Hemorrhoids (Piles) Symptoms, Surgery and Treatment Methods

Hemorrhoids, which are very common today and also known as piles among the people, is the enlargement of veins detected in anus and its cause is unknown. Although this disease, which is seen in an average of one-fourth of adults, does not always show symptoms, it can cause severe pain that can affect daily life in some patients.

* What is Hemorrhoids (Piles)?
* How to Identify Hemorrhoids (Piles)?
* What are Hemorrhoid Symptoms
* How to Treat Hemorrhoids?
* Hemorrhoid Surgery

Due to the prevalence of the disease, most people research how to recover from hemorrhoids. Today, many different methods are used in the treatment of this disease. In addition to surgical operations, home treatment methods are also effective in cases where the disease does not progress. Hemorrhoids are taken under control thanks to these methods, which are also the answer to the question of what counters hemorrhoids, and small changes in the lifestyles of the patients.

What is Hemorrhoids (Piles)?
Hemorrhoids is a disease caused by the enlargement and swelling of the veins around the rectum and anus, just like varicose veins in the legs. The disease, also known as piles, is characterized by sagging of the surrounding tissues due to the enlargement of the veins in the breech region. In patients with hemorrhoids, this tissue covered with veins swells like varicose veins and hangs outward. Although the cause of these vascular swelling and tissue sagging is not known exactly, some factors have an effect on the emergence of this disease:

* Chronic constipation and diarrhea,
* Pregnancy,
* Older ages,
* Spending time sitting all the time,
* Lifestyle away from exercise,
* Sports activities such as cycling,
* Consuming excessive alcohol or spicy foods,
* Genetic predisposition.

Hemorrhoids are divided into two as internal and external hemorrhoids according to the location:

Internal Hemorrhoids
Internal hemorrhoids, also known as internal hemorrhoids, is a type of hemorrhoid that occurs in the deep and inner parts of the anus and rectum. Vein swelling, which usually occurs at a point that cannot be seen with the naked eye, is often not felt by the patients because the nerves in this area are not dense. In this sense, the most important symptom of internal hemorrhoids is painless bleeding. The most important among the symptoms of internal hemorrhoids is bleeding during defecation. However, these tissues can come out during defecation and only in this case can cause pain and ache.

Internal hemorrhoids are divided into four according to the sagging of tissues:
Stage I: Hemorrhoid pouches are inside and do not come out with straining. Sometimes they can cause bleeding. Because the tissues do not protrude, this stage of hemorrhoids is diagnosed only by rectoscopy.
Stage II: At this stage, the tissues come out due to the straining of the patients during defecation, but go inside after defecation. Symptoms such as minor bleeding and mild pain after defecation are observed in patients.
Stage III: The tissue that comes out of the anus during defecation does not enter unless there is manual intervention after defecation. In addition to bleeding and itching, wetness can also be seen as a result of the pouches remaining outside. There may be a feeling of pain during and after defecation.
Stage IV: At this stage, where the most severe pain and bleeding is seen among the hemorrhoid stages, the hemorrhoid pouches, also known as piles, come out of the anus and can come out again even when manually intervened. In some cases, these piles do not go in at all. At this stage, intense bleeding, itching, pain and discharge can be seen.

External Hemorrhoids
The type of hemorrhoids that are seen in the outer periphery of the anus and that are painfully felt and visible by the patients due to the dense nerves found here are called external or external hemorrhoids. External hemorrhoids with symptoms such as pain, itching and bleeding are treated according to the severity of the symptoms. Most people who encounter these symptoms during defecation are investigating whether external hemorrhoids go away spontaneously. In cases where bleeding and pain are at a low level, changes in lifestyle allow hemorrhoids to go away spontaneously. One of the important points is not to experience constipation, which increases the symptoms of hemorrhoids during this period.

How to Identify Hemorrhoids (Piles)?
Hemorrhoids, which can turn into a very painful disease depending on the area, is one of the most common diseases in adults today. The disease, which is divided into internal and external hemorrhoids, is generally characterized by pain, swelling, discharge and bleeding felt in the anus. Internal hemorrhoids are usually characterized by bleeding and discharge, while external hemorrhoids are characterized by pain and swelling. The diagnosis of hemorrhoids is made by physical examination and rectoscopy. Swellings that occur inside the anus usually do not show any symptoms other than bleeding.

Rectal bleeding and pain caused by anal fissures are confused with hemorrhoids. For this reason, it is necessary to apply to a health institution when these symptoms are seen around the anus.

Hemorrhoid Symptoms
Symptoms of hemorrhoids vary according to the area and stage of the disease. Hemorrhoidal bleeding is the most common symptom of the disease. However, patients may also complain of different symptoms:

* Light red bleeding in stool,
* Itching
* Discharge and wetness around the anus,
* Painful swelling around the anus.

Some of these symptoms may not be caused by hemorrhoids. These symptoms are also seen in diseases such as rectal cancer and digestive system problems.

How to Treat Hemorrhoids?
Diagnosed after anus and rectum examination, hemorrhoids are treated using various methods in accordance with the type of disease. These methods include medical drugs and surgical operations, as well as changes in the lifestyles of patients.

Treatment of external hemorrhoids is usually shaped according to the severity of the symptoms. In patients without severe pain and bleeding, these symptoms may disappear on their own. Therefore, specialist doctors create a treatment plan according to the symptoms.

In early-stage patients, it is primarily aimed to relieve the discomfort that causes hemorrhoids. Consuming fibrous foods, not standing too long and drinking plenty of water during the day are easy methods to relieve constipation. Those who have external hemorrhoids and research ways for getting rid of the piles can also apply these methods.

Hemorrhoid drugs are also used to relieve constipation and reduce pain after defecation in stage I and II patients with mild symptoms. In addition to pills taken orally, pomade and hemorrhoid suppositories to be applied to the painful area are also effective. Hemorrhoid creams, suppositories and creams are important parts of the treatment, especially in patients whose symptoms do not go away on their own.

In cases where there is no response from these methods, interventional methods and surgical operations are applied. Band ligation is widely used in internal hemorrhoids. With this method, pouches showing signs of bleeding and hanging out of the anus are ligated. This ligament comes off with the piles in a few days and the area heals within a few weeks.
In the Sclerotherapy method, also known as injection, fluid is injected into the vein in order to prevent enlargement and sagging outward. Sclerotherapy is an effective method for bleeding internal hemorrhoids.



Hemorrhoid Surgery
While hemorrhoid surgery is generally not preferred in I and II stage hemorrhoids, surgical operation is performed in III and IV stage hemorrhoids where symptoms are severe.

Open hemorrhoidectomy (Milligan/Morgan) and closed hemorrhoidectomy (Ferguson) are performed with similar methods. In open surgery, the expanding tissue is removed with a scalpel and this area is left open, while in closed surgery, this area is covered with healthy tissues. These operations are performed under general anesthesia.

In addition to these traditional methods, the longo method, in which staplers are used in the removal of hemorrhoids, is one of the operations. In this method, it is aimed to cut the hemorrhoidal pouches hanging from the anus in a region where the nerve endings are not dense and to normalize this area. This method is ideal for stage III and IV prolobe hemorrhoids.


Laser hemorrhoid surgery, which is widely preferred today, is preferred to dry up the hemorrhoidal pouches in stage I and II patients, and to cut enlarged and sagging pouches in stage III and IV patients. Patients usually return to their daily lives after 1 day of rest.


Before Hemorrhoid Surgery
Before hemorrhoid surgery, blood thinners such as Aspirin and Plavix should be discontinued at least one week in advance. No food or water is consumed the night before the surgery. However, before most hemorrhoid operations, patients are given laxative drugs or enemas to empty the intestines.


After Hemorrhoid Surgery
Recovery time after hemorrhoid surgery varies according to the surgical technique. Since there are no open wounds in operations performed with laser and stapler, patients are discharged after 1 day of rest. It takes longer for the injured area to heal after open and closed hemorrhoidectomy surgeries.


In order for the symptoms not to recur after the operations, it is necessary to pay attention to the diet and hygiene conditions after the hemorrhoid surgery. According to the recommendations of the specialist doctor, pulp-free foods that are easy to digest should be consumed for the first few days. After this period, foods high in fiber can be taken.