Posts Tagged ‘Hemorrhoids Treatment’
Sclerotherapy for Hemorrhoids
This is an old treatment of hemorrhoids and rarely used these days due to it not being as effective as banding, as people require repeated injections. People do not want to go through having a doctor rummaging around in their bottoms once let alone repeatedly.
It is a quick treatment involving the injection of Oily Phenol Injection BP 5%w/v into the base of the hemorrhoid causing the soft tissues to harden and scar, the hemorrhoid will then wither and fall off.
The Sclerotherapy Treatment Procedure
- 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.
- This procedure is performed on grade1-2 hemorrhoids
- 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.
- You will be asked to take your clothes off and put on a gown and placed in the correct position for the procedure/ or just to remove your lower garments
- 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
- 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.
- The doctor will then inject the base of the hemorrhoid with the oily phenol.
Post procedure pain
The procedure itself is usually not too uncomfortable and you may experience pain for the next 24 – 48 hours. Regular paracetamol should keep you comfortable.
Special precautions
- Make sure you inform your doctor if you have any nut allergies as you will not be able to have this procedure
- Ensure you inform you doctor prior to the procedure if you think you may be pregnant or are breast feeding
- 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 the 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
In two weeks the scar will have blocked off the blood supply to the hemorrhoid and it will have withered and been passed with your stools
Complications and risks
- Your Doctor can inject 2-3mls of oily phenol at one time and it can be injected at the base of different hemorrhoids around the anal canal but the total used must not exceed 10mls or else you may suffer from a toxic reaction.
- Dizziness
- You may have an allergic reaction to the almond carrier oil
- Discomfort – the phenol is supposed to cause numbing of the nerves but it may not be effective causing pain.
- The area treated may form an ulcer or abscess possibly leading to Necrotising fasciitus
- Urinary incontinence
- The phenol may be injected incorrectly and enter the blood stream causing Hepatitis
- Prostatitis (a painful inflammation of the prostate in men) or Impotency due to the phenol
- Bleeding after the procedure
Prolapsed Hemorrhoids Treatment
This type of hemorrhoid is one which has originated from above the dentate line in the anal canal this has no nerve therefore are often painless. Below the line which has nerves are called external Hemorrhoids. This is why it can be a bit of a shock when you feel a piece of tissue outside your body which should be inside. This piece of tissue will not feel painful unless it has become strangulated or thrombosed that is to say that the hemorrhoid has become stuck outside the anus and you cannot push it back inside. If the tissue has become strangulated it will become painful and inflamed and you will need to seek medical help urgently.
Treatment for Prolapsed Hemorrhoids
If you have suffered with prolapsed hemorrhoids this will mean that when you visit your Doctor you will referred to a Consultant at a hospital in your area. The surgeon will discuss your options with you when you go for your initial consultation and will usually suggest surgery of a Hemorrhoidectomy or Hemorrhoidopexy.
Bleeding Hemorrhoids Treatment
It is important to state that if you have blood coming from your rectum it is not necessarily hemorrhoids. Bleeding of unknown origin needs to be investigated by a qualified healthcare worker.
If you treat your bleeding hemorrhoids prior to diagnosis from your doctor you could be missing a more serious condition.
The anal veins supply the cushions of the anal canal and it is these cushions which have swollen and become hemorrhoids. Bleeding usually occurs when hard stools (faeces/poo) and straining have caused the thinned walls of the hemorrhoid to bleed. The bleeding can vary from just noticing red blood on the toilet paper after wiping your bottom, to blood dripping into the toilet from perhaps a prolapsed hemorrhoid. It is very alarming the first time this happens and can be the incentive you need to get you along to see the doctor.
If you have small amounts of blood on the toilet paper after you wipe you bottom this will stop fairly rapidly it may well be internal hemorrhoids which will stop bleeding quite quickly.
If you are bleeding from hemorrhoids near to the anus and they are itching as well as bleeding it is important to treat this with care, you will need to wash carefully after your bowel motion so your bottom is clean. Do not use perfumed soap as this will aggravate and sting. If you use baby wet wipes these are very gentle as well as cooling. If bleeding persists use a clean piece of toilet paper wet it with cold water and hold it against the bleeding area firmly for a couple of minutes it can take up to five. This can seem an awfully long time to put pressure on the hemorrhoid but if you keep dabbing at the wound it will continue to bleed. If you have been prescribed cream for use after you have had a bowel motion, wait until the bleeding has stopped prior to application.
Hemorrhoidectomy Operation
Hemorrhoidectomy:
This operation is the final step when all other avenues have been explored to relieve the symptoms, or the situation has arisen where you have thrombosed or strangulated grade 3-4 hemorrhoids which need treatment. You will have been to visit the doctor and have the operation explained to you and any tests that you need will have been organised and completed prior to going into hospital when you went for your pre assessment.
You will have been given instructions regarding not eating and drinking anything before the operation and also about your bowel preparation this can include bowel prep which empties your bowels prior to the operation. You may not want to do this but unless the surgeon has a good view they may not proceed.
You will have been advised by the anaesthetist which anaesthetic is appropriate for you this can be either
Regional block – spinal or epidural – numb from waist down
General anaesthetic – a state of unconsciousness whereby you feel no pain or distress
The Hemorrhoidectomy 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 3-4 hemorrhoids
- 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.
- You will be asked to take your clothes off and put on a gown
- You will have discussed which anaesthetic is suitable for you and the anaesthetist will then either give you a general or spinal anaesthetic
- 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
- You will have sterile drapes put over you to maintain a sterile field for the surgeon
- An antiseptic/bacterial solution will be painted around the perineal area to eliminate germs from the skin surface
- An instrument called a proctoscope will be gently placed in your anus so the doctor will be able to have a good view the hemorrhoid. This will have a light attached so the surgeon may see easily.
- Local anaesthetic and a blood vessel constrictor will be injected around the hemorrhoids to be treated this will give pain relief tto the area as wll as reducing the blood flow.
- The surgeon will then excise (cut away) from the base of the hemorrhoid carefully sealing bleeding vessels with cautery (burn) from the diathermy.
- Sutures are used to tie of f larger blood vessels and the hemorrhoid is removed.
- Once the operation is completed non adhesive dressing will be placed on the wound site with dressing gauze and a large sanitary pad this will be taped in position
- You will be placed on your side after the procedure to cause your buttocks to press together helping with the pressure which reduces bleeding.
- When you are in recovery the wound site will be inspected frequently to check on bleeding a small amount is expected but larger quantities may require surgical opinion.
- 24 hours after the operation the dressings will be removed and you will be encouraged to take a bath.
- Normal bowel habits should be resumed as soon as possible, and you will be encouraged to eat finer 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.
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
This is a painful procedure, and it can continue to be painful for up to 2 weeks after the operation. You will be given regular pain relief medicines to alleviate the pain
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
- Take any stool softener or laxatives you have been prescribed
- Try and do some gentle exercise, do not lie in bed or on the couch all the time
- 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 after Hemorrhoidectomy
The initial healing takes approximately two weeks until you feel more comfortable but full health can take up to 6 weeks. Most people will takes two weeks off work for recovery but may not be able to return to work for a month depending on the type of work you do. You may be able to discuss reduced hours with your employer so you are able to resume work gradually.
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 unexpectedly days after the operation
- Infection – the internal bowel surface may become infected, you will experience a foul smelling discharge with pus if this occurs.
- Return of the hemorrhoids – the operation may not be effective
- Faecal (stool/ poo) incontinence – this can happen in the short term but usually sorts itself out if not you will need to see your doctor
- Inability to pass urine (wee) – this is something that might happen immediately post operatively and would be rectified at the hospital
- Anal Fistula / Fissure (a narrow track from inside the bowel to the skin surface)
- Narrowing of the lumen of the bowel (the internal scaring of the bowel has caused it to become smaller)
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.
