19/04/2021
Hemorrhoids - Piles Treatment in Ghana
Definition
Hemorrhoids (also known as "piles") are dilated or bulging veins of the re**um and a**s, caused by increased pressure in the re**al veins. Fifty to seventy-five percent of all Americans develop hemorrhoids.
Description
Hemorrhoids involve the blood vessels that line the a**s. Pressure on the walls of the re**um weakens the muscles that support the hemorrhoidal vessels. They then become enlarged and lose their support and result in a sac-like protrusion inside the re**al ca**l (called internal hemorrhoids) or under the skin around the a**s (called external hemorrhoids).
If the internal hemorrhoid pushes out of the a**l opening, this hemorrhoid is called a pr*****ed hemorrhoid. Sometimes, blood can pool in an external hemorrhoid, forming a clot (thrombus). This hemorrhoid is called a thrombosed external hemorrhoid.
Hemorrhoids can occur at any time, but become more common with advancing age. Younger people, pregnant women and women who have had children are most apt to develop hemorrhoidal problems. The condition occurs more frequently in some families.
Causes
The causes of hemorrhoids include:
habitually straining (due to constipation)
diarrhea
coughing
sneezing
vomiting
prolonged sitting
pregnancy (pressure on the lower abdomen caused by the uterus)
sedentary lifestyle
eating a low-fiber diet
overweight
standing or lifting too much
cirrhosis of the liver
a**l in*******se
a**l or re**al infection
Symptoms
The most common symptoms of hemorrhoids are:
small amount of blood in the stool or on the toilet paper after wiping
incomplete bowel movements
re**al itching
soft lump felt at the a**l opening
Note: Bleeding from the re**um should be reported to the doctor. Bleeding could be a symptom of other medical conditions, such as inflammation of the intestines, a**l fissures (crack in the lining of the a**l ca**l), re**al polyps and/or colore**al cancer.
Diagnosis
To diagnose hemorrhoids, the doctor will do a re**al examination. The doctor places a gloved and lubricated finger into the re**um to feel for abnormalities. External hemorrhoids can be diagnosed by a visual and/or re**al examination.
To diagnose internal hemorrhoids, the doctor will insert a thin tube-like instrument (called an anoscope) into the lower few inches of the re**um. The anoscope has a light at the end and an eyepiece at the front for viewing into the a**l ca**l.
To look for other sources of bleeding, the doctor may perform a colonoscopy (an examination of the inside of the colon) or a sigmoidoscopy (an examination of the re**um and the last part of the colon - the sigmoid colon).
Treatment
Medical treatment of hemorrhoids is initially aimed at relieving symptoms. Measures to reduce symptoms include:
warm tub or sitz baths several times a day in plain, warm water for about 10 minutes
ice packs to help reduce swelling
application of petroleum jelly, cortisone creams, hemorrhoidal cream (such as Preparation-H) or suppositories to the affected area
wearing cotton underwear and loose clothing
cleaning the a**s after each bowel movement by patting gently with moist toilet paper or moistened pads
taking acetaminophen or aspirin
For hemorrhoids that don't respond to self-care measures, there are some other techniques to alleviate the hemorrhoids:
For treatment of internal hemorrhoids, one of five methods is usually used:
1. Rubber Band Ligation - This procedure involves placing a small rubber band at the base of the internal hemorrhoid. The band cuts off blood supply to the hemorrhoid, causing it to shrivel up and fall off in about four to seven days.
2. Injection Sclerotherapy - This procedure involves injecting a chemical solution into the mucous membrane near the hemorrhoid. This chemical causes inflammation and closure of the veins, thereby shrinking the hemorrhoid.
3. Infrared Photocoagulation - This procedure involves directing an infrared light to coagulate (clot) the dilated veins of the hemorrhoid. This causes the hemorrhoids to shrink, since the blood does not flow through the coagulated blood vessels.
4. Laser Coagulation - This new procedure involves the application of an electric current to the hemorrhoids. The electric current, emitted by an electrode probe, triggers a chemical reaction that shuts down the blood supply in the hemorrhoid and causes the inflamed tissue to shrink.
5. Hemorrhoidectomy - This procedure involves surgically removing the hemorrhoid groups in the a**l ca**l, and is performed with a scalpel, cautery device or laser.
For the treatment of external hemorrhoids, one of three methods is used:
1. Infrared Photocoagulation
2. Laser Coagulation
3. Hemorrhoidectomy
For the treatment of a pr*****ed hemorrhoid, a hemorrhoidectomy is recommended.
For the treatment of a thrombosed external hemorrhoid, drainage of the hemorrhoid or a hemorrhoidectomy is recommended.
Self-Care
Most hemorrhoids heal on their own in a week or two. Hemorrhoids have a tendency to return unless something is done to prevent them. The most effective preventive measures are:
Eat between 25 and 30 grams of fiber a day.
Drink at least 8 glasses of water a day.
Increase your amount of daily physical activity.
Add stool softeners or laxatives to diet. Consult with the doctor regarding the prolonged use of stool softeners and laxatives.
Lose weight.
Change bowel habits. Respond to the urge to defecate and stay relaxed to avoid straining.
Exercise the buttocks muscles.
Practice good personal hygiene. Keep the a**l area clean and avoid using rough toilet paper.
