Hemorrhoids (Piles): Causes and Treatment

Hemorrhoids are structures normally found in the human body. These structures, which we normally do not feel, can sometimes cause complaints. There are many treatment methods for hemorrhoids.

Our internal and external hemorrhoids, located along the anal canal and the anal opening respectively, are made up of blood vessel structures. Internal hemorrhoids can cause symptoms such as bleeding and protrusion from the anus. External hemorrhoids can cause intense pain when a blood clot forms in them, and bleeding may follow.

What Causes Hemorrhoidal Disease?

Some factors that can lead to hemorrhoidal disease are:

• Excessive straining and heavy lifting,
• Sitting on the toilet for long periods,
• A low-fiber diet,
• Pregnancy and vaginal delivery,
• Aging.

What Are the Symptoms of Internal Hemorrhoids?

• Rectal bleeding, usually bright red and seen after a bowel movement,
• Pain in the anal area, especially during bowel movements,
• Itching or burning in the anal area,
• Difficulty keeping the anal area clean,
• Protrusion of hemorrhoids, which may occur especially after a bowel movement or excessive straining; they may go back in on their own, or the patient may have to push them back in,
• Discharge.

How Is Hemorrhoidal Disease Diagnosed?

Hemorrhoidal disease is diagnosed by a doctor's examination. During the examination, your doctor:

• Examines the skin around the anus,
• Uses a digital (finger) examination to check the condition of the internal hemorrhoid cushions located at the bowel outlet, called the anal canal,
• An important point at this stage is that, if the doctor suspects it, further tests such as colonoscopy may be requested to rule out other diseases that can be confused with hemorrhoids.

How Are Internal Hemorrhoids Treated?

Treatment is planned according to the stage of the disease. For people whose disease does not require surgery, the following are recommended:

• A stool-softening diet (containing 30 grams of fiber per day),
• Establishing regular bowel habits (stopping unnecessary sitting on the toilet, and giving stool-softening medications if there is constipation),
• Warm sitz baths to reduce pain.

For people with more serious disease, interventional treatment methods are used.

Band ligation: A procedure that does not require anesthesia or a hospital stay. The blood flow to the internal hemorrhoid is cut off with a rubber band. The strangulated hemorrhoid cushion withers and falls off.

Sclerotherapy: Another treatment method that does not require anesthesia or a hospital stay. A chemical agent is injected into the hemorrhoid, causing it to scar and shrink (dry up).

Doppler-guided hemorrhoidal artery ligation: This procedure is performed under anesthesia in an operating room. With the help of a Doppler device, the vessel supplying blood to the hemorrhoid cushion is located and tied off.

Stapled hemorrhoidopexy (PPH): In this method, a ring-shaped piece of tissue is removed from above where the hemorrhoids begin, lifting the prolapsed hemorrhoids back up.

Hemorrhoidectomy: The commonly known type of hemorrhoid surgery. It is performed under anesthesia and requires an operating room. The hemorrhoid cushions are appropriately cut and removed.

Laser procedures: A short and generally painless procedure. The hemorrhoid cushions are treated with a laser, and no stitches are used.

When a blood clot forms in an external hemorrhoid, healing can be speeded up in the early period by making a small cut and draining the clot. This does not require anesthesia or a hospital stay.

How Can I Prevent Hemorrhoidal Disease?

• Avoid hard stools. Make sure your daily diet contains enough fiber, which is plentiful in foods such as fruits, vegetables and oatmeal. If these are not enough, supplements can be used,
• Regular exercise and staying active help protect against constipation,
• Improve your toilet habits. Do not sit on the toilet for long periods,
• Do not delay bowel movements, as this will cause your stool to harden.

At İzmir Özel Can Hastanesi and Salihli Özel Can Hastanesi, the diagnosis and treatment of hemorrhoidal disease are evaluated by general surgery specialists who have extensive scientific knowledge, skill and experience in their field, and the most appropriate treatment approaches are applied. Please contact us for information and appointments.