Hemorrhoids (Piles): Small in Size, Painful Disease

Did you know how easy it is to protect yourself from hemorrhoids, also known as piles, which people endure in pain because they are embarrassed to talk about them and which, unfortunately, are usually brought to a doctor only at an advanced stage?

Hemorrhoids (Piles) are the loosening of the venous plexus around the anus and its protrusion outward in a nipple-like shape.‘This loosening and enlargement usually does not happen suddenly. A certain amount of time must pass. Therefore, a person with a hemorrhoid problem has complaints that have lasted a long time, although they may not be obvious. However, sometimes people who have no complaints at all, or who know they have hemorrhoids but are not very bothered by them, come in because of a painful swelling that suddenly appears around the anus. This condition, which we call acute thrombosed hemorrhoid, is a disease that must be treated due to severe pain.’

Could I have hemorrhoids?

If you have been suffering from constipation for a long time,

If you see blood in your stool,

If you experience swelling, pain and itching in the anal area,

If there are family members who have previously had hemorrhoid (piles) problems (especially mother/father),

If you consume plenty of spicy and hot foods, since they cause burning and irritation during bowel movements, your risk of developing hemorrhoids (piles) is high.

You say you have hemorrhoids, but to what degree…

Piles, i.e., hemorrhoid disease, has four degrees.

In first-degree hemorrhoids, the patient experiences a small amount of bleeding during bowel movements. Hemorrhoids cannot be seen on visual examination. When looking inside the rectum with an anoscope, enlarged hemorrhoid nipples (papillae) are seen.

In second-degree hemorrhoids, the nipples protrude during bowel movements and then go back in on their own. Bleeding, itching and similar discomforts occur.

In third-degree hemorrhoids, the nipples can only be pushed back in by hand after a bowel movement. Complaints such as bleeding, swelling and itching have also increased.

In fourth-degree hemorrhoids, the nipples are now completely outside and do not go back in even when pushed by hand. Bleeding, discharge, itching, discharge and a feeling of discomfort in the rectum occur.

Can hemorrhoids be a sign of other diseases?

Hemorrhoid complaints can be confused with the complaints of a patient with colon cancer. Cancer may be overlooked while hemorrhoids are being treated. Therefore, depending on the patient's condition, a colon examination (colonoscopy) may be required before hemorrhoid treatment. Other conditions frequently seen in and around the anus, such as anal fissure (tear), fistula (tunnel), ingrown hair and warts, can also be confused with hemorrhoid disease. These conditions can be diagnosed and treated with a careful examination.

When and how should I be treated?

Unfortunately, patients with hemorrhoid complaints both neglect them and feel ashamed, so they apply to a doctor late and seek help for treatment at an advanced stage. However, hemorrhoids should be treated from the very beginning of the disease so that complaints do not progress and increase, a condition that can be corrected with medication does not require surgery, and anemia does not develop due to a large amount of blood loss. There are various treatments for hemorrhoids according to their stages.

In first-degree hemorrhoids, medication treatments, regulation of bowel habits, avoiding spicy foods and relieving constipation are generally sufficient.

In second-degree hemorrhoids, medication, light therapy (infrared coagulation) and rubber band ligation treatments are also applied. The rubber band ligation method is very suitable for internal hemorrhoids that have not yet reached the surgical stage; it is a short-term, painless procedure lasting 5-10 minutes. After the procedure, one returns to normal life immediately.

In third-degree hemorrhoids, rubber band ligation and surgical treatments are applied.

In fourth-degree hemorrhoids, only surgical treatments are applied. Surgery removes the nipples that cause the disease.

Among these treatment methods, surgery is still the most effective in the long term and has the lowest chance of recurrence. Currently, hemorrhoids can be treated painlessly with a method called the Longo method. In this method, a cylindrical ring approximately 2 cm wide is removed from about 4 cm inside the anus, and the remaining two ends are stitched together end to end using a single-use device (stapler). In this way, the hemorrhoid nipples are pulled into the anus and their blood flow is interrupted so that they shrink.

1. Degree Hemorrhoid

2. Degree Hemorrhoid

3. Degree Hemorrhoid

4. Degree Hemorrhoid

Treatment

Medication treatments, regulation of bowel habits, avoiding spicy foods.

Medication treatments, light therapy (infrared coagulation) and rubber band ligation treatments are applied.

Rubber band ligation and surgical treatments

Only surgical treatments

How is the return to daily life after surgery, and does hemorrhoid recur?

After surgery, a little pain and bleeding during the first bowel movement is normal. In subsequent bowel movements this decreases. Avoiding constipation, regular use of medications and warm water sitz baths both relieve pain and speed up healing. No recurrence is seen after a surgery in which all hemorrhoid nipples have been removed. However, in cases where wound healing is not complete, patients may complain of pain and bleeding. This is not a recurrence of the disease, but discomfort caused by a wound that has not yet healed.