Do you suffer from hemorrhoids? Don’t worry. You are not alone. People are often embarrassed to talk about hemorrhoids. But everyone has hemorrhoids. Yes, you read that correctly. Everyone has hemorrhoidal tissue as part of his or her normal anatomy. Hemorrhoids are cushions of connective tissue with blood vessels. While there is no real scientific evidence as to the function of hemorrhoids, many physicians believe hemorrhoids help keep stool from leaking out of the anus.
Enlarged hemorrhoids, which can result in bleeding, pain, discomfort, and a prolapse or protruding hemorrhoid tissue, are caused when excess blood flows into the hemorrhoids causing the tissues to swell and stretch. This often occurs when the veins are under pressure from straining during a bowel movement, chronic diarrhea or constipation, obesity, pregnancy or even sitting for long periods of time on the toilet. When the veins around your rectum and anus stretch under pressure, hemorrhoids can bulge or become swollen either internally or externally.
It’s true that hemorrhoids are more likely to affect people as they age because the tissues that support the veins in your rectum and anus weaken as you get older, however, it’s important to note that hemorrhoids can affect anyone regardless of age. In fact, hemorrhoids affect 86% of Americans, and 50% of Americans will have suffered from hemorrhoids by the time they are 50 years old.
There are a number of treatment options for hemorrhoids. First and foremost is changing your diet. Physicians recommend eating a diet that is rich in high-fiber foods and low in processed foods, as well as increasing your fluid intake to six to eight eight-ounce glasses each day. In addition, topical creams and ointments such as hydrocortisone, warm sitz baths and Tylenol may help alleviate symptoms. Once you have enlarged hemorrhoids, however, they usually do not go away completely and you may need one of the following procedures to better manage the symptoms.
- Injection sclerotherapy: This involves injecting the hemorrhoid with a solution that creates a scar and reduces the blood flow, however, it cannot be used for prolapsed or external hemorrhoids.
- Photocoagulation: This uses an intense beam of infrared light. Heat created by the infrared light causes scar tissue, which cuts off the blood supply to the hemorrhoids. This procedure can only be used for small to mid-size internal hemorrhoids.
- Rubber Band Ligation: This process ties off internal hemorrhoids at its base with rubber bands and cuts off the blood flow. It can require multiple procedures to fully remove all of the hemorrhoids.
- Hemorrhoidectomy: This procedure involves making an incision, removing the external and internal hemorrhoidal tissue, and a recovery period of two to three weeks that is very painful.
- Stapled hemorroidopexy (PPH): This minimally invasive technique uses a circular stapling device to remove the prolapse and secure the remaining hemorrhoidal tissue back in place with staples. It removes the rectal mucosal tissue, which is above the anus where the nerve endings are less sensitive, so the patient is not in as much pain during recovery as with a traditional hemorrhoidectomy. Usually patients can return to normal activities within four days.
New hemorrhoid surgical procedure boasts great results
All of the above treatments and procedures focus on fixing the symptoms of hemorrhoids not the source of hemorrhoid disease—excess blood flow. They remove the hemorrhoids or strive to alleviate pain, bleeding, and discomfort from enlarged or prolapsed hemorrhoids. Today, patients have access to a new, minimally invasive surgical technique that treats the source of hemorrhoid disease, offers a quick recovery, and has yielded great results for patients suffering from hemorrhoids. The procedure is called transanal hemorrhoidal dearterialization (THD). It targets the arterial blood flow that feeds the arterial plexus. The surgeon uses an anascope fitted with a light and a Doppler ultrasound probe.The procedure uses sound waves to locate hemorrhoidal arteries. Then the surgeon uses a ligation technique to tie off the blood flow.
Next, the surgeon repairs the prolapse by lifting the tissue back into a more normal position.
This hemorrhoidopexy procedure takes place in a part of the anal canal where nerve endings are less sensitive so it’s not as painful as traditional surgery. There is no excision of tissue and patients can resume normal activities within four days.
THD received FDA approval in 2007 and has been gaining traction in the United States recently with more than 20,000 procedures performed annually. The benefits of THD to treat hemorrhoid disease include:
- No removal of hemorrohoidal tissue
- Reduced bleeding during the procedure
- Less painful than traditional surgery
- No anal stenosis, which is a narrowing of the anal canal that can make bowel movements painful. It can be a complication from traditional hemorrhoidectomy or PPH.
- Low risk of complications and deformities
- Quicker recovery
If you are suffering from hemorrhoid-like symptoms, you should go to the doctor and rule out any other causes of your symptoms such as colitis, Crohn’s disease, diverticulitis, or colorectal cancer. Then, if your hemorrhoids can’t be managed with the more conservative treatments, you should consider THD as a solution to rid yourself of painful hemorrhoids. Fortunately, most insurance and Medicaid plans to cover the THD procedure.