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Treatment of hemorrhoids

introduction

Hemorrhoids do not always require treatment. Only a hemorrhoid disease is a reason for further therapy. The type of treatment depends on the general condition and the severity of the hemorrhoid disease. As a rule, there are no surgical interventions, so conservative treatments are usually sufficient. The following section deals with the surgical treatment as well as the application of hemorrhoid cream.

Therapy hemorrhoids

Grade 3 and 4 hemorrhoids can be surgically removed.

Grade 3 and 4 hemorrhoids are treated surgically.
Here there is the option of treatment by so-called submucosal hemorrhoidectomy according to Milligan, Morgan and Parks, in which the vessels of the plexus are ligated and the hemorrhoidal node is cut out. The wound in the mucous membrane can be sutured or left open. The wound area is tamponized.

After the operation, hip baths and medicated stool softening are necessary.

Another treatment using the surgical technique is the removal of the hemorrhoids with a special stapler (Stacker hemorrhoidoplexy), which is able to cut out the hemorrhoidal ring in one work step and at the same time to sew the rectal mucosa all around. This technique is used for very pronounced findings.

For less pronounced hemorrhoids, i.e. hemorrhoids 1st and 2nd Degree is not operated on. A general help here Weight reduction with existing Obesity, avoidance of gas and constipation, and exercise, i.e. not sitting for too long.

The bowel movement can also be caused by high fiber nutrition and mild laxatives such as Indian psyllium or Bifiteral be regulated.

Sitz baths with chamomile extracts, i.e. careful anal hygiene, are also indicated for correct treatment.

There are also locally effective ones Anoint and Suppositoriesthat contain anti-inflammatory agents and often also a local anesthetic, which superficially numbs the itchy and painful areas of the anal mucosa. In this way, the main symptoms of itching and pain are eliminated quickly and easily. However, it should be noted that the active ingredients of these topical drugs reduce the tear resistance of Condoms can affect.

Furthermore, the doctor can check for 2nd degree hemorrhoids with a so-called rubber band ligation Barron to treat. To do this, he places a firm rubber band on the base of the hemorrhoids, which ultimately leads to the hemorrhoids dying off by preventing the blood supply. This treatment is not painful. The hemorrhoids simply fall off after a while.

Treatment with a cream

There are a variety of hemorrhoid creams and ointments that are used for the brief symptomatic treatment of hemorrhoids. They are supposed to relieve itching and burning, but cannot eliminate the cause. Such ointments contain anti-inflammatory agents, local anesthetics and astringents. These so-called astringents have anti-inflammatory, hemostatic and drying effects. This is beneficial, as creams of such a composition help well with itchy, oozing and burning inflammations. For more severe symptoms there are also ointments containing cortisone.

Lidocaine and benzocaine, for example, can be used as pain relieving components of hemorrhoid ointments. All these active ingredients are mixed with lubricants and vasoconstrictors (open vessels). The latter also lead significantly to hemostasis. Overall, all available ointments and creams are used for the local symptomatic treatment of mild to moderate ailments, but they cannot replace surgical therapy in more severe ailments.

You can find additional information here: Home remedies for hemorrhoids or Tannolact fat cream

The operation for hemorrhoids

Very advanced and severe hemorrhoids cannot be treated conservatively on an outpatient basis. In such a case, surgery is essential. Such surgical interventions largely restore the normal anatomical relationships of the Afters as goal. Under no circumstances should the entire hemorrhoidal cushion be removed, as this would lead to a loss of fine continence. There are now various surgical procedures that can be used to treat particularly severe hemorrhoidal diseases.

A very important classic procedure is that Hemorrhoidectomy. This procedure is mainly used for tissue that has fallen out and cannot be repositioned. This procedure entails an inpatient hospital stay and a painful healing process lasting several weeks. The procedure is generally performed under or under general anesthesia Spinal anesthesia carried out. Before surgery, hemorrhoids are treated conservatively in the acute stage.

You can divide the hemorrhoidectomy under different points of view: First of all, one differentiates between circular and segmentary, as well as between open and closed Procedure. Circular and segmental are terms that describe the extent of the prolapsed (herniated) tissue.A circular prolapse means that all of the hemorrhoidal pad has prolapsed. The segmental procedure includes, for example, the open hemorrhoidectomy Milligan-Morgan or the closed procedure Ferguson. An example of a circular procedure is post reconstructive hemorrhoidectomy Fansler-Arnold. The various procedures differ according to their exact operative course and are each named after their discoverer. What they have in common, however, is a very low recurrence rate, which means that there are usually no new cases after the operation. In addition, all of these procedures involve a lengthy healing process that sometimes has to be accompanied by pain therapy. In any case, the patient is initially unable to work after such an operation.

Apart from these classic procedures, there are also modern procedures, some of which are less painful. However, they are only used for less severe hemorrhoids. To mention is that Stacker hemorrhoidopexyin which the anal skin is lifted with the help of a special surgical device, the stacker. In contrast to hemorrhoidectomy, a large part of the hemorrhoidal cushion is preserved. This method is popular with third-degree hemorrhoids. For fourth-degree hemorrhoids, however, the procedure is contraindicated as it can cause renewed prolapse.

Furthermore there is minimally invasive procedures, in which the arteries supplying the hemorrhoidal nodes are tied off, and the hemorrhoids are thus shrunk. Clamping the arteries cuts off the blood supply to the hemorrhoids. A distinction is made between different procedures depending on the exact sequence.

What happens after the operation?

As a rule, patients are on sick leave one to three weeks after the operation. In the first few days, stool continence may be reduced, but this will improve by itself over time. The risk of surgery is scarring and the associated anal stenosis (tightness of the sphincter), which can lead to stool retention. Urinary retention is very common, especially in patients with spinal anesthesia.