HEMORRHOIDS
40-50% of the population has a complaint in the breech area at least once in their lifetime. One of the most common causes of these complaints is hemorrhoid disease. Hemorrhoid disease develops as a result of swollen sagging of the cushions filled with blood in the anal canal or bleeding due to trauma. Disease, internal hemorrhoids and external hemorrhoids are two types. External hemorrhoidal disease develops around the anus. The most common complaint is the mass that comes into the hands of the patient. Internal hemorrhoidal disease develops on the inside of the breech. The most common complaints are bleeding from the breech, breast formation in the breech, and sometimes itching and itching.
What is hemorrhoid clotting?
If blood clots in one of the veins in the hemorrhoid pouch, the patient will experience severe pain as the flow will stop. This condition is called hemorrhoid clotting or thrombosis.
Do hemorrhoidal diseases turn into cancer?
No, hemorrhoidal disease is not a cancer precursor. However, it should never be neglected by a mass and bleeding in the rectum. This is because similar cancers and symptoms may also occur in cancer of the large intestine, rectum (colorectal) and rectal (anus).
How should hemorrhoids be treated?
This disease can resolve spontaneously in the early stages without any treatment, and in many patients, some simple measures can achieve successful treatment results. However, surgical interventions are inevitable in patients with long-term and advanced disease that impair the quality of life of the patient.
CURRENT INTERVENTIONAL METHODS IN THE TREATMENT OF HEMOROIDAL DISEASE
Coagulation Method: It is based on the principle of tissue damage on the hemorrhoid pouches with a heat or light source (laser). In this way, the packets become smaller and bleeding is prevented. This method can be chosen for hemorrhoidal disease that does not come out of the anus (Stage 1-2) but causes bleeding. It is a short-term procedure that can be performed under policlinic conditions.
Band Ligation Method: It is a painless and quite simple procedure that can be performed under polyclinic conditions. It is an appropriate treatment for patients with hemorrhoids and rectal bleeding that come out of the anus (Stage 3-4). In this method, with the help of a special hand tool, hemorrhoid packs are connected at the root with rubber band. These hemorrhoid tissues are excreted with defecation within a few days. Generally, the procedure is performed on a single hemorrhoid pakes. Therefore, it may be necessary to repeat the procedure at regular intervals. There may be discomfort or minor bleeding in the breech after the procedure. These methods, when supplemented with locally administered drugs and diet, can provide 90% treatment for early stage diseases. Although these methods have advantages such as being painless and providing early return to work and social life, it should be remembered that the disease will recur in 70% of the patients treated with these methods.
Surgical Treatments:
Classical Surgery Technique
It is the most appropriate treatment choice for long-term patients, who do not respond to medication and preventive measures, who come out of the anus (Stage 3-4), cannot avoid complaints of pain and bleeding, and also have external hemorrhoidal disease. The classical surgical method is based on the principle of cutting out the hemorrhoid packs. The removal of these packs, the use of high-tech instruments with improved technology has allowed for less postoperative pain. Under the operating room conditions, it is an operation performed with spinal anesthesia and usually after 1 day of hospitalization, patients are sent home.
LONGO Method
It is a surgical procedure performed with a surgical device (stapler) specially developed for the disease that protrudes from the anus (Grades 3-4). In this technique, hemorrhoid packs are not removed, with an incision made just above the anal canal, where there is no sense of pain in this region, the process of removing excess bowel tissue circularly and thus pulling the pouches that hang out outwards into the breech. Since the procedure is performed on the intestine without pain, the comfort of the patient is very good. In 10% of patients, the disease may recur during long-term follow-up.
THD (Transanal haemorrhoidal dearterialisation) Method
In this technique, the tip of the ultrasound device is inserted into the breech, which is very thin and shows the artery leading to the hemorrhoid pouches. Thanks to this device, there are arteries leading to hemorrhoid packs and connected with sutures. It is applied in internal hemorrhoidal disease that hangs outward (Stage 3), causing bleeding (Stage 2) and selected Stage 4. It is a very easy method and patients can return to normal life the next day after surgery.
Laser Method
In hemorrhoidal disease, a tiny incision in the pockets and a thin laser probe enters the hemorrhoid, clotting the vessels. It helps to disappear by shrinking the veins and hemorrhoids pakes by burning them in public. The incision made during this process is about 2 mm. Significant pain, tenderness is not expected. Appropriate cases can be discharged on the same day.
Is there any problem of defecation and gas incontinence after hemorrhoid surgery?
Although it is a very rare complication, fecal and gas incontinence may be observed especially in elderly patients due to the interruption and damage of sphincters (muscles) during surgery.
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