How are hemorrhoids detected?

Hemorrhoids are the most frequent reason for consultation in the office of Coloproctology, it is estimated that more than 50% of the population aged over 50 years, will have some hemorrhoidal symptoms at some point in their lives.

We suspect the presence of hemorrhoids when we see blood on the toilet paper or in the WC with bowel movements, they can also be itchy/itchy. Other times, they appear acutely, in the form of a painful lump of recent appearance in the anus (usually as a result of a defecatory effort), a situation that, with proper treatment, resolves in a few days.

They can also be silent, and only become evident from an aesthetic point of view, when the patient notices “exuberant skin” in the perianal area.

Differences between a hemorrhoid and a nodule

The word nodule can include many perianal conditions (abscesses, cysts, etc.), including hemorrhoids themselves. It means a rounded lesion, not always painful perianal. It is best to consult a proctologist if a nodule appears.

Types of hemorrhoids and ways to distinguish them

Hemorrhoids are classified into two types: internal, when they are located inside the anal canal, and external, when they are located on the surface.

Forms of treatment for hemorrhoids

During the acute crisis:

  • Sitz baths in warm water several times a day, for at least 10 minutes.
  • Specific medication prescribed by your family doctor/coloproctologist.
  • Abundant fiber intake and drinking plenty of water to facilitate bowel movements. Sometimes a mild laxative or intestinal lubricant will be prescribed.
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How can recurrence be prevented?

To prevent them from coming back: A change in eating habits is necessary. It is essential to avoid constipation:

  1. Increase the amount of fiber in meals (fresh fruits, vegetables, bread, cereals…).
  2. Drink liquids: 2 to 3 liters a day (juices, soups, avoid alcohol, spicy foods).
  3. Exercise daily.

In which cases is it necessary to resort to surgery?

Surgery is recommended in those hemorrhoids that

  • Frequent bleeding, with risk of anemia.
  • Frequent inflammation/pain crises that interfere with the patient’s personal/work/family life.
  • When they are very large and bother the patient and do not allow proper hygiene.

The type of surgery will depend on the characteristics of the hemorrhoids and the patient and will be assessed once the patient has been examined.

Currently the surgical options are wide ranging from minimally invasive techniques such as hemorrhoidal banding indicated in grade 2-3 hemorrhoids, laser techniques, infrared techniques +/- pexy, hemorrhoidopexy techniques with doppler (HAL/RAR trilogy technique) to the classic Milligan Morgan hemorrhoidectomy technique.

Can hemorrhoids recur?

In minimally invasive techniques, there is a small percentage of recurrences, since they are techniques based on “not eliminating” the hemorrhoidal tissue and therefore are less aggressive and less uncomfortable in the postoperative period. But then, it is essential that the patient strictly follows the medical indications.

In the case of the other techniques, such as the classic hemorrhoidectomy, the hemorrhoidal tissue is removed, therefore the removed hemorrhoid does not reproduce. If there is discomfort, it means that for some reason another hemorrhoid has come out.