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Hemorrhoid Surgery

Surgical treatment is performed when symptoms continue despite previous medical treatment or severe pain, bleeding, or obstruction to the exit of defecation.

What are hemorrhoids?

Hemorrhoids, by definition, are veins located under the mucosa lining the anus and the end of the rectum. The veins carry poorly oxygenated blood from the periphery to the heart.

Dr. Víctor Calao

Dr. Víctor Calao

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These are some of the FAQs about Hemorrhoid Surgery

The symptoms of the hemorrhoidal disease are foreign body sensation, pain, itching, irritation, burning, increased sweating, scanty discharge, and problems in keeping the region clean. Patients also report difficulty in toileting after evacuation due to the presence of hemorrhoids. In advanced cases, there may be obstruction of defecation.

Bleeding may initially be droplets after evacuation or spotting of the paper. On other occasions, bleeding is profuse and may require hospitalization.

The treatment of the hemorrhoidal disease depends on the phase in which it is found; in the early stages, medical treatment can be given based on stool softeners, water intake, supplemental fiber intake, local anesthetics, among others.

Surgical treatment is performed when despite these measures, the symptoms continue or when there is intense pain, bleeding, or obstruction at the exit of defecation.

Other treatments include ligation of hemorrhoidal vessels with bands, coagulation with infrared light, and hemorrhoidectomy with a stapler. The first two are indicated for initial and small hemorrhoids. The third involves the use of expensive instrumentation and delivers the same results.

The medical name for hemorrhoid surgery is Hemorrhoidectomy and can be performed with a scalpel or special cutting and coagulation instruments.

We perform hemorrhoid surgery with the latter, also known as Ligasure. This instrument coagulates the root of the hemorrhoid, making a clean and quick cut. Generally, 2 hemorrhoidal bundles are removed; the third one is evaluated whether or not to be removed due to the risk of stenosis of the region.  It involves little or no bleeding because nothing is cut; it is a coagulation resection. No foreign material is left behind, as in the case of rubber bands. It is not a procedure that involves the use of expensive instrumentation.

During hemorrhoid surgery recovery, it is recommended to rest for two weeks so that the worked area heals entirely and there is no discomfort. Care after hemorrhoid surgery consists of keeping the anal site clean by washing in the shower or taking sitz baths, reducing inflammation, and promoting healing. It also helps with anti-inflammatory and antibiotics.

The diet will be based on high fiber foods such as lettuce, chard, raw carrots, spinach, cooked vegetables such as asparagus, beets, mushrooms, turnips, squash, broccoli, and artichokes. Fruits are also a good source of fiber, and we have apples, bananas, pears, kiwis, peaches, tangerines, plums, figs, and dried fruits. Grains such as oatmeal, whole grain bread, brown rice, fiber-rich cereals such as bran, shredded wheat, and puffed wheat.

Avoid eating simple carbohydrates such as cookies, bread, bottled soft drinks, processed juices, French fries, pasta, pizzas, spicy or spicy foods.

A minimum of two liters of water should be drunk every day.

They do not return, but it should be clarified that there are 3 hemorrhoidal sacs in the anorectal canal; if one of them becomes inflamed and is operated on, the other two may be affected in the future. Therefore the patient should continue with medical treatment.

It is not indicated to remove hemorrhoids without problems. It is not recommended to remove more than two affected hemorrhoidal sacs because of the risk of anal obstruction due to the inflammatory and scarring process generated.

As mentioned above, the hemorrhoidal disease is divided into grades I to IV; in grade I, there is the only discomfort in the anal region, such as itching, burning, pain, slight bleeding. There is no protrusion of the vein into the anus. There is a protrusion of hemorrhoid in grade II and the symptoms, but this is temporary and spontaneously returns to its place. In grade III, there is a protrusion, but it does not return on its own; the patient digitally relieves it. In grade IV, it is no longer possible to return hemorrhoids with maneuvers.

In stages I and II, the treatment is conservative; it does not require surgery. Adjustments are made to the diet, increasing the consumption of foods rich in fiber and reducing fats and simple sugars. Hydration is irrigated with a minimum of two liters of water per day. Fiber supplements such as psyllium Plantago, which is sold as a powder to be diluted in water, are also added. The initial intake is one glass a day, increasing to two glasses after 4 weeks.

When episodes of acute inflammation occur, such as pain, burning, or itching, a treatment based on creams and ointments of local application is given with transitory improvement. Sitz baths are also required, i.e., baths in a tub with warm water to reduce inflammation and discomfort and cleanse the region.

If there is no improvement in the symptomatology of the disease despite all these measures, the only option is surgery.

Hemorrhoids, by definition, are veins located under the mucosa lining the anus and the end of the rectum. Veins carry poorly oxygenated blood from the periphery to the heart. They are typical anatomical structures with the function, in addition to returning the blood, to serve as cushions, cushioning the passage of fecal matter at the time of defecation and helping the sphincter to co-capture the closure and prevent incontinence.

When hemorrhoids become inflamed or begin to descend through the anus, one can already speak of hemorrhoidal disease. This is presented by various factors, including excessive effort, increased intra-abdominal pressure, and hard stools from a diet low in fiber and high in carbohydrates.

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