Normally, humans have spongy vascular networks in the last part of the large intestine that opens out. Hemorrhoidal disease (piles) occurs with the expansion of these structures called hemorrhoidal vessels.
Hemorrhoidal veins have important functions in the body: Normally, the blood accumulating in these vascular networks ensures complete closure of the anus (anus). Thus, hemorrhoidal veins help to control defecation even though the person does not voluntarily contract the muscles controlling the anus.
It acts as a protective cushion layer on the muscle ring that we call the sphincter surrounding the anus.
During rest and sleep, it completely closes the anus (breech) and prevents the leakage of stool.
Hemorrhoidal vessels are divided into external (external) and internal (internal) according to the location. External hemorrhoids are located around the anus and are covered with thin skin.
Hemorrhoidal disease is the excessive expansion and sometimes overflow of the spongy hemorrhoidal vessels in the anus and rectum. There may be hemorrhoidal disease (Piles) separately in external and internal hemorrhoids. If clotting (thrombosis) occurs in external hemorrhoids, the patient feels a lot of pain. Internal hemorrhoids manifest themselves with more bleeding.
One of the main causes of the disease is straining. Urination causes high pressure to fill this area with blood. Apart from straining, other factors that increase intra-abdominal pressure can also cause hemorrhoidal disease (Piles), such as:
Bleeding during defecation (bowel movements)
It is the most common symptom. It is often drip fresh bright red in color. Blood can be noticed on the stool and during cleaning.
Anus coming out during defecation (defecation), palpable swelling.
The patient complains of a soft swelling and mass protruding from the anus. Some patients may push this protruding swelling back into the anus.
Itching in the anal area (anus)
With the failure of hemorrhoidal vessels to perform their normal functions, the hygiene of the anus region is also impaired. With the incomplete closure of the anus, stool and discharge
leakage. Itching occurs due to this.
Patients cannot fully express these complaints. They may describe the pain as a stinging or burning sensation. Especially the presence of thrombosis (blood clot formation in the vein) of external hemorrhoids (hemorrhoids) causes severe pain.
Swelling that is constantly outside the anal canal and is painful to the touch
It may develop as a result of internal hemorrhoids protruding from the anus, or may occur with thrombosis of external hemorrhoids.
Stage 1: Bleeding occurs
Stage 2: In addition to bleeding, internal hemorrhoids (piles) come out after defecation (stool) and after a while they enter themselves.
Stage 3: In addition to bleeding, internal hemorrhoids (piles) come out after defecation (stool) and must be pushed in with the help of a hand.
Stage 4: In addition to bleeding, internal hemorrhoids (Piles) are always outside.
The anus region of the patient is examined visually by the doctor in a bent forward or lateral lying position on his knees, then the examination is completed by inserting the finger through the anus. This examination is usually sufficient to diagnose hemorrhoidal disease (Piles). However, since hemorrhoid-like complaints can also be seen in diseases such as colon cancer and other diseases that are not noticeable on examination with hemorrhoids, sigmoidoscopy or colonoscopy is definitely required.
Many discomfort may occur with bleeding during defecation as the first symptom. Large intestine cancer (colon and rectum cancer), colon polyps, crack in the anus (anal fissure), inflammation (abscess), fistula formation, inflammatory bowel disease (ulcerative colitis and Crohn’s disease), bowel prolapse (prolapse), stool incontinence ( incontinence), itchy rectal disease, irritable bowel syndrome, sexually transmitted diseases and many other conditions can affect this area. Therefore, differential diagnosis is very important and should be done by a specialist.
The treatment of hemorrhoidal disease varies according to the patient’s complaints and the stage of the disease. There are many alternatives to treatment. But the ideal is to choose the appropriate method for the patient. First of all, defecation and eating habits should be regulated.
– Regulation of defecation habits
Regular defecation habits are important for treatment. Sitting for a long time on the toilet (smoking, reading a newspaper, etc.) and avoiding excessive straining reduces the tension and pressure in the hemorrhoidal vessels, thus preventing hemorrhoids from escaping from the anus.
– Diet regulation
Increasing the proportion of fiber (fiber) food in meals and gaining regular defecation habits can help. Another important issue is to drink enough water. At least 10-12 large glasses of water should be drunk a day. Fruit juice, coffee, tea does not replace water.
Sitting for 10 minutes in warm water several times a day will reduce symptoms (signs, complaints). After the sitz bath, the anus area should not be left wet and should be kept dry. With this treatment, even in the most severe hemorrhoids, pain decreases within 2-7 days and the hard swelling around the anus regresses within 4-6 weeks.
There are many pomades used in the treatment of hemorrhoidal disease. Your doctor may recommend a pomade depending on the condition of the disease.
There are medications that control the blood flow of the rectal vessels and prevent their excessive swelling and facilitate the recovery of hemorrhoidal disease in a short time. These drugs should be used under the supervision of a doctor.
It is an increasingly used method in recent years. Very good results are obtained when applied by suitable patients and by an experienced team. Post-procedure pain is almost nonexistent. Stand up immediately, no need to lie down.
Hemorrhoidectomy- Classical Surgical method
It is the process of removing hemorrhoid packs. This process can be done by classical methods or by using instruments such as ligasure, cautery, ultrasonic scalpel. The recovery period can be up to three weeks depending on the size of the surgical procedure.
Stapler (Longo) method (Stapler hemorrhoidopexy, Stapled hemorrhoid surgery)
It is a method developed in recent years. It is a less painful, effective method, recovery and return to daily life are quicker. These are surgeries performed using disposable instruments called stapler.
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