Diagnosis and Treatment of Haemorrhoids
Symptoms and causes of haemorrhoids
Symptoms may include bleeding from back passage; prolapse, itching, mucous discharge and pain. Haemorrhoids are common after the age of fifty. Contributory factors are constipation, overweight, lifting heavy objects, pregnancy and family history of haemorrhoids.
Degree of haemorrhoids: Haemorrhoids can be internal or external.
First degree: Internal piles that bleed.
Second degree: Piles that bleed and prolapsed but reduce spontaneously.
Third degree: Prolapsing piles that can be pushed back.
Fourth degree: Prolapsing piles that cannot be reduced
Before treatment it is crucial to exclude a sinister cause for bleeding. Treatment depends on the degree of haemorrhoids. Simple changes in diet by increase fibre and fluids may improve the symptoms.
Conservative management: Creams, ointments and laxatives
Banding and Injections: Out-patient treatment for first and second degree haemorrhoids
Surgery THD Procedure
Doppler-guided, transanal hemorrhoidal dearterialization is a minimally invasive treatment using an ultrasound doppler to accurately locate the arterial blood inflow. These arteries are then “tied off” and the prolapsed tissue is sutured back to its normal position. This causes the haemorrhoids to shrink. The procedure is a day case procedure and causes minimal discomfort. Majority of patients can go back to work the next day.
Stapled haemorrhoidectomy What happens in this procedure is a circular stapling gun is used to cut out a circular section of the lining of the anal canal above the haemorrhoids. This has an effect of pulling the haemorrhoids back up the anal canal. It also has an effect of reducing the blood supply to the haemorrhoids which shrink as a consequence.
Haemorrhoidectomy An operation to cut away the haemorrhoids is an option to treat 4th degree haemorrhoids. Is no more a common operation. The operation is done under general anaesthetic and is painful and recovery takes 4-6 weeks.