WHAT IS HEMOROID (HEAD, MAYASIL)?

To briefly define hemorrhoids, it is the enlargement of the veins in the anus (breech) region. As this expansion increases, the veins gradually approach the tissues in the anus and begin to hang outward from the anus. As the veins become superficial, the probability of bleeding increases, and as they protrude out of the anus, the muscles that hold the ablution begin to cause more pain as the muscles that hold the stool compress them, causing them to swell even more.

When this condition progresses too far, blood supply to the tissues around the anus becomes impaired. In this case, it can turn into a picture called hemorrhagic, necrotic prolapsed hemorrhoids with rectal discharge, bleeding and severe pain. If this troublesome situation is not treated well, it can lead to much more serious conditions by progressing to decay and severe infection in the tissues in the breech area.

WHAT ARE THE SYMPTOMS OF HEMOROIDS?

When hemorrhoids start in the rectum, we can see pain, discharge, stiffness and bleeding during and after defecation in the rectum.

WHAT ARE THE TYPES OF HEMOROIDS?

Hemorrhoids are basically divided into two diseases, internal hemorrhoids and external hemorrhoids. This distinction is made according to where the hemorrhoid originates. In the last part of the large intestine, near the anus, where the rectum is stored, the large intestine tissues change shape towards the rectal skin tissues. This point is medically called the "dentate line". Hemorrhoids originating above this part are called internal hemorrhoids, and those originating below this point are called external hemorrhoids. External hemorrhoids are relatively rare. It usually manifests itself with the formation of a blood clot in the hemorrhoidal vein in patients who stand or sit for a long time. In this case, severe pain and round swelling occur. Very rarely it can bleed. Internal hemorrhoids rarely clot, but they can cause pain and bleeding.

HOW TO CLASSIFY HEMOROIDS?

Essentially, surgically classified hemorrhoids are internal hemorrhoids. Internal hemorrhoids are divided into 4 degrees according to the degree of swelling and the degree of expulsion from the anus:

In First Degree (Grade 1) hemorrhoids, the enlarged vein is in the anus. It can bleed rarely and is mostly not noticed by the patient, but can be detected by detailed breech examination.

In Second Degree (Grade 2) hemorrhoids, the enlarged veins can now hang out of the anus during defecation, but they can return to their normal state in the anus spontaneously after defecation. During this period, the patient may experience rectal pain, itching and discharge. Rare bleeding may also occur.

In Third Degree (Grade 3) hemorrhoids, the enlargement of the vessels progresses and the enlarged hemorrhoids hanging from the anus after a large wudu do not spontaneously return to the part inside the anus where they should be. These hemorrhoids can only return to the state they should be with the help of fingers.

In Grade 4 (Grade 4) hemorrhoids, the enlargement of the vessels is severely increased. Unlike the others, they always stay outside the breech and do not return to the place they should be with finger pushing. Hemorrhoids in this condition tend to cause constant pain, fullness, discharge, swelling and bleeding.

HEMOROID TREATMENT

Treatment of hemorrhoids varies according to the stages in which they are detected. Generally, in Stage I and II hemorrhoids, changes in life style, prevention of constipation and excessive straining, and drug treatment when necessary, are tried to be kept under control. Lifestyle modification and drug therapy are usually effective in Stage I and II hemorrhoids, but recurrence may occur over time. Different interventional procedures are required for patients who do not fully recover with drug therapy and/or progress to Stage III.

Among these, options such as sclerotherapy and rubber band ligation are available. The effect of these methods is temporary and recurrence rates are high. Standard hemorrhoid surgeries have a lower probability of recurrence, but they are the methods that should be applied only when desperate, due to their severe pain, long recovery time, and serious side effects such as rectal stenosis, incontinence of ablution or constant wetting in the rectum. In recent years, another method has been developed, which is close to standard surgery and has low recurrence rates. As a result of the reduction of the hemorrhoid tissues by burning with laser and the healing of the burned tissues by shrinking, the hemorrhoids return to their normal anatomical region and level without cutting or sewing.

In this method, hemorrhoidal vessels and surrounding tissues are burned and shrunk with the help of a computer-controlled probe that emits laser light and heat. Since there are no cutting and sewing procedures, patients experience very little pain, the patient can go home the same day and return to his normal life within 3-7 days. Laser therapy is also used successfully in the treatment of anal fistula and pilonidal sinus (ring ingrown hair) by using different laser tips. In some well-chosen patients with advanced hemorrhoids, another method such as laser therapy, which is painless and does not have serious side effects, can be used. The name of this method is hemorrhoid artery ligation. In this method, the location of the hemorrhoidal veins is determined with a special color ultrasound and these veins are tied during the procedure by means of a mechanism. Since less blood goes to the hemorrhoid area, severely swollen hemorrhoids quickly deflate.

In cases where the tissues in the breech hang out of the anus with advanced hemorrhoids, a method called Longo surgery, which cuts and stitches the hemorrhoids in the breech with an automatic tool, can also be used when necessary. All these methods, including the laser used in the treatment of hemorrhoids, are successfully applied by us in our clinic and in the hospitals we have contracted with, in accordance with the condition and stage of our patients. More than 400 laser and more than 100 hemorrhoid artery ligation procedures have been performed in our clinic in 7 years.