Haemorrhoids (Piles) Treatment

Haemorrhoids occur as a result of dilation of vessels in the anus area. It is colloquially known as piles.

What are the Symptoms of Haemorrhoids ?

• Palpable lump near the anus
• Bleeding from the anus (fresh red colour)
• Pain
• Burning sensation
• Feeling of dampness around the anus

Why do Haemorrhoids occur ?

• Constipation and diarrhoea
• Pregnancy and childbirth
• Tight clothes
• Squatting for a long time
• Straining for a long time
• Lifting heavy
• Sedentary life

These conditions increase the pressure in the anus area, causing the formation of haemorrhoids.

What are piles?

“Piles” is another name for haemorrhoids. It is a condition occuring as a result of dilation of vessels in the anus area. Squatting for a long time, straining, heavy lifting, sitting on the toilet, constipation, pregnancy, heavy lifting are risk factors.

How are Haemorrhoids Diagnosed?

It is usually diagnosed by rectal examination. However, patients, whose condition that causes bleeding cannot clearly be diagnosed , are recommended to undergo “Rectoscopy”, where the inner part of the anus that cannot be seen during examination is seen.

Before the treatment process, perianal fistula, perianal abscess, anal fissure and rectal cancers must be differentiated.

Remember that bleeding from the anus may be due to haemorrhoids but it might also be a symptom of rectal cancer or colon cancer.

What is good for Haemorrhoids (Piles)?

First of all, preventing its formation is of essence. If it has already formed, appropriate medication treatments will be beneficial in the early stages. If it has already progressed, it might be treated by laser and similar treatments.

Is the Cure for Haemorrhoids (Piles) Surgery?

Treatment options are decided based on the examination results. Changes in lifestyle and diet provide benefit in the early stage, whereas it is possible to recover from the disease by virtue of laser and similar technologies without stitches.

Are Haemorrhoids (Piles) Cured with Herbal Treatment?

Creams and medications used during the treatment are mostly made of herbs and their effectiveness and side effects have been revealed by many preliminary studies. Therefore they can bu used safely under the supervision of a doctor. It is necessary to avoid herbs and creams that have not been standardised and whose side effect profile is unknown.

Is Hot Sitz Bath Good for Haemorrhoids?

Hot sitz bath provides benefit for anal fissures rather than haemorrhoids treatment, by relaxing the anal sphincters. From time to time, it can also provide relaxation in some haemorrhoidal diseases.

How should the Diet be, that Protects from Haemorrhoids?

Considering that one of the main causes of haemorrhoidal diseases is constipation and straining too much; a diet based on anti-constipation vegetables and pulps, increasing the water consumption and avoiding hot spices and foods will be beneficial.

Degrees of Haemorrhoids

Haemorrhoids are divided into 2 as internal and external haemorrhoids.

External Haemorrhoids:

These are the haemorrhoids originating from vessels on the outside of the anus and presenting with lump and pain.

Internal Haemorrhoids:

Internal haemorrhoids are haemorrhoids origination from vessels in the inside of the anus and are divided into 4 stages;

Stage 1: The vessels inside the anus dilate but they do not bulge outward from the anus

Stage 2: The dilated vessels bulge outward during defecation and straining and then go back inside on their own

Stage 3: Haemorrhoids coming out of the anus cannot go back inside on their own but they go back inside by pushing by hand

Stage 4: Haemorrhoids that bulge outward from the anus cannot go back inside anus in any way

Treatment Methods for Haemorrhoids

Lifestyle recommendations:

Fiber-rich diet should be preferred
Regular exercising is recommended
Tight clothes should be avoided
Squatting for a long time and do the chores while squatting (wiping the floors, hoeing etc.) should be avoided
Heavy lifting should be avoided
Spicy foods should be avoided
Medication treatment:

Vasoconstrictors

Creams, pomades and suppositories effective in the anus area
Surgical Treatment:

1-Sclerotherapy

It is a medication treatment, where vasoconstrictors are applied into the dilated vessels in the anus, ensuring that vessel walls stick together. The procedures takes 3-5 minutes and the patient can continue his/her normal life on the same day. The procedure may need to be repeated for a few times.

2-Infrared Coagulation

The public knows this procedure as laser treatment. This procedure that is known as laser, is the process of burning the vessels using infrared ray. The procedure takes 3-5 minutes. The patient can be discharged on the same day.

3-Band Ligation Method

It is the procedure, where a rubber band is applied to the base of the haemorrhoids, thus the shrunk vessel will dry and fall off. The patient can continue his/her life on the same day.

4- What is Longo Method?

Longo method is a surgical technique and a stapling mechanism, where we apply for the treatment of stage 3-4 haemorrhoids and cut off anal vessels from the inside that hang the tissues that bulge outward from the anus are hanged inside. In order to decide whether this method is appropriate, the haemorrhoidal condition must be evaluated by examination.

5- Surgical Haemorrhoidectomy (Ferguson Technique)

These are the surgeries, during which the vessels are removed by surgical method, i.e. using bistoury and the integrity of the remaining tissue is ensured by stitching. It still is a commonly used method all over the world, the recovery period can be more painful compared to other methods since it includes stitching.

6- Ultrasonic Haemorrhoidectomy

High-frequency sound waves are used to burn the vessels and remove them. The operation is a bloodless surgery. Since ultrasonic waves are used, tissue damage and pain is less compared to cautery-like devices. Lack of stitches and short duration of the procedure is a big advantage. It is a common method used by us.

7- Laser Haemorrhoidolysis

Laser is a very strong, single-colour beam of light. Laser haemorrhoidolysis method is a safe treatment method that can be applied painlessly, without bleeding and quickly in suitable haemorrhoid patients. It is also a method used successfully by us.

What Surgery is Suitable for Which Haemorrhoids?

The method we recommend for each patient might not be the same based on the general condition of the patient, his/her expectations from the treatment, the stage of the disease and examination findings. All the methods described above are used by us in suitable patients. The patient is examined before surgery and the most suitable method for that patient is determined. Advantages and disadvantages of the method are explained in detail to the patient. Thus, the patient will have detailed information about the entire treatment process.

It must be noted that bleeding from the anus is an important finding. A differential diagnosis must be established. Anal fissure, perianal fistula, perianal abscess, rectal cancers must not be confused with haemorrhoids before the treatment.