Painful haemorrhoid removal surgery can be replaced by the advanced treatment method, which...

Painful haemorrhoid removal surgery can be replaced by the advanced treatment method, which allows the patient in few days to return to the normal life

Hemorrhoids is a very common disease manifesting by different symptoms; about 80 % individuals of world population at least once in the life get this disease. Physician Saulius Švagždys from the Centre of  Abdominal Surgery of “Kardiolita Hospital” states that this disease usually is diagnosed in able bodied patients irrespective of their gender. Though haemorrhoids are not malignant, they can reoccur interfering with the quality of life, therefore it important to seek medical advice; physicians will select the most appropriate treatment  – medical, or surgical, if the disease has progressed to the advanced grade.

Because of fear of surgery many people delay treatment  and search of medical assistance. Some of them come to the doctor when haemorrhoids develop to the advanced grade and interfere with everyday life. However, the medicine develops continually and currently for these patients we can offer less invasive and painless treatment method, which allows the patient returning to the normal life faster, – explains abdominal surgeon, physician S. Švagždys.

Haemorrhoid's development is predetermined by genetics and life style

Haemorrhoids usually manifest by bleeding which is caused by traumatic lesion of haemorrhoids by faeces, they also can prolapse out of the anus because of too much straining on the toilet. The disease affects both genders equally, however, in females the external haemorrhoids can increase because of pregnancy and birth giving causing increased pressure on the pelvic blood vessels.

There are two theories explaining haemorrhoid development – related to the connective tissue and vascular. Because of genetically inherited peculiarities of the connective tissue the walls of blood vessels are weaker and haemorrhoid lumps are improperly fixed in the anal canal; sometimes the subcutaneous varicose veins of calves may develop additionally. On the background of such inheritance straining during bowel movements can provoke the disease even more. Another theory explains that in case of disturbed drainage of venous blood from pelvis,  the venous blood accumulates in the pelvis as well as in the haemorrhoid lumps,” –further explains Dr. S. Švagždys.

These inherited health conditions can be aggravated by the unhealthy life style; therefore, it is recommended to have regular bowel movement and to avoid straining. Even people without genetic predisposition, minimally involved in sports, avoiding straining during bowel movement or consuming alcohol more often  are under the increased risk of haemorrhoid symptom manifestation.

Haemorrhoid grading and how to recognise them

Four grades of haemorrhoids are recognised; haemorrhoid grading is based on the enlargement of haemorrhoid lump and its protrusion from the anus.

The first-grade haemorrhoids can manifest by insignificant signs – mild bleeding, discomfort and feeling of fullness in the anus. The second-grade haemorrhoids are diagnosed if they protrude through the anus during straining or evacuation but return back spontaneously. Grade three haemorrhoids are diagnosed when haemorrhoid protrudes through the anus during straining or evacuation but needs to be manually returned to position, – explains the physician abdominal surgeon.

Grade four haemorrhoids currently are especially rare however, they can be recognised by separating buttocks  and visualising the mucous membrane covering the protruding haemorrhoids which will not go back into the anus.

Surgical treatment is not always necessary

The first-grade haemorrhoids are commonly treated applying conservative methods, such as change of life style; i.e. It is important to avoid constipation, consume sufficient amount of liquids and fibres, and regularly participate in physical activities. Different preparation can also help – haemorrhoid suppositories before bowel movements and discomfort relieving ointments, flavonoids strengthening blood vessels.

Surgical treatment methods are applied when medical treatment fails to restore previous quality of life and anaemia develops. Grade one haemorrhoids are usually treated applying minimally invasive techniques when internal haemorrhoid lumps can be reduced by certain measures – some patients can benefit from such treatment during the rest of life. The most popular treatment method is a rubber band ligation of the haemorrhoid lump. It can be carried out without anaesthesia in an out-patient setting within several minutes, - said Dr. S. Švagždys.

Another possible option – partial destruction of the haemorrhoid lump by infrared radiation (infrared coagulation). Nevertheless, previously applied methods such as cryotherapy or sclerotherapy of haemorrhoid today are only a part of the history of medicine.

The traditional treatment methods are replaced by the new ones

Third grade haemorrhoids usually were treated applying the radical treatment techniques when the enlarged haemorrhoid lump is resected; as a result of such intervention the patient suffered from pain for several weeks until the surgical wounds have healed completely.

In Kaunas “Kardiolita Hospital” we have introduced a new less invasive THD (Transanal hemorrhoidal dearterialization) method when the arteries supplying blood to the haemorrhoid lumps are ligated and the enlarged haemorrhoid lumps are fixed but not resected during the surgery. By using the special ultrasound system “Trylogy” that is introduced into the anal canal we can locate the blood vessel supplying blood to the haemorrhoid lump and ligate it. This disturbs blood circulation in the haemorrhoid lump and lump ligation disturbs anatomical structure. Disturbed blood supply the cavernous  bodies start to shrink and eventually become overgrown by the connective tissue”  – explains the physician abdominal surgeon.

As the surgery is carried out in the anal area covered by the mucous membranes free of pain receptors, the post-surgical period is less painful and free of large surgical wounds. After few days the patient can return back to his (her) routine and, if follows the principles of healthy life style, actually has no risk of relapse.

For those who want to avoid the problem of relapsing haemorrhoids or to prevent it in general, physician of Kaunas “Kardiolita Hospital” S. Švagždys recommends to follow the balanced diet rich of fibres and fluids, limit the time spent in the toilet during bowel movements (avoid long sitting on the toilet), prevent constipation and try to maintain a normal body weight. If you notice the first of recurrent haemorrhoid symptoms it is important to seek advice from your family physician or physician coloproctologist without delay.