Hemorrhoid Surgery - Grades, Types, and Home Remedies

What Are Hemorrhoids?

Hemorrhoids are swollen veins found inside and outside the rectum and anus. Everybody has hemorrhoids, and they do not cause any symptoms unless they become irritated. This irritation can be mainly because of overstraining during defecation or constipation. The swollen veins cause symptoms like pain, bleeding, redness, and swelling around the anal region.

Treatment For Hemorrhoids:

Treatment for hemorrhoids usually depends on the grade or stage of the hemorrhoids:

• Grade 1: Also called internal hemorrhoids, they are present in the anal canal, but they do not descend outside the anus. Usually, grade 1 hemorrhoids can be treated by following certain dietary changes like intake of high-dietary food and drinking plenty of water. In some cases, topical ointments are suggested, like Hydrocortisone which is available over the counter.

• Grade 2: In this, hemorrhoids come out through the anus only during defecation and instantly return back after emptying the bowel.

• Grade 3: Hemorrhoids come out of the anus during the evacuation of the bowel but do not go in spontaneously. The person needs to push the hemorrhoids manually to get them back into the anus.

• Grade 4: Irrespective of defecation or at normal times, hemorrhoids remain protruding out of the anus all the time.

What Are the Types of Surgical Treatment for Hemorrhoids?

Surgical Procedures: They are advised when other treatments, home remedies, medications, and minimally invasive techniques fail and are usually carried out under general anesthesia.

• Stapling Of Hemorrhoids: This procedure is usually indicated in the treatment of internal hemorrhoids that are very large. This procedure is carried out under anesthesia, where the surgeon uses special devices to staple back the hemorrhoids into the normal position within the anal canal. This stapling causes restricted blood flow to hemorrhoids, and thereby the hemorrhoids shrink in size.

Advantages and Disadvantages

1. Less pain when compared to conventional hemorrhoidectomy.

2. Early recovery time.

3. The chances of recurrence are more when compared with other methods.

4. It can cause rectal protrusion.

• Hemorrhoidectomy: Well-known as hemorrhoid surgery, it is one of the standard methods of treating hemorrhoids. This is done under spinal anesthesia, local anesthesia, or general anesthesia. The surgeon opens the anus very widely and smoothly cuts off the hemorrhoids with the help of surgical instruments. Depending on the location, it is the surgeon’s choice to suture the wound or leave it open.

Advantages and Disadvantages:

1. It is the most successful way of removing the hemorrhoids completely.

2. It has no chance of recurrence.

3. It causes bladder disturbances leading to UTI (urinary tract infections).

4. The patients could complain of pain from spinal anesthesia. These can be subsided by using medications.

• Minimally Invasive Techniques: These are suggested for painful and bleeding hemorrhoids and can be done in a doctor's room or carried out in minor OT (operation theater).

• Ligation of Hemorrhoids by Rubber Bands: In this procedure, local anesthesia is administered, and one or more rubber bands are used to tie the base of the hemorrhoid. By doing this, the blood supply to the hemorrhoids will be cut off, and the hemorrhoids become weak and drop off within 5 to 6 days. The main disadvantage is banding can be painful, inconvenient, and can cause bleeding post-procedure.

• Coagulation: In this process, the doctor uses heat, laser, or infrared and creates a scar on the internal hemorrhoid, and the scar prevents further blood supply to the hemorrhoid, which will cause the hemorrhoid to shrink in size and fall off. This causes little discomfort to the patient, especially while using devices such as lasers and electrocautery.

• Injection Technique: It is also called sclerotherapy. The doctor injects a chemical solution into the hemorrhoids, which leads to numbness of the hemorrhoids. The chemical in the injections restricts the blood supply making the hemorrhoids dry and fall off. However, this technique is inferior to the rubber band technique and coagulation.

What Are the Home Care Instructions to Prevent Hemorrhoids?

Home care remedies should be strictly followed to avoid pain, swelling, and discomfort caused by hemorrhoids. The remedies include:

• Eating Fiber Rich Foods: It is always advised not only to the patient postoperatively but also as a preventive measure to avoid hemorrhoids. A diet rich in fruits, vegetables, multigrain, and soups is advised. This causes the stools to become soft so that defecation can be done easily.

• Avoiding Straining: During the evacuation, too much pressure should not be exerted on the rectum. Too much pressure causes hemorrhoid formation or may worsen the existing hemorrhoids.

• Over-the-Counter Medications: Such as topical ointments and sprays containing Hydrocortisone are used to numb the area around the anus.

• Warm Water Bath: The anal area should be soaked regularly for about ten to fifteen minutes. This causes the muscles around the anal region to relax. Soaking is advised 3-4 times a day. In the United States of America, a special bath known as sitz bath is available for soaking the anal region.

• Use of Laxatives: Also called stool softeners, when ingested, they prevent constipation and help in easy evacuation of the bowel.

• Prolonged Usage of Toilet Seats: Long stretch sitting on the toilet seats should be strictly avoided, as this causes excess pressure on the rectum. In a recent survey, prolonged usage of potty seats is seen in people who are using cell phones during defecation.

• Fluid Intake: In general, people are suggested to take plenty of fluids in the form of water, juice, and soups to avoid constipation. Insufficient water intake can make the stool hard, dry and makes it very difficult to defecate.

Conclusion:

Hemorrhoids (piles) are a common complaint among people irrespective of sex. Too much straining during the passage of stool leads to hemorrhoids. Most of the hemorrhoids would resolve by following home remedies within 7 to 10 days. Prolonged pain, swelling, bleeding, and discomfort require surgical intervention. The choice of surgical procedures depends upon the grade and intensity of the hemorrhoids.