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Posts Tagged ‘Hemorrhoid Treatments’

Hemorrhoid Banding

Banding / Baron Ligation Technique

This is a treatment which is very popular as it is 80% effective and the procedure can be performed without a general anaesthetic. It is more effective than any of the other hemorrhoid treatments.

The hemorrhoid banding procedure

  1. The doctor who is performing the procedure will explain what they are going to do, and will ask for your permission to perform the procedure.
  2. This procedure is performed on grade2-3  hemorrhoid
  3. If you are happy that you understand both what procedure you are going to have done and have been told of the risks involved with the procedure then you can sign the relevant document.
  4. You will be asked to take your clothes off and put on a gown and placed in the correct position for the procedure.
  5. You will be positioned either on a couch with stirrups for your feet to go in or on you side on a couch with your knees drawn up to your chest it will depend on the location of the hemorrhoid. ( it will seem all a bit undignified but you will have either a sheet or blanket covering you until the procedure begins
  6. An instrument called a proctoscope or anoscope will be gently placed in your anus so the doctor will be able to have a good view the hemorrhoid.
  7. The doctor may use some local anaesthetic around the base of the hemorrhoid to numb the area.
  8. The hemorrhoid will be grasped gently with a forceps and the hemorrhoid fed through a ringed instrument.
  9. The small elastic band will then be released at the base of the hemorrhoid which will cut off its blood supply.
  10. You will usually have only one or two hemorrhoids treated in this way at a time. Further treatment will be done at 4- weeks’ interval to allow for healing.

Post procedure pain after hemorrhoid banding

  • You may feel faint or sick after the procedure
  • You will usually experience pain for anything between 24- 48 hours after the procedure
  • You may feel as if you want to have your bowels open

Special precautions

  • Ensure you have adequate pain relief available to you.
  • Make sure you have someone available to help you should you need it for at least he next twelve hours
  • Make sure you are able to urinate easily after the procedure(go for a wee)
  • Do not use aspirin for pain relief post procedure as it may encourage bleeding
  • Drink plenty of fluids
  • Try and do some gentle exercise
  • Eat plenty of fibre rich foods so you do not become constipated
  • Do not do any heavy lifting for at least two weeks

Healing / recovery time after hemorrhoid banding

In one – two weeks the bands will fall off as the hemorrhoid has been strangled as there is no blood supply to it. The hemorrhoid withers and falls off and is expelled when you have a bowel movement. A scar will be left behind which should prevent a further hemorrhoid occurring.

Complications and risks of hemorrhoid banding

  • You may experience problems passing urine (going for a wee) after the procedure
  • You may experience pain during the procedure
  • There is a risk of infection
  • Your hemorrhoid may return
  • You may have severe bleeding

Hemorrhoid Artery Ligation Operation


Hemorrhoid artery Ligation Operation (HALO) Also known as Doppler-Guided Hemorrhoidal Artery Ligation (DGHAL or HAL)

This procedure seems to have the potential for revolutionising hemorrhoid treatments. It was devised by Japanese surgeon Dr Morinaga and reported on in 1995. This is an exciting development in the treatment of hemorrhoids’ and seems to be getting rave reviews regarding post op recovery time, pain and time spent in the hospital. The operation can be done as a day patient with the success rate being 95% effective two years on. The procedure itself takes 20 minutes it is also said to be very effective on bleeding hemorrhoids.

The Hemorrhoid artery Ligation operation (HALO) operation

The doctor who is performing the procedure will explain what they are going to do, and will ask for your written permission to perform the procedure. This procedure is performed on grade 2-4 hemorrhoids

  1. If you are happy that you understand both what procedure you are going to have done and have been told of the risks involved with the procedure then you can sign the relevant consent form.
  2. You will be asked to take your clothes off and put on a gown
  3. If you are having a General or spinal anaesthetic then this will be performed by an anaesthetist you will have discussed this prior to the operation
  4. If you are having local anaesthetic and sedation this will be done once you are on the operating table
  5. You will be positioned either on the operating table with stirrups for your feet called the lithotomy position. Or on your front with your bottom raised it will depend on the location of the hemorrhoids. ( it will seem all a bit undignified but you will have either a sheet or blanket covering you until the procedure begins
  6. You will have sterile drapes put over you to maintain a sterile field for the surgeon
  7. An antiseptic/bacterial solution will be painted around the perineal area to eliminate germs from the skin surface
  8. An instrument called a modified proctoscope will be gently placed in your anus so the doctor will be able to have a good view the hemorrhoids.
  9. Local anaesthetic will be injected either before or after the operation depending on the type of anaesthetic you have been given.
  10. The equipment houses a miniature Doppler transducer which is used to locate the blood vessels which are supplying the hemorrhoids.
  11. The device has a small window which allows the surgeon to place a suture (stitch) around the artery cutting off the blood supply to the hemorrhoid
  12. If there are protruding hemorrhoids these will be hoicked back inside the bowel and secured in place
  13. An absorbent pad will be placed over the anus and a minor amount of bleeding may occur

Normal bowel habits should be resumed as soon as possible, and you will be encouraged to eat fibre rich foods and drink plenty of fluids. The first bowel movement is often dreaded due to pain however it is important that you open your bowels regularly to prevent constipation.

Post Operative pain

As there is no excision involved in this procedure therefore there are no wounds, general discomfort is the main problem but most people feel well enough to go home the same day.

Special Precautions

  • Ensure you have adequate pain relief available to you; if you are uncomfortable ask the nursing staff for additional pain relief.
  • Make sure you have someone available to help you when you are discharged form hospital
  • Make sure you are able to urinate easily after the procedure(go for a wee)
  • Maintain a good fluid intake
  • Try and do some gentle exercise, do not lie in bed or on the couch all the time
  • Take any stool softener or laxatives you have been prescribed
  • Eat plenty of fibre rich foods so you do not become constipated
  • Do not do any heavy lifting for at least two weeks
  • Maintain a good hygiene regime wash after each bowel movement

Healing / Recovery time

Research has shown that recovery time is staggeringly good with people returning to work after 48 hours. The hemorrhoids shrink as the blood supply has been cut off

Complications and risks

  • Pain – you may find that having your bowels open may continue to cause you pain
  • Bleeding – a post operative bleed can sometimes take place 1-3weeks after the procedure
  • Do not use aspirin for 3 weeks after the procedure as this is known to cause bleeding
  • Return of the hemorrhoids – the operation may not be effective
  • Inability to pass urine (wee)

Hemorrhoid Treatments


 

Relief from Hemorrhoids

The following treatments have been popular in past years but do not appear to date to have been thoroughly researched therefore the effectiveness of the treatments require further research

Stiz baths Treatment for Hemorrhoids  

These seem to have been popular for quite some time for relief from hemorrhoids with some people advocating sitting in these water baths for up to 8 times a day – I am not sure of anyone at work who has the facilities to do this and there does not seem to be any firm agreement on;- 

  1. The temperature of the water – if it is too warm it has the potential of burning the skin or increasing the blood flow to the hemorrhoids therefore increasing the pain. In addition for women if the anus and vagina are submerged in warm sitz baths there is the potential for faecal fluid to contaminate the water and possibly cause vaginal problems.
  2. The question of the sanitation of these toilet baths as a form of contamination needs to be considered
  3. The research regarding the herbal potions/salts which are added to these baths and the effects on the  hemorrhoids have not been researched
  4. The length of time you are expected to sit in the sitz bath – there does not appear to be any researched specified length of time or frequency with any measurable benefits
  5. This form of treatment needs to be clinically trialled to confirm the benefits for people. Currently it may used either as a soothing option or to encourage hygiene.

Flavanoid Treatment for Hemorrhoids 

Flavanoids have been used recently to as a relief from hemorrhoids as they are purported to have anti – inflammatory and cell enhancing properties. The benefits of these are in the process of being researched in clinical trials but as this site goes to print in UK the licensed use of these is not recommended. 

Glyceryl Trinitrate Ointment Treatment for Hemorrhoids 

This cream is not licensed in the UK for use with Hemorrhoids it is used for the relief of pain with chronic anal fissure. One of the side effects of this treatment is headaches and low blood pressure. Research has been undertaken in Australia and further research is expected.

Less used Hemorrhoid Treatments


Other less common hemorrhoid treatments include: Cryosurgery  for hemorrhoids This is a procedure where hemorrhoid tissue is frozen and eventually sloughs off, it are not popular as a form of treatment due to pain and the watery discharge. The major disadvantage to cryosurgery is the post operative pain associated it seems to be not as effective as other treatments and people do not tend to want to have repeated treatments due to the pain.   Diathermy – bi-polar for hemorrhoids This is used to cause coagulation (burning) of the tissue of the hemorrhoid causing the tissue to fall away. This leaves the tissue underneath fibrosed, like a scar which is hoped will keep the cushions of the anal canal from forming another hemorrhoid. One of the main draw backs of this is the burning sensation which local anaesthetic did not completely eliminate during the procedure and post operative pain. Post operative bleeding was another of the complications. Radiofrequency coagulation for hemorrhoids This is another form of coagulation (burning) which seals the skin surface causing scaring. Research showed that with early stage 1-2 hemorrhoid treatment this was effective and although patients still experienced pain immediately post operatively the majority of people returned to their activities of daily living quite rapidly. It should be noted that grade 1-2 hemorrhoids do not require the same level of intervention as 3-4 and to date more research is needed with regard to this. However the outlook is distinctly promising with reduced pain, complications and return to work.

Haemorrhoids Home Treatment


Conservative/ non invasive hemorrhoid treatments include

  • Change of diet
  • Plenty of fluids
  • Creams with either local anaesthetics/ corticosteroids or both
  • Controlled use of Laxatives

 

There are a great many home treatments for haemorrhoids which you can find on the internet some proven others not. If you are shy and have found it difficult to consult your doctor the internet and information can be a mine field for you. First and foremost I would urge you to visit your doctor to exclude any other type of condition. Secondly be reassured that often people who have had one incident of haemorrhoids don’t always go on to develop long term problems.  There are positive steps you can take at home to help yourself.

 

Haemorrhoids and diet

 

  • Foods which are rich in fibre such as vegetables, fruit and wholemeal products like bread and pasta, bran, brown rice. In consultation with your doctor you may be advised to take a bulk-forming laxative not a bowel stimulating  one like senna but one with ispaghula husk or similar to help with your bowel movements and the affect it has on your haemorrhoids.

 

 

Hemorrhoids and Exercise

 

  • 20-30 minutes exercise everyday will keep you fit and strong which helps to maintain a healthy digestive system. Always consult your doctor prior to embarking on a regular activity which you have not undertaken before, begin gently and work up to a regular routine.

 

 

Hemorrhoids and Weight loss

 

  • If you are overweight the pressure you will be unnecessarily exerting on the blood supply around you anus will be increased, therefore by lowering you weight that pressure will decrease.

 

 

Hemorrhoids and Fluids

 

  • One of the fundamental things to help yourself is to drink more fluids ideally that should be water, however if you drink milk or juice or Squash just by increasing those fluids will help with your digestive system. Your body needs fluids approximately two litres a day, and if it doesn’t have enough fluids it removes it from the food travelling through your intestines (gut) thus making your stools (faeces /poo) hard and lumpy.  If you drink more your stools will be soft and more easily expelled more like toothpaste consistency.
  • One cautionary word about alcohol and caffeine. These  drinks are counterproductive they act as a diuretic making you urinate(wee) more often this causes your intestines to loose fluid and again the stools become hard and difficult to pass. If you drink lots of tea or coffee during the day try switching to decaffeinated.

 

Hemorrhoids and Personal Hygiene

 

  • It is important to keep your bottom clean; this will help prevent rashes and irritation. You can carry small packets of baby wipes or moisten toilet paper to use after you have had a bowel motion. This will ensure no stool motion remains on the skin surface to cause irritation. Do not use perfumes soaps to wash with as these can irritate the skin and  do not use talcum powder to dry the area or to prevent moisture build up it does not work and can make the itching worse. Pat your bottom dry with clean toilet paper.  If you have a constant problem with leakage you will need to visit your doctor for advice but in the meantime you can use a small amount of nappy cream which will protect your skin and sanitary pad can be used effectively to absorb fluid.

 

Medicines and creams for Haemorrhoids

 

  • There are a huge amount of products out there to help you with your problem some of which make outrageous cure claims. As stated before piles cannot be cured they CAN be relieved and treated but there is not sure way any one can tell you that if a haemorrhoid is reduced and not causing a problem that it won’t rear its ugly head again or that another won’t occur.
  • Many creams will be wonderful and soothing and some will contain a local anaesthetic which will numb the affected area for a period of time. Other creams have corticosteroids in them which are used to reduce inflammation. There are precautions which you will need to be aware of prior to using any of these products so always read the information supplied with the medication. Make sure you are not allergic to any of the ingredients. Burning stinging and itching are some of the side-effects but these symptoms should pass. These products should notbe used for more that 7 days at a time due to further irritation from over use. If your problem continues after this you will need to consult your doctor. Always wash you hands after using any of these preparations

 

Pain relief for Haemorrhoids

 

  • If you are in discomfort with your haemorrhoids you can take regular pain relief tablets which you can obtain from your local chemist or supermarket. Usually the pain is short lived just when you are passing stools (faeces /poo) and the creams with local anaesthetic can help with this. You should follow the instructions on the packaging when using creams but they usually say to be used after each bowel movement or morning and night
  • If you have other ailments which are causing you pain please be aware that some pain relief medications can contain codeine i.e co-codamol. This is known to cause constipation and exacerbate your symptoms. Consult your doctor to perhaps look for alternative pain relief.

 

Hemorrhoids and Toilet Habits

 

  • It is both unhygienic and ill advised to sit and read either the newspaper or books whilst sitting on the toilet. This is something which should be avoided as it increases the pressure exerted on the blood vessels supplying the anus causing them to engorge. You should aim at spending only a couple of minutes evacuating your bowels  and always respond to your body when you feel you need to empty your bowels – do not wait until later as the stool will  become dry making it more difficult to pass. If you are unable to open your bowels as soon as you sit on the toilet get up and walk around until the urge to go again happens then try again. Sitting straining will make mattes worse.

Hemorrhoids and Constipation

  • If you are having problems with constipation you can improve your digestive system by combining the main elements of health. Eat fibre enriched food drink plenty of fluids and become more active. If you are still having problems after you have improved your life style it may be time to speak to your doctor regarding laxatives. It is very important that you have the correct one as products like senna cause contractions in the bowel which may give you further problems. Stools softeners,  bulk forming laxatives or lactulose will be far better as they improve the stool making the passage through the bowel easier.

Hemorrhoids and  Cold compresses

  • If you want some cooling soothing relief from you haemorrhoids you can use cold compresses. I am concerned about the amount of advice that I have read especially on the web that says to use ice for this as there doesn’t seem to be any warning or acknowledgement that using ice straight onto the skin surface can itself cause damage.  Cold water compresses are just as effective however, if you do use ice it should be wrapped up in a flannel and used for only short periods at a time.  It can be counter productive due to the nature of the body wanting to warm the skin surface after it has been chilled to such an extreme.