Hemorrhoids

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The Immense Risks of the Surgical Treatment of Hemorrhoids


    Surgical treatment of hemorrhoids (piles) is reserved only for severe cases. Non-invasive remedies are highly recommended for less severe cases.



    The severity of haemorrhoids depends on its developmental stage. Internal hemorrhoids are staged according to their degree of prolapse.



Grade 1: 

Hemorrhoid is not prolapsed. Bright red blood is the only visible symptom.



Grade 2: 

Hemorrhoid prolapses during bowel movements. Hemorrhoid may also prolapsed due to any increase in intra-abdominal pressure. However, hemorrhoid spontaneously retracts after pressure is withdrawn.


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Grade 3: 

Hemorrhoids (piles) are prolapsed. The prolapsed piles can be reduced by manually pushing them back into the rectum.



Grade 4: 

Hemorrhoids are permanently prolapsed and irreducible. Internal piles are usually not painful. However, they might become painful at this developmental stage.



    Treat your grade 1&2 internal piles without invasive surgical techniques. Request natural remedies from your doctor.



    Sometimes grade 3 internal piles require surgical treatment. Sometimes they can be perfectly treated with natural remedies like venapro. Topical ointments and suppositories could also provide relief.



    Grade 4 internal piles often require surgical intervention. You shouldn’t wait around till your piles aggravate to this point because surgery comes with a ton of risks.



    Thrombosed external hemorrhoids can be treated with natural home care remedies. Your doctor might opt for surgery, if conventional treatment fails.



The best piece of advice you’ll ever receive is to treat your hemorrhoids as soon as you discover the symptoms. 


Untreated haemorrhoids aggravate over time. In the advanced developmental stage, only medical intervention becomes possible.


Dangers of Surgical Procedures


Most of the medical complications which result from surgery are none life-threatening. In addition, most can be reversed with further medical intervention.



Bleeding


The risk of bleed due to local treatment is about 1%. The bleeding is hardly anemic. A full colonic examination might become necessary, if you suffer from anemia.



Infection


    In recent years, the general rate of infection has dropped significantly to below 1%. The highest rates of infection occur after hemorrhoidectomy and are still at about 5%.



Anal Strictures


    Anal strictures or anal stenosis is the narrowing of the anal canal. This can obviously lead to increased difficulty in passing stool. The highest rates occur after excisional hemorrhoidectomy.



Urinary Retention


    Urinary retention difficulties are a symptom of occult sepsis. The neural network supplying the bladder is in close proximity to the anal region. Any tempering with these nerves can provoke urinary retention (ischuria) issues.



    Incidentally, constipation also causes urinary retention. And constipation is one of the most frequently cited causes of haemorrhoids.



Fecal Incontinence


    Fecal incontinence (bowel incontinence or anal incontinence) is the loss of control over your stool. You will find your stool passing involuntarily, if you suffer from fecal incontinence.



    Hemorrhoidectomy, laser surgery, cauterization and cryosurgery all have the potential to cause fecal incontinence. The risk of fecal incontinence resulting from surgical intervention is as high as 28%.



Mucosal Ectropion

    

    Mucosal ectropion frequently occurs together with anal stenosis. Hemorrhoidectomy is the biggest culprit in producing this medical complication.



    When you suffer from mucosal ectropion, your anal mucosa becomes everted from the anus. The mucosa might protrude from the anus due to the weakening of rectal tissue, provoked by the surgery.



Perianal Sepsis


    Perianal sepsis (anorectal abscess) is the collection of pus in tissue due to inflammation. All surgical techniques can lead to perianal sepsis. Fortunately, perianal sepsis is a medical condition, which is very easy to cure.



    On average, the success rate of surgical procedures is above 70%. This figure is constantly increasing as technology improves and the understanding of hemorrhoids becomes more lucid.



Hemorrhoidectomy


    Hemorrhoidectomy is a surgical procedure to remove pathological haemorrhoids. Due to its invasive nature, this surgical technique is reserved only for severe hemorrhoidal cases. There are two types of hemorrhoidectomy: excisional hemorrhoidectomy and stapled hemorrhoidectomy or stapled hemorrhoidopexy.



    Your doctor is unlikely to recommend hemorrhoidectomy; unless, less risky treatment options have been exhausted.



    Your doctor will only recommend hemorrhoidectomy, if the following conditions are met:



    You have other colonic or anorectal conditions which require surgery.



    You simultaneously have internal and external hemorrhoids. Having both types of piles simultaneously is rather common.



    Other less invasive office procedures like sclerotherapy or cauterization have failed.



    You are suffering from a strangulated internal haemorrhoid. Internal haemorrhoids can be strangulated by the anal sphincter.



    You suffer from recurring hemorrhoids. Less invasive office techniques like rubber band ligation have a recurrence rate of over 28%. Recurrence might also occur after a hemorrhoidectomy but the rate is less than 1%.



    You have grade 3 or grade 4 prolapsed internal hemorrhoids.



Excisional Hemorrhoidectomy


    This surgical technique involves the cutting the hemorrhoid off. Your surgeon has the option to either leave the cut open or to close it by stitching. Most surgeons prefer closed excisional hemorrhoidectomy because it produces fewer complications.



    It is associated with excruciating post-operation pains and the recovery period can last anywhere between 2 to 4weeks. Applying glyceryl trinitrate ointment post-procedure helps alleviate the pain.



    Hemorrhoidectomy has a higher success rate than rubber band ligation.



Stapled Hemorrhoidectomy


    Stapled hemorrhoidectomy is a surgical procedure in which the hemorrhoidal tissue is partially excised. The bulk of the inflammation is removed. The remaining tissue is then inserted back into its normal anatomical position and stapled using a special device.



    This is a complicated medical procedure, which is conducted under anesthetics. Please do not attempt to do it with an office stapler.



    Stapled hemorrhoidectomy (stapled hemorrhoidopexy) is associated with less pain than excisional hemorrhoidectomy. Average recovery time is also much shorter.


    The drawback of stapled hemorrhoidectomy is its higher rate or recurrence.



Doppler-guided Transanal Hemorrhoidal Dearterialization


    Doppler-guided transanal hemorrhoidal dearterialization is a minimally invasive surgical procedure. In Doppler-guided dearterialization, ultrasound is used to accurately locate the arterial blood inflow. The arteries are subsequently tied off to starve the hemorrhoid of blood supply.



    The prolapsed tissue is inserted back to its normal anatomical position.



    This procedure has a slightly higher recurrence rate than conventional hemorrhoidectomy. However, the medical complications are fewer.



Less Invasive Office Procedures

Sclerotherapy


    In sclerotherapy involves injecting a sclerosing agent directly into the hemorrhoid. Phenol is the most predominately used sclerosing agent. The sclerosing agent provokes the collapse of the venal walls. This leads to the hemorrhoid shriveling up and falling off.



    Sclerotherapy has a success rate well over 70%.



Rubber Band Ligation


    Rubber band ligation is a minimally invasive procedure in which an elastic band is used to tie up the hemorrhoid’s blood supply. The hemorrhoid is tied up at approximately 1cm from the dentate line. The blood-starved hemorrhoid usually dries up with 5 to 7 days and shrivels up.



    The success rate of rubber band ligation is about 87%. Among the 13% failure rate, only 3% involves serious medical complications.



Cauterization


    Cauterization is minimally invasive. It is still surgery; in spite of the fact that, it is minimally invasive. The most commonly used cauterization techniques include electrocautery, infrared radiation, laser surgery and cryosurgery.



    Electrocauterization is a surgical procedure, in which, heat generated from electric plates is used to destroy the hemorrhoidal outgrowth. Electrocauterization in favoured over chemical cauterization in treating hemorrhoids because chemicals have the propensity to leach beyond the boundaries of the affected area.



    Infrared cauterization is mostly used for grade 1 and grade 2 internal hemorrhoids.


    Laser surgery or cryosurgery involves using a laser beam to pulverize the hemorrhoid.


    Every surgical intervention presents risks of medical complications. You might end up with medical complications such as anal strictures, fecal incontinence, anemia, mucosal ectropion and urinary retention problems.