Hemorrhoids are a common problem that many people experience. This condition occurs when the anal cushions become enlarged and displaced. The most common symptom of hemorrhoids is rectal bleeding, which can happen during a bowel movement. It can be treated with non-operative methods, such as sitz baths and stool softeners, or with operative methods, such as hemorrhoidectomy.
It looks like uncontrolled blood vessel width and growth could play a big role in hemorrhoid development and might be something that you can aid with medical treatment. Most of the time, you treat hemorrhoids by changing lifestyle habits, adding fiber to your diets, using anti-inflammatory drugs delivered via suppository, and taking venotonic drugs.
There are a few different ways to treat hemorrhoids that don’t involve surgery, like sclerotherapy or rubber band ligation. But if those methods have not worked or you have developed complications, surgery might be the best option. There are several surgical approaches for treating hemorrhoids, including hemorrhoidectomy and stapled hemorrhoidopexy, but postoperative pain is always a possibility.
Surgical treatments for hemorrhoids can potentially cause a lot of additional problems, such as anal stricture and incontinence. It is important to discuss the applications and outcomes of each treatment option with your doctor before making a decision.
Dietary Adjustments
Straining during defecation can cause damage to the anal cushions and lead to symptomatic hemorrhoids. Increasing your intake of fiber or adding bulk to your diet may help reduce straining and improve your symptoms. In clinical studies of hemorrhoids, fiber supplements reduced the risk of persistent symptoms and bleeding by approximately 50%, but did not improve symptoms of prolapse, pain, and itching.
Fiber supplements are effective for treating non-prolapsing hemorrhoids, but it may take a few weeks for results to be noticeable. Fiber supplements are safe and affordable, making them a great option for initial treatment or as part of a long-term care plan following other hemorrhoid treatments.
Medical Treatment
Oral calcium dobesilate
Calcium dobesilate is a drug that is commonly used to treat diabetic retinopathy and chronic venous insufficiency. It can also be used to treat the symptoms of hemorrhoids. Studies have shown that calcium dobesilate can help to reduce capillary permeability, inhibit platelet aggregation and improve blood viscosity. This can lead to a reduction in tissue edema.
A recent clinical trial testing a new hemorrhoid treatment showed that combining calcium dobesilate with a fiber supplement was an effective way to relieve acute bleeding and significantly improve inflammation. This new treatment option may provide much-needed relief for hemorrhoid sufferers.
Topical treatment
Most topical treatments aim to control symptoms instead of curing the disease. This means that other therapeutic treatments might be necessary later on. There are a lot of different topical preparations available, like creams and suppositories, and most of them can be bought without a prescription.
However, there isn’t a lot of strong evidence proving how effective these drugs actually are. These topical medications can contain various ingredients such as local anesthesia, corticosteroids, antibiotics and anti-inflammatory drugs.
Non-Operative Treatment
Rubber band ligation
Rubber band ligation is a quick and easy way to treat first and second-degree hemorrhoids, as well as selected third-degree hemorrhoid patients. Tying off the affected tissue with a rubber band leads to a lack of blood flow and eventually death of the tissue, which then leads to the connective tissue attaching itself to the rectal wall.
Be careful not to place the rubber band too close to the dentate line, though, as this can cause severe pain due to the nearby somatic nerve endings. If this happens, you’ll need to remove the band immediately.
Rubber band ligation is a safe and effective haemorrhoid treatment that can be performed in one or more sessions, using a commercially available ligator. This device uses suction to draw the redundant tissue into the applicator, making the procedure a one-person effort.
Radiofrequency ablation
Radiofrequency ablation (RFA) is a new hemorrhoid treatment that uses heat to shrink hemorrhoids. A small, heated ball is placed against the hemorrhoid tissue for a short time. This coagulates and evaporates the tissue, shrinking the hemorrhoid. RFA is less invasive than surgery, and the tissue around the hemorrhoid heals quickly after treatment.
This method can help reduce the size of hemorrhoids and keep them in place by causing scar tissue to form. RFA is similar to a procedure called sclerotherapy, and can be done without spending a night in the hospital.
The main risks are infection, bleeding, and a blood clot near the anus. Even though RFA is not a painful procedure, it does have a higher chance of the hemorrhoids coming back or dropping down into the anal canal.
Operative Treatment
Hemorrhoidectomy
Excisional hemorrhoidectomy is the most effective treatment for hemorrhoids, with a very low rate of recurrence compared to other methods. hemorrhoidectomy can be performed using scissors, diathermy, or a vascular-sealing device such as Ligasure or Harmonic scalpel.
Hemorrhoidectomy comes with the risk of postoperative pain, but former patients have reported less pain, shorter hospital stays, and faster wound healing with Ligasure hemorrhoidectomy.
Other possible complications include acute urinary retention, postoperative bleeding, bacteremia and septic complications, wound breakdown, unhealed wound, loss of anal sensation, mucosa prolapse, anal stricture, and even fecal incontinence.
Plication
Plication is a medical procedure that can help heal anal cushions without needing to remove anything. The surgery involves oversewing the hemorrhoidal mass and tying a knot at the uppermost vascular pedicle. Even though this is a common procedure, there are potential complications that can happen afterwards like bleeding and pelvic pain.
Key Takeaway
Hemorrhoids are unfortunately a pretty common issue that people experience. The good news is that there are a number of different treatment options available, depending on the severity of the hemorrhoids. In some cases, dietary and lifestyle changes may be enough to provide relief. Surgery is often effective, but it is reserved as a last resort due to the complications that can be associated with it.
