Hemorrhoids

Hemorrhoids are veins of the anus. Due to various reasons (constipation, genetic factors, physical factors, some diseases such as liver cirrhosis, malnutrition …) these veins expand and protrude beyond the anus. Swelling and pain begin. Bleeding occurs when making ablution. Itching, not being able to sit on it, and difficulty in making bowel movements may develop.

The swelling that goes out of the anus in the early stages of the disease re-enters after stool. However, if it is not treated, this swelling will no longer go inside. so it gives more complaints.

Examination is sufficient to diagnose the disease. however, in some cases (the patient’s family has bowel cancer, the presence of some other systemic diseases, ..) endoscopy may be required.

1- Endoscopic methods: Methods such as rubber band, infrared: Generally, local anesthesia is applied. The patient does not need to be hospitalized.

2-Laser hemorrhoid surgery: It is the flow and coagulation of hemorrhoids by entering them with a thin laser cable. It cannot be applied with local anesthesia, spinal anesthesia (by numbing the waist) or general anesthesia (by anesthetizing) can be applied. takes twenty to 30 minutes. Requires hospitalization even for a short time after surgery. usually no dressing is required. patients are usually on their feet and able to do their own work the next day. Return-to-work time is variable.

3-classical hemorrhoid surgeries: It is the method of removing a certain amount of hemorrhoid tissue and closing it with sutures in advanced hemorrhoids. It is done by anesthetizing or anesthetizing the waist. The type of surgery varies according to the patient, the hemorrhoid and the surgeon. The post-operative situation also differs.

4-Longo method (Stappler, with staples) hemorrhoid surgery: Hemorrhoids in the breech come out over time and can no longer enter. Hemorrhoids that continue to grow now cause the last part of the breech to hang out. It is not possible to correct this situation with classical surgical methods. this is called breech prolapse (anal prolapse). In suitable patients to correct this situation, a circular part is removed by a stapler within a few cm of the anus, and the same staple sticks the ends of the protruding part together. Thus, the part that hangs out of the breech is placed back in its place, and the surgical procedure for hemorrhoids is applied at the same time. It can be done by anesthetizing the waist or with general anesthesia. takes about half an hour. In general, patients are kept under control in the hospital for 1 night. In the postoperative period, the pain is not too much. however, rectal edema, difficult defecation, and sometimes a feeling of restlessness may develop. these complaints can last for weeks. Implementation requires experience.

After these methods, it is necessary to take measures to prevent the recurrence of hemorrhoid disease. drug treatments, prevention of constipation, dietary measures, physical activity recommendations are the main ones. however, the disease may recur. Recurrence rates vary according to the treatment applied. In case of recurrence, the necessity of re-intervention is decided according to the current situation.

If hemorrhoid disease is left untreated, it can lead to bleeding, clot accumulation (thrombosis), inflammation, and prolapse of the anus. however, it does not cause cancer as popularly thought.

As a result, the period when the disease is diagnosed and the patient’s condition guide the treatment. The recovery period after surgery also varies depending on the method applied and the condition of the hemorrhoids.

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