Hemorrhoids, commonly referred to as hemorrhoids, are inflamed and swollen blood vessels located in the anorectal area that often initially cause painless bleeding during defecation, but may later progress to painful sensations and discomfort. . Hemorrhoids can also cause itching and swelling near the anal area.
Classification of hemorrhoids
In an interview with HT Lifestyle, Dr. Rajeev Premnath, a general laparoscopic surgeon and endoscopist at Hitech Hernia Center, Ramakrishna Hospital Jayanagar, Bangalore, said that hemorrhoids cause pain, itching, bleeding and mucus drainage. , said that they vary in terms of discomfort and that hemorrhoids are classified as: Different levels or stages based on these symptoms –
- First degree: These hemorrhoids are internal hemorrhoids, which primarily cause painless bleeding and no noticeable swelling outside the anal canal. Diagnosis is usually made using proctoscopy instruments.
- Second degree: At this stage, it begins to protrude from the anal canal, but usually retracts on its own after a bowel movement.
- Third degree: In this category, they appear during defecation and require manual reduction after defecation. Failure to reposition may cause discomfort.
- Fourth degree: External hemorrhoids always remain outside the anal canal, causing pain and discomfort.
- Fifth degree (thrombotic hemorrhoids): At this stage, hemorrhoids become extremely painful.
Causes of hemorrhoids
Dr Rajeev Premnath says, “Hemorrhoids can be caused by a variety of factors. These include weakening of the rectal tissues and hormonal changes during pregnancy, which affects around 35% of pregnant women.” Hemorrhoids are more common in adults over 50, but they can occur in younger people as well. Straining during chronic diarrhea or constipation can put pressure on blood vessels and contribute to their development. Sitting for long periods of time, especially on the toilet, can increase your risk. A low-fiber diet and repetitive heavy lifting can also increase your chances of getting hemorrhoids. Being overweight can increase your risk due to abdominal pressure. Some people are genetically predisposed to developing hemorrhoids. Nicotine also promotes hemorrhoid formation.”
signs and symptoms
Dr. Rajeev Premnath emphasizes that internal hemorrhoids are often painless and often go unnoticed, saying, “They can cause rectal bleeding. Along with bleeding, it causes itching and pain in the anus. Prolapsed hemorrhoids can be painful and require manual adjustment.”
diagnosis and treatment
Dr. Rajeev Premnath says, “It is wise to seek the guidance of a general surgeon who can assess your condition, provide a final diagnosis, determine the severity of your hemorrhoids, and develop a treatment plan.” I insisted. Additionally, your surgeon may perform a sigmoidoscopy or colonoscopy to investigate potential underlying causes of your hemorrhoids. ” He recommended:
- The main treatments for grade I and II hemorrhoids are medication and lifestyle adjustments, such as a high-fiber diet and adequate fluid intake.
- It is important to avoid straining for long periods when defecating.
- If medical treatment proves ineffective for grades I and II, surgical or outpatient treatment may be recommended.
- Grade III and IV hemorrhoids usually require surgery, and there are a variety of surgical options to choose from.
- For grade V or thrombosed hemorrhoids, initial treatment includes medication to reduce inflammation, followed by consideration of the possibility of surgery.
Laser hemorrhoidoplasty – treatment options
Dr. Rajeev Premnath explained: “Laser treatment has clear advantages over traditional hemorrhoid surgery in terms of reduced pain and faster recovery. It also reduces complications and allows for natural anatomy of the anal canal and anal cushion. It also leads to better preservation of the hemorrhoids. With laser hemorrhoidoplasty, surgeons have two options: using a CO2 laser or a diode laser. During this procedure, laser energy is directed at the hemorrhoids, causing protein denaturation. This causes a fibrosis process. Laser treatment is performed through a process called photoablation, where the laser passes through the water and breaks the H2O bonds. This destruction reduces the size of the hemorrhoid tissue. In addition, photocoagulation occurs, which denatures proteins and seals blood vessels.”
He elaborated further, “Photoevaporation is another effect of laser treatment, where the hemorrhoid absorbs the laser energy, causing fibrosis and tissue fixation within 6 to 8 weeks. Laser hemorrhoidoplasty is It is important to note that some degree of discomfort is involved and will require the use of pain medication.However, this discomfort is significantly less than that typically experienced with traditional surgical approaches. .”
Prevention and lifestyle changes
Dr Rajeev Premnath advised: “Preventing hemorrhoids and maintaining a healthy lifestyle requires several key factors. First, focus on fiber-rich foods and adhere to dietary guidelines that support digestive health. Proper hydration and regular physical activity are fundamental to maintaining overall bowel function. Eating enough fiber helps soften stools. , is very important because it helps prevent constipation, a common cause of hemorrhoids. Healthy bowel habits, such as responding quickly to the urge to defecate, reduce the risk of straining during defecation, which can worsen hemorrhoids. Finally, we recommend scheduling regular health checkups to promote early detection and management of potential problems related to hemorrhoids and digestive health.”
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