Hemorrhoids Treatment
Hemoroid Ameliyatı

WHAT IS HEMORRHOIDS?

In fact, hemorrhoids are normal anatomical elements of the human body. The name of the disease comes from Latin and it is composed of both the words (blood) and roos (flow). It is a common disease in Turkish society because of its eating habits and lifestyle.

Generally, the expansion of the hemorrhoidal veins (vascular structures) that feed the last part of the intestine and the sagging of it in the breech channel cause the beginning of the disease. In relation to this; bladder muscles and vessel wall due to weakening often seen in the 50-70 age around, but nowadays, ready-to-eat foods, low-fiber foods, constipation and diarrhea due to reasons such as the occurrence of hemorrhoids have been attracted to earlier periods. There is no difference but pregnancy is an important risk factor in women.

WHAT ARE THE REASONS OF HEMORRHOIDS? 

  • Irregular bowel habits (chronic constipation and diarrheal episodes) 
  • Excessive and spicy foods, rich in fiber-consuming foods and water-long work standing or sitting down 
  • Week often remove heavy (athletes and heavy-duty workers) or a long time in the toilet 
  • Anal way of relationship 
  • Chronic cough 
  • Orality and excess weight 
  • Alcohol consumption
  • Inflammatory bowel diseases such as chron and ulcerative colitis 
  • Chemical diseases such as severe heart failure, liver cirrhosis

WHAT ARE THE TYPES OF HEMORRHOIDS?


1-Internal Hemorrhoids 

Hemorrhoids located in the inner part of the breech channel.

STAGE1: The hemorrhoid pouch (= breast) is prominent in the anal canal but cannot be seen. Only anoscopy (visualization of up to 10 cm of the breech canal with an instrument) or rectosigmoidoscopic (endoscopy of the intestine up to 30-40 cm) can be seen during the examination. 

STAGE2: It is in the form of jams, which appear during winding and excretion and then disappear spontaneously. It can cause bleeding, discharge and itching. 

STAGE3: It is in the form of pouches that disappear after self-regeneration. It is itchy because it does not provide enough cleaning after the toilet and can cause a feeling of fullness in the breech.

STAGE4: It is the last stage of the disease. All pouches are outside and cannot return to the breech channel. Swollen and overwhelmed jaws between the tight breech muscle causes serious pain and bleeding.

2-External Hemorrhoids 

Hemorrhoids are located in the area between the end of the breech channel and the anal region skin. 

3-Mixed Hemorrhoids 

The patient has both internal and external hemorrhoids.

WHAT ARE THE SYMPTOMS OF HEMORRHOIDS?

Rinse hemorrhage is the most common cause of the patients. In some patients, it can sometimes be a drop in the toilet after defecation, sometimes only in the form of contamination of toilet paper. Although internal hemorrhoids are the most common cause, the external hemorrhoid pouches which are erosive may also bleed.

Another reason for admission is pain in the rectum. It is most commonly seen in the external hemorrhoid pouch due to a blood clot (thrombus). This is what we call a thrombosis hemorrhoid, which usually occurs suddenly after a difficult stool. The patient recounts a recurrent lanma pain cycle dış by the pressure of solid stool, which is hardened by the patient due to the difficulty in defecation and the lack of stool. In such cases, discharge of the existing clot by applying local anesthesia will be a quick and relaxing treatment for the patient.

The incision of the breasts in the shape of the meat in the anus is the result of hemorrhoid pouches hanging out of the anal canal. 

Findings that the disease is in advanced stage. Pruritus of the anus is due to the mucus content released from both prominent hemorrhoid packs, and due to faecal leakage from the breech muscles which cannot be fully squeezed due to existing cavities. In addition, patients with stage 3 and 4 hemorrhoids feel itching because they cannot clean the stool on the pouches after toilet. Hygienic problems are common.

HEMORRHOID DIAGNOSIS 

Anal and rectal examination is very valuable for our surgical physicians, although it seems to be a very unpleasant examination by our patients. Rectal touch (finger examination) is important for the diagnosis of benign diseases such as hemorrhoids, breech tears, condyloma, as well as diseases such as rectum tumor, anal cancer and polyp. Generally, the patient is enough to diagnose the visual examination performed on the knee and elbows. However, for the diagnosis of stage 1 and 2 internal hemorrhoids, it would be appropriate to evaluate the rectal touch (based on experience) or by looking into the breech channel with an instrument called anoscope.

If there is no hemorrhoid or breech rupture to explain the situation, especially during the examination, especially in patients presenting with rectal bleeding, it is necessary to perform further tests such as colonoscopy and reveal the cause of bleeding.

IS HEMORRHOID FREQUENT IN PREGNANCY?

Most of our female patients indicate pregnancy for the onset of complaints. The frequency of hemorrhoids during pregnancy is high due to increased intra-abdominal pressure caused by the growing baby, changes in bowel movements due to hormonal effects and decreased blood flow. The complaints gradually increase towards the last period and decrease slightly with the birth Yakın. Pregnancy neck, as far as possible surgical intervention is avoided with medical treatment. However, if there is not enough improvement, re-evaluation should be made. Hemorrhoidal disease is not a condition that prevents normal delivery.

WHAT ARE THE SURGICAL METHODS IN HEMORRHOID?

Most of our patients who have been taken for surgery are those who have tried most of the medical treatment methods until now, but their current complaints have not regressed. Depending on the type of surgery planned, spinal anesthesia (numbing of the waist down) or general anesthesia (patient anesthesia) is preferred.

The aim of surgery is to remove problematic hemorrhoid packs. The current techniques used are LİGASURE vascular sealing system, HARMONIC scalpel, LONGO stapler hemorrhoidopexy and LASER coagulation method.

Thanks to these techniques, parameters such as hemorrhage, duration of surgery, postoperative pain, and length of hospital stay are minimized according to classical methods.

Ligasure is an instrument with a scissor-like tip, the pache is placed in the lower part and the vascular structure is cut out and sealed. In this way, there is no bleeding or very little, there is no need to stitch. Harmonic scalpel is also removed by cutting through the lower part of the package using ultrasonic waves with the help of a scissor-like tip. No bleeding or very little, no need for stitching..

Longo stapler is a rounded tip instrument used in patients with all-round internal hemorrhoid pouches. It is a surgical form that cuts all internal hemorrhoid pouches at the same time, staples with metal stitches and protects the opening of the breech channel.

Laser ablation is a preferred method in terms of patient comfort (postoperative discharge, minimal pain after surgery, bleeding and risk of infection). It is a technique that allows the laser to penetrate into the hemorrhoid pouch through a small incision at the end and it is damaged by its effect and light effect and it adheres to the wall of the breech channel due to the structural change. In spite of all these options, it is important to keep in mind that no matter how well you undergo surgery, hemorrhoids are a recurrent disease.

Lazer ablasyon ise son zamanlarda oldukça sık kullandığımız ve ameliyat sonrası hasta konforu (aynı gün taburcu olabilme , ameliyat sonrası minimal ağrı ,kanama ve enfeksiyon riski ) açısından tercih edilen bir yöntemdir. Ucunda lazer olan bir fiber yardımıyla küçük bir kesiden hemoroid pakesi içine girilerek , pakenin ısı ve ışık etkisiyle tahribata uğraması ve sonucunda yapısal değişikliğe bağlı olarak makat kanalı duvarına yapışmasını sağlayan bir tekniktir. Dikişsiz ve kansız bir yöntem olarak kabul edilir.

Vascular structures within the rectum channel are always present due to her dam the same mechanisms.

Ask to Op. Dr. Mehtap Ertürk

Mide Balonu Tedavisi, Anal Fissür sorunlarınız, Hemoroid ve bir çok cerrahi problemleriniz için sizde Doktor Mehtap Öztürk'e merak ettiklerinizi sorabilirsiniz.

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