Hemorrhoids, commonly known as piles, are cushions of vascular tissue found within the anal canal. Approximately 50% of adults, over the age of 50 have symptomatic “hemorrhoidal disease”. Although it is more common in adults, it is still possible to experience hemorrhoidal disease at a younger age.
Hemorrhoids, like many diseases, do not discriminate to one’s age, gender, or socio-economic status. Therefore, it is essential to gain the necessary knowledge to help prevent, detect, and treat hemorrhoids.
CAUSES OF HEMORRHOIDS
Risk factors:
Straining and constipation
Obesity
Prolong sitting
Chronic diarrhea
Pregnancy
Portal hypertension
TYPES AND SYMPTOMS
External hemorrhoids: develop below the dentate line (the dentate line divides the upper 2/3rd and lower 1/3rd of the anal canal).
Symptoms include:
Pain, if there is a thrombus (blood clot) formation
A leftover skin tag
Irritation and itching
Hygiene issues
Internal hemorrhoids: develop above the dentate line.
Symptoms include:
Rectal Bleeding
Usually painless
Prolapse
DIAGNOSIS
Complete physical examination to include visual/digital examination and anoscopy
Flexible sigmoidoscopy or colonoscopy may be performed to rule out other more severe conditions such as colon cancer, polyps, or inflammatory bowel disease.
TREATMENTS
Medical management:
Dietary and lifestyle modification (proper hygiene, high fiber diet, stool softeners)
Non operative/office based procedures:
Injection sclerotherapy – injection of chemical agents into hemorrhoids to cause fibrosis, scarring, and shrinkage.
Rubber band ligation – placement of rubber band at the base of hemorrhoid constricting and compromising the blood supply. Hemorrhoids will shed within a few days.
Surgical:
Hemorrhoidectomy – procedure in which hemorrhoids are surgically removed .
THD (transanal hemorrhoidal dearterialization) – minimally invasive surgical procedure which has show to cause less pain and discomfort. It does not involve surgical removal of the hemorrhoids but rather a doppler probe is used to stop hemorrhoidal blood flow and to suture pexy of the hemorrhoid back into the anal canal.
PREVENTION
Weight loss and exercise
High fiber diet
Increased fluid intake
Avoid constipation and straining
DR. YOSEF NASSERI
FOR PROFESSIONAL TREATMENT OF HEMORRHOIDS
Dr. Yosef Nasseri is an experienced, highly skilled board-certified colorectal surgeon in treatment of hemorrhoids. He concentrates on hemorrhoid management, and avoidance of surgery is the desired treatment.
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