Hemorrhoids are small vessels that exist naturally in the anus of all humans. In the normal state, these vessels are numerous and small in size at the end of the rectum and above the anus. In medical terms, these veins are called "hemorrhoid cushions". The task of these vascular pads or cushions is to help the elimination process and protect the delicate elements in the anus.
If these cysts become larger than normal or become symptomatic, they are called "hemorrhoid disease" or "hemorrhoids". This disease is one of the common diseases of the anus, which often manifests itself in the form of a lump feeling around the anus by the patient or painless bleeding during defecation. If the hemorrhoid is accompanied by a blood clot inside one of these sacs, it becomes painful and is known as "Thrombotic Hemorrhoid".

According to the statistics, about half of the people experience this problem at some point in their lives, which is often resolved by following some tips, but if it becomes chronic and recurs several times, this problem can become a problem for the patient and cause chronic pain in the person, especially during defecation.

The prevalence of hemorrhoids in people between 40 and 65 years old is more than other people.

Types of hemorrhoids

• Internal hemorrhoids: Internal hemorrhoids are formed above the serrated line of the anus. The dentate line is a part of the anal canal where the skin tissue around the anus becomes the mucous tissue of the right intestine (rectum). These types of hemorrhoids are divided into different degrees from 1 to 4 based on their size and whether or not they come out of the anus during defecation.
• External or external hemorrhoids: this type of hemorrhoids occurs under the dentate line of the anal canal and at the beginning of the anal opening.
• Mixed hemorrhoids: which is a combination of internal and external types at the same time.

hemorrhoid symptoms

• Painless bleeding is the most common symptom of hemorrhoids, which occurs in the form of streaks of blood on the stool or seeing a few drops of blood after defecation. Spontaneous bleeding can also be seen without connection with feces.
• The presence of a palpable mass around the anus is one of the common symptoms of this disease, especially in high grade internal cases or external hemorrhoids.
• Mucous discharge from the anus
• anal itching
• Pain around the anus, which intensifies especially during defecation, usually indicates a blood clot inside one of the external hemorrhoidal cysts, or thrombosed hemorrhoids.
• The feeling of incomplete elimination and difficulty in elimination is also seen in some sufferers.

treatment methods

In order to treat this complication, you should consult a specialist and subspecialist in colorectal surgery and a surgeon for colon and rectal diseases so that the treatment is done according to the type and severity of the disease.

In the first step, the patient is examined by a surgeon and a decision is made based on the results of the examination. It should be noted that the symptoms of hemorrhoids are very similar to other diseases of the anus and rectum, and it is very important to perform this examination. In addition, colonoscopy or rectoscopy can be recommended for patients who have rectal bleeding based on the surgeon's opinion.

Diet plays an important role in the management and treatment of hemorrhoids, a diet rich in fiber including fresh fruits and vegetables, nuts and seeds, whole grain bread, legumes, and adequate water consumption during the day should be observed in patients with this condition, the patient should avoid consuming foods that cause cysts because constipation and frequent and constant straining are one of the most important factors. which brings the risk of occurrence and aggravation of hemorrhoids.

In people with severe constipation, in addition to diet, the doctor may advise the patient to take laxatives. Of course, these drugs should not be used in an amount that causes Diarrhea and should not be used in the long term because it causes the intestine to become dependent on laxatives and eventually worsens constipation after stopping the laxative medicine. Doing light sports such as regular and short-term walks during the day are also effective in creating regular bowel movements and helping with proper bowel elimination, and patients with this condition are advised to include exercise and walking in their daily schedule.

Sitting in a hot tub two to three times a day for 5 to 10 minutes each time improves blood circulation in the pelvis and anus and helps relieve the symptoms of hemorrhoids and pain.

Local drug treatment is usually suggested as the first treatment in many patients. At this stage, the doctor will try to treat and control the symptoms of this disease by prescribing ointments or suppositories. There are different ointments for the treatment of hemorrhoids, which are prescribed based on the doctor's opinion. In case of pain, the use of painkillers is also effective in relieving pain.

A group of patients who do not respond to the above initial treatments or are facing severe disease symptoms, are recommended for surgery. At this stage, the colorectal surgeon suggests the right method of surgical treatment to the patient based on the degree of hemorrhoid disease and the previous history of anal surgeries.

Minimally invasive surgical methods can be used in hemorrhoid patients with low grades. For example, methods such as rubber bands, sclerotherapy, laser therapy and radiofrequency therapy are suggested. There are other methods such as using a stapler or pulling up hemorrhoids (hemorrhoidopexy) and closing hemorrhoid vessels, which can be used according to the type of disease. However, in severe cases of the disease and patients with a previous history of failed or repeated operations, hemorrhoidectomy surgery is recommended. This type of surgery has the lowest recurrence rate among all the mentioned methods.

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