Hemorrhoids

Hemorrhoids are enlarged veins in the anal canal, similar to varicose veins, that develop due to increased pressure in the rectal area. They can occur internally or externally.

Types of Hemorrhoids

Internal hemorrhoids
Located inside the rectum and usually painless, though they may cause bleeding during bowel movements.

External hemorrhoids
Located under the skin around the anus and may cause pain, swelling, itching, and irritation.

Thrombosed hemorrhoids
Occur when a blood clot forms inside an external hemorrhoid, leading to sudden pain, swelling, and inflammation.

Hemorrhoids often develop due to increased pressure in the rectal veins. Common causes include:

• Chronic constipation or straining during bowel movements

• Prolonged sitting, especially on the toilet

• Low-fiber diet

• Obesity or excess body weight

• Pregnancy and childbirth

• Heavy lifting

• Aging-related tissue weakening

• Family history of hemorrhoids

Identifying contributing factors helps guide appropriate treatment and prevent recurrence.

Symptoms may vary depending on type and severity and can include:

• Anal itching or irritation

• Pain or discomfort, especially when sitting

• Swelling or lump near the anus

• Bright red blood during or after bowel movements

• Mucus discharge

• Sensation of incomplete evacuation

Persistent symptoms should be medically evaluated to rule out other conditions and to plan appropriate treatment.

Diagnosis begins with a clinical examination by a qualified doctor and may include:

• Physical examination to identify external hemorrhoids

• Digital rectal examination for internal hemorrhoids

• Anoscopy or proctoscopy to visualize the rectum

• Colonoscopy if bleeding is unexplained or in patients over 45 years of age

After diagnosis, a personalized treatment plan is created based on the grade and severity of hemorrhoids.

Mild to moderate hemorrhoids may be managed with non-surgical approaches.

1. Lifestyle and dietary management

• Increasing fiber intake (fruits, vegetables, whole grains)

• Adequate hydration

• Avoiding straining during bowel movements

• Regular physical activity

• Maintaining a healthy body weight

2. Medications and topical treatments

• Anti-inflammatory creams or suppositories

• Pain-relieving ointments

• Stool softeners if needed

3. Rubber band ligation

A small band is placed at the base of the hemorrhoid to stop blood flow, causing it to shrink and fall off naturally.

4. Sclerotherapy

A medication is injected into the hemorrhoid, leading to gradual shrinkage.

5. Infrared coagulation (IRC)

Heat energy is used to shrink hemorrhoidal tissue by sealing small blood vessels.

For advanced or recurrent hemorrhoids, laser treatment may be recommended. This minimally invasive technique uses focused laser energy to shrink hemorrhoidal tissue while minimizing damage to surrounding areas.

Laser hemorrhoid treatment is associated with:

• Reduced postoperative discomfort

• Minimal bleeding

• Faster recovery

• Short hospital stay

Suitability is determined after clinical evaluation.

Surgical Hemorrhoids Treatment

When conservative and minimally invasive treatments are ineffective, surgery may be required.

Hemorrhoidectomy

Surgical removal of hemorrhoids, typically used for large or advanced cases.

Stapled hemorrhoidopexy

A procedure that repositions prolapsed hemorrhoids and reduces blood flow to them.

Doppler-guided hemorrhoidal artery ligation (DGHAL)

Uses Doppler technology to locate and tie off hemorrhoidal arteries, reducing blood supply to the hemorrhoids.

All procedures are performed following standardized surgical protocols.

Recovery depends on the treatment type but is generally straightforward.

Patients are advised to:

• Maintain proper hygiene

• Use sitz baths if recommended

• Follow dietary guidance to prevent constipation

• Avoid heavy lifting for a few weeks

• Attend follow-up visits as scheduled

Most patients resume normal activities within a short period, depending on the procedure.

The cost of hemorrhoids treatment depends on:

• Type of treatment (medical, laser, or surgical)

• Severity and number of hemorrhoids

• Surgeon expertise

• Hospital or clinic facility fees

• Anesthesia and follow-up care

A detailed cost estimate is provided after clinical assessment.