Coagulation can also be used on bleeding hemorrhoids that do not protrude. Both methods are relatively painless and cause the hemorrhoid to shrivel up.
Surgery for haemorrhoids
Transanal Haemorrhoidal De-arterialisation or THD uses a doppler probe to locate the terminating branches of the hemorrhoidal arteries. Once the artery is located the surgeon uses an absorbable suture to ligate or “tie-off” the arterial blood flow. The venous “out flow” remains to “shrink” the cushion. This is done without excision of tissue. If necessary the surgeon will perform a hemorrhoidopexy to repair the prolapse. Again, this is done with suture and no excision of tissue. This repair restores and “lifts” the tissue back to its anatomical position.
The entire procedure is performed above the dentate line so that there is minimal discomfort. The procedure takes about 20 minutes and is performed as day case surgery under general anaesthetic.
Open Haemorrhoidectomy
An open hemorrhoidectomy removes excessive tissue that causes the bleeding and protrusion. It is done under general anesthesia using electrocautery and may, depending upon circumstances, require hospitalization and a period of inactivity.
It is necessary when:
- clots repeatedly form in external hemorrhoids causing pain (thrombosed haemorhhoids);
- ligation fails to treat internal hemorrhoids; (3) the protruding hemorrhoid cannot be reduced; or (4) there is persistent bleeding.
There is no relationship between hemorrhoids and cancer. However, the symptoms of haemorrhoids, particularly bleeding, are similar to those of colorectal cancer.
Therefore, it is important that all symptoms are discussed with your GP.
