Hemorrhoid surgery is used to treat hemorrhoids (also known as piles), which consist of inflammation and swelling of the veins and blood vessels in the hemorrhoidal tissue. This tissue, which is located around the anal canal and contributes to a more effective closure of the anus, hypertrophies (enlarges) and becomes flaccid over time, which can cause the appearance of hemorrhoids and their symptoms, among which are bleeding, itching, pain and discomfort.
Hemorrhoids can occur both internally and externally, and it is the most common anal pathology, estimating that more than 50% of the population suffers from some hemorrhoidal symptom at some point in their life.
Diagnosis of hemorrhoids and when surgery is necessary
Often, the most common symptom of hemorrhoids and that usually manifests first is bleeding, although they can also cause prolapse (protrusion through the anus), itching, episodes of inflammation with more or less pain and anal lumps.
In any case, before the appearance of symptoms, it is important to go to the specialist’s office to carry out a correct inspection and anorectal examination, not only to confirm the diagnosis of hemorrhoids, but also to rule out other pathologies that can produce similar symptoms of bleeding and anal pain, as is the case with rectal tumors and other inflammatory conditions (ulcerative colitis, Crohn’s disease).
In addition to confirming the diagnosis and ruling out other pathologies, the review by the specialist also makes it possible to assess the degree of the hemorrhoids, thus allowing to determine which is the most appropriate treatment in each case and whether or not it is necessary to resort to surgery. Surgical treatment is generally used for grade III and IV hemorrhoids, which have more severe symptoms.
Treatment of hemorrhoids and types of surgery
As already mentioned, once the diagnosis has been confirmed and the degree of hemorrhoids assessed, the specialist will decide which is the most appropriate treatment in each case for the improvement and resolution of the symptoms.
The different treatments for hemorrhoids, from least to most aggressive, are as follows:
In the first place, especially in mild cases of hemorrhoids, a series of hygiene measures and changes in the patient’s diet are started, which include a diet rich in fiber with plenty of water intake, avoiding spices, spicy or alcohol, among others. In cases of hemorrhoids whose symptoms present acute episodes, it is recommended to take sitz baths, using warm water (hotter than cold), for no more than 10 minutes, which usually relaxes the anal sphincter.
When the above measures are not enough, treatment with medications is used. These can be topical (creams and ointments), or oral medications.
In the case of creams and ointments, they are used to reduce edema and inflammation, although they are not used to treat bleeding or prolapse. These creams and ointments are usually used in acute episodes of hemorrhoids, for no more than 7-10 days.
On the other hand, oral medications that are prescribed for hemorrhoids aim to prevent constipation and facilitate bowel movements. These include bran, Psyllium, Plantago ovata, flax seeds, methylcellulose, laxatives…
Like the hygienic-dietetic actions, pharmacological treatment is usually used in cases of lower grade hemorrhoids (I and II), for which in many cases they are sufficient, not requiring a more complex treatment.
In those cases of lower grade hemorrhoids (I and II) for which the previous treatments have not been effective, and in some cases of grade III, there are instrumental treatments that allow eliminating the hemorrhoids without having to resort to surgery. These are performed on an outpatient basis (they do not require hospitalization) and are less aggressive, with a faster recovery with less discomfort and less pain.
The most used instrument treatments are the following:
- Banding: elastic bands are placed around the hemorrhoids, without the need to make incisions or wounds, which makes the hemorrhoids fall off. The patient can resume their daily activity the next day.
- Laser “coagulation/sclerosis” treatment: unlike the surgical laser used in laser hemorrhoid surgery, this technique does not make a wound, and the recovery is faster.
Treatment through surgery
Surgical treatment of hemorrhoids is used only in cases of larger and more severe hemorrhoids (grade III and IV), and in those cases in which it has not been possible to treat by any of the previously mentioned instrumental treatments.
Through this surgery, which is usually performed on an outpatient basis and under general anesthesia, hemorrhoids are removed. There are various techniques to carry it out:
- Hemorrhoidectomy (conventional surgery): Hemorrhoids are removed using a scalpel, covering the wounds with sterile gauze.
- Hemorrhoidopexy with stapler: also known as the PPH or Longo method, in which a mechanical suture is used anally, which removes the excess rectal tissue while suturing the mucosa with metal stitches, repositioning the hemorrhoids in their natural position.
- Transanal Hemorrhoidal Dearterialization (THD): this minimally invasive and practically painless technique uses a Doppler probe to locate and suture the hemorrhoidal artery that carries blood to the hemorrhoids, so this method does not involve removing tissue.
- Laser resection: this surgical technique uses a surgical laser instead of a scalpel to section and remove hemorrhoids. It is used especially in external hemorrhoids. Although this technique does not shorten the healing time, thanks to the greater precision of the laser it produces less inflammation and no stitches are required, which translates into less pain and postoperative discomfort.
As it is a sensitive area, postoperative discomfort and pain are usually somewhat greater than after other types of surgery, although thanks to the most recent techniques and pain relieving medications that are used today it is somewhat more bearable.
In general, the results of the surgery are usually very positive, the patient being fully recovered in a few weeks. After the operation, it is important for the patient to adopt healthy diet and exercise habits to prevent new hemorrhoids from forming.
Hemorrhoid treatments and surgery at Vithas Xanit Internacional
If you are looking for a specialist for hemorrhoid treatment or surgery, remember that at Vithas Xanit Internacional we put at your service the best specialists and the latest in medical technology and treatment techniques, which allows us to offer you the best care and the best possible results. Contact us for more information or make an appointment.