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Hemorrhoids, the venous dilatations of the anorectal hemorrhoidal plexus, have become an increasingly common pathology today, affecting even young people in proportion to 60%. This alarming reality highlights the need for understanding and education about the causes, symptoms, treatments and prevention of this condition.

Dr. Marina Dumitraș – Primary Physician General Surgery, Proctology, Doctor of Medical Sciences helps us in this regard.

Dr. Marina Dumitraș: About 50% of the planet’s population is affected by stage III hemorrhoidal disease, with surgical indication; about 60% of young people reach the first proctological consultation, already being in an episode of complication of hemorrhoidal disease. Therefore, awareness of risk factors, false myths, and treatment options is essential to managing this condition responsibly and successfully.

Causes of hemorrhoids

The main trigger of hemorrhoids is the altered structure of collagen fibers in the walls of the hemorrhoidal plexus. However, chronic constipation and diarrheal syndrome play important roles, generating stools of increased consistency or continuously irritating the smooth sphincter. These conditions favor dilation of the veins, leading to the appearance of hemorrhoids.

Symptoms and complications

Symptoms of hemorrhoids include bleeding after stool, anorectal itching, and swelling in the anorectal region. Ignoring this pathology can lead to serious complications such as hemorrhage, thrombosis, suppuration or hemorrhoidal prolapse.

Advanced surgical treatments and techniques

In the advanced stages of the disease, modern surgical techniques such as Longo type stapler-anopexy are resorted to. This approach consists of resection of the excess mucosa, correction of the prolapse, and interruption of the blood supply to the internal hemorrhoids. The advantages are obvious: the absence of the operative wound, reduced postoperative pain and quick recovery.

Classic technique: Classic hemorrhoidectomy.

Presupposes serial interventions for advanced hemorrhoidal pathology, there is an operative wound that must be cared for at least 14 days, high risk of sphincter incontinence (the patient does not feel that he has the sensation of defecation).

Banding technique with ligatures:

It involves a gradual atrophy of the hemorrhoidal bundles (these ligatures are successively tightened), they can slip quite easily, it does not correct the hemorrhoidal prolapse (excess).

What does post-operative recovery entail?

First of all, it should be noted that after a surgical cure of hemorrhoidal prolapse with Longo stapler-anopexy, there is no surgical wound.

In the anal canal, practically the entire anastomosis remains after resection of excess anal mucosa.

There is a high risk of thrombosis (clots), therefore venous tonics are recommended.

The pain is residual, but I also recommend an anti-inflammatory as well as local and intrarectal applications with anti-hemorrhoidal ointments containing anti-inflammatory and local anesthetic.

Administering a mild laxative is extremely effective as it regulates stool consistency.

Recovery is extremely fast, in a few days the patient already has digestive tolerance for any food.

During the first 7 postoperative days, the patient is advised to avoid red meat, soups, peas, beans, cabbage, as well as to consume cooked vegetables and fruits.

He is called for a postoperative control after 7 days or as needed, depending on his own evolution, when the anal canal is explored and the local situation after hemorrhoidal resection is checked.

The risk of recurrence after this surgical technique is extremely low

Myths about hemorrhoids

It is crucial to dispel the myths surrounding hemorrhoids.

Popular treatments and effective prevention

Suppositories, creams and teas can relieve symptoms temporarily, but they do not effectively treat the disease. Proctological consultationhigh-fiber diet, avoidance of irritants, routine colonoscopy, and rigorous hygiene are the keys to managing and preventing hemorrhoids.

Hemorrhoids in pregnancy: a worrying reality

Pregnant women are more susceptible to hemorrhoids due to hormonal changes and increased pressure on the veins. Today, about 40% of pregnant women suffer from hemorrhoids. Treatment in this context is exclusively medicinal, under the supervision of the gynecologist.

Prevention and correct diet

Adopting a healthy lifestyle, avoiding constipation and diarrhea, maintaining an optimal body weight and avoiding risk factors are essential to prevent hemorrhoids. A diet rich in fiber, adequate hydration and avoiding strenuous physical exertion are effective preventive measures.

Read also: Dr. Marina Dumitraș: “Acute appendicitis represents a major surgical emergency”

2024-01-25 14:16:55
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