Hemorrhoids, a common condition among many in Sri Lanka is a normal vascular cushion like structure in the anal canal which helps with stool control, but when it becomes pathological it is known as ‘piles’ or Haemorrhoids.
Speaking to The Sunday Leader, Consultant Surgeon at Asiri Hospitals, Dr. K.L Fernando explained that among the factors that lead to the formation of hemorrhoids (including irregular bowel habits, exercise, nutrition (low-fiber diet) and prolonged straining) the main cause remains poor diets which feature ‘junk’ or fast food.
Dr. Fernando also stressed that the best method in which to combat hemorrhoids is early detection and to seek medical assistance at the earliest stage.
Dr. Fernando said, “Many patients suffer in silence because of the embarrassment they feel. You can tell when hemorrhoids is present with itching, rectal pain, or rectal bleeding. In most cases, symptoms will resolve within a few days but external hemorrhoids are painful while internal hemorrhoids usually are not unless they become thrombosed or prolapsed.
The most common symptom of internal hemorrhoids is passage of bright red blood after passing stools, a condition known as hematochezia, or blood on toilet paper or in the toilet bowl. Pile mass may protrude through the anus. Symptoms of external hemorrhoids include painful swelling or lump around the anus.
The best way to prevent hemorrhoids is to keep stools soft, so they pass easily, thus decreasing pressure and straining, and to empty bowels as soon as possible after the urge occurs. Exercise, including walking, and increased fiber in the diet help reduce constipation and straining by producing stools that are softer and easier to pass. Spending less time attempting to defecate and avoiding reading while on the toilet have been recommended.
Dr. Fernando went on to say that with new state of the art techniques and equipment, the treatment of hemorrhoids is faster than ever and no longer painful.
On the topic of diagnosis, Dr. Fernando said that after visual examination of the anus and surrounding area is conducted to diagnose external or prolapsed hemorrhoids, a rectal exam may be performed to detect possible rectal tumors, polyps, fissures, fistulas and abscesses.
Visual confirmation of internal hemorrhoids is via proctoscopy or sigmoidoscopy. This device is basically a hollow tube with a light attached at one end that allows one to see the internal hemorrhoids, as well as possible polyps and growth in the rectum.
On the new minimally invasive treatments offered at Asiri Surgical, Dr. Fernando stated that even second and third degree hemorrhoid conditions can now be treated in a cost effective and pain free surgery that allows the patient to return home the very same day, allowing them to resume work faster and less time and money spent on hospitalisation.
One of these methods involves using a Doppler guided transanal hemorrhoidal artery ligation, which is a minimally invasive treatment using an ultrasound doppler to accurately locate the arterial blood inflow. These arteries are then “tied off” and the prolapsed tissue is sutured back to its normal position.
Dr. Fernando added, “One of the great advantages of this technique is that it is pain free, so patients no longer need to worry about or be embarrassed about a long drawn out surgery and recovery.”
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