TREATMENT OPTIONS FOR HAEMORRHOIDS
Most haemorrhoids, also known as piles, can be detected via a physical examination and visual inspection. While external haemorrhoids may be diagnosed by simply looking at the anal area, internal haemorrhoids typically require a digital rectal exam (DRE), in which the physician inserts a gloved, lubricated finger into the anus to feel for piles.
In some cases, the doctor may order an anoscopy or sigmoidoscopy, both of which use a lighted viewing tube to get a clear and closer view of piles that have developed deep within the rectum and anal canal. A barium X-ray, where a barium enema is used to highlight abnormalities in the colon during X-rays, can also be done.
Piles treatment varies and depends on the condition’s size, stage, location and number. For 1st- or 2nd-degree haemorrhoids, symptoms can be relieved by reducing straining during bowel movements. This could mean taking more fluids or laxatives. Oral medication or suppositories may be given by your doctor to relieve the symptoms.
If these do not help, further treatment may be required. This includes:
Banding
Banding is an office procedure used to treat internal haemorrhoids. Also known as rubber band ligation, this procedure involves using a tight band around the base of the haemorrhoid to cut off its blood supply. Banding is not painful, but you may feel pressure or mild discomfort, or a feeling of needing to pass motion. This is usually transient.
Sclerotherapy
This procedure involves injecting a chemical next to the haemorrhoid. This chemical causes the root of the blood vessel leading to the haemorrhoid to narrow and stops it from bleeding. Most people experience only minor discomfort with the treatment.
Sclerotherapy is done at the doctor’s office. There are few known risks. This may be a better option if you’re taking blood thinners because your skin is not cut open. Sclerotherapy tends to have the best success rates for small, internal haemorrhoids.
Ultrasound-Guided Haemorrhoidal Artery Ligation
This procedure uses an ultrasound probe to locate the arteries. A stitch is then used to tie off the artery. By interrupting the blood supply, the haemorrhoid shrivels up.
Haemorrhoid Energy Transfer (HET)
This is a new technique that uses a special device to burn off the piles.
One of the major determinants of which type of treatment is suitable is the location of the piles with respect to the dentate line. The dentate line is a line that can be seen in the anus. Above the dentate line, there are not much pain nerves, and hence all the procedures done in that area can be done without causing much pain.
For 3rd and 4th Degree Piles, Treatment Includes:
Hemorrhoidectomy - Also known as piles surgery, it is the best method for permanent piles removal. It is usually used for 3rd- or 4th-degree piles or 2nd-degree piles that have failed other treatments, such as ligation. There are numerous ways to perform piles surgery:
Conventional Hemorrhoidectomy - This method involves making small incisions around the anus to access and excise the piles. After the haemorrhoids have been removed, the wound is commonly left open to facilitate healing. The procedure takes around one hour and does not require an overnight stay at the hospital.
However, as with most traditional surgeries, conventional hemorrhoidectomy entails a longer recovery period and more post-operative discomfort, and carries a higher risk of infection and bleeding. However, it is the most effective among piles treatment options, having the lowest recurrence rate.
Stapled Hemorrhoidectomy - Commonly used to treat 3rd- or 4th-degree and prolapsed piles, stapled hemorrhoidectomy involves stapling the protruding piles back into position and cutting off their blood supply, causing them to wither and die. This newer method is a quicker and less painful alternative to traditional haemorrhoidectomy and results in a shorter recovery. However, it also poses a higher chance of recurrence, particularly of prolapsed piles.
Other Techniques:
Laser haemorrhoidectomy or laser piles surgery is the use of laser to cut the haemorrhoids away in a manner similar to conventional haemorrhoidectomy. They do not offer any advantage over standard operative techniques, and contrary to popular belief, are not less painful.
