Treatment for Haemorrhoids
Treatment of Haemorrhoids
Medical treatment of haemorrhoids is aimed initially at relieving symptoms. Measures to reduce symptoms include :
1. Warm tub baths several times a day for about 10 minutes.
2. Application of a cream or suppository to the affected area.
3. Relieving the pressure and straining of constipation.
Bathing in tubs with warm water eases painful perianal conditions as this produces relaxation of the spasm of the sphincter mechanism. Application of ice also relieves the pain of thrombosed piles.
Cream is good for haemorrhoids that are sticking out from the anus ( prolapsed haemorrhoids), while the suppositories ( which are tablets pushed to be up inside the anus where they dissolve) are better suited for haemorrhoids which are still inside. Both methods shrink the haemorrhoids and are often sufficient.
Decreasing straining and treating constipation shrinks internal haemorrhoids and alleviates the symptoms; thus, first-line treatment for all haemorrhoids should include measures to decrease straining and constipation.
Fibre and fluids should be increased in the diet. Eating the right amount of fibre and drinking 8-10 glasses of fluid result in softer, bulkier stools. Psyllium seed and methylcellulose are the most commonly used fibre supplements. A softer stool makes emptying the bowels easier and lessens the pressure on haemorrhoids caused by straining. Eliminating straining also helps prevent the haemorrhoids from protruding. Many haemorrhoid symptoms resolve when treated merely with dietary alterations.
Toilet training involves reminding patients that the lavatory is not the library. Patients should sit on the toilet only long enough to evacuate the lower intestines. Persistent straining or prolonged sitting can lead to engorged haemorrhoids.
Many patients get complete resolution of their symptoms with the above conservative measures. Aggressive therapy is reserved for patients who have persistent symptoms after one month of conservative therapy.
Numerous methods are available to destroy internal haemorrhoids. These include rubber-band ligation, sclerotherapy injection, infrared photocoagulation, laser ablation, carbon dioxide freezing and surgical resection.
Haemorrhoid injection : For small irritating haemorrhoids which do not protrude out and do not respond to medications, injecting them with a scarring agent will cure them . Within a few days of the injection, the dilated veins shrink.
Haemorrhoid banding, or rubber-band ligation of internal haemorrhoids : For problematic haemorrhoids a special type of rubber band is slipped tightly over the haemorrhoid's base. This cuts off the haemorrhoids blood supply.
Surgical Therapy of Haemorrhoids
Indications for operative treatment are :
1. Heavily bleeding haemorrhoids.
2. Big protruding haemorrhoids
3. Acutely painful haemorrhoids
4. Patients who do not respond to non-operative therapy.
5. Patients who also have significant symptoms or recurrent
external thromboses.
During surgery each hemorrhoid is cut and the bleeding points are stitched. Surgery usually leads to a permanent cure. Complications of surgery, though rare, can include narrowing of the anal canal ( stenosis), bleeding, infection, recurrence, wounds which do not heal easily, and fistula formation.
When performed well, operative haemorrhoidectomy ( removal of haemorrhoids) should have a 2-5 per cent recurrence rate. Non-operative techniques such as rubber-band ligation produce recurrence rates of 30-50 per cent within 5-10 years. However, these recurrences can usually be treated with further non-operative treatments.
Prevention of Haemorrhoids
To prevent haemorrhoids :
1. Keep stools soft so they pass easily, thus decreasing
pressure.
2. Empty bowels without undue straining as soon as the urge
occurs.
3. Increase fibre in the diet and drink adequate amount of fluids.
Anal Fissure and Haemorroids
Symptoms, Causes and Diagnosis Anal Fissure and Haemorroids
Haemorrhoids
Symptoms of Internal and External Haemorrhoids
Treatment for Haemorrhoids
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