Stapled Hemorrhoidectomy, a New Treatment

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A new entry into the arena of excisional hemorrhoidectomy is the circular stapled hemorrhoidectomy .The technique uses a circular, transanally placed pursestring suture 4 cm from the dentate line and within the enlarged internal hemorrhoids. A 31-mm stapler is then placed transanally to perform a circumferential excision of the hemorrhoidal tissue and a repositioning and fixation of the anoderm to its proper location in the anal canal. The results appear promising, with decreased postoperative pain, shorter periods of convalescence, and similar complication rates compared with other forms of excisional hemorrhoidectomy.

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Posted in Hemorrhoids, Surgery, Treatment

Sclerotherapy in Hemorrhoids Treatment

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Although sclerotherapy, first advocated by Mitchell in 1871, has been used often in hemorrhoids, it is rarely performed in the United States.The purpose of sclerotherapy is to scar the submucosa, resulting in atrophy of the tissue injected and scarification with fixation of the hemorrhoidal complex within its normal location in the anal canal. A variety of solutions have been advocated, although it appears that sodium morrhuate and sodium tetradechol sulfate predominate. This modality is most effective in situations with minimal enlargement of hemorrhoidal complexes where the primary complaint is bright red rectal bleeding.

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Posted in Hemorrhoids, Treatment

Non-Excisional Treatment of Hemorrhoids

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The majority of patients evaluated for hematochezia that ultimately proves to be hemorrhoidal in origin can be and should be managed with fiber supplementation. Although it is not clearly proved that constipation contributes to hemorrhoidal symptoms, it is certainly reasonable to improve bowel function to reduce hemorrhoidal complaints in the majority of early-stage patients. The remaining nonoperative and operative interventions should be reserved for patients with advanced hemorrhoids and patients who are unresponsive to this simple but effective medical management routine.

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Posted in Treatment

History of Hemorrhoids

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About hemorrhoids ,there are few diseases that are more chronicled in human history than symptomatic hemorrhoidal disease.References occur in ancient texts dating back to Babylonian, Egyptian, Greek, and Hebrew cultures. Included in many of these writings are multiple recommended treatment regimens such as anal dilatation, topical ointments, and the intimidating red-hot poker. Although few persons have died of hemorrhoidal disease, many patients have wished they had, particularly after therapy; this fact led to the beatification of St. Fiacre, the patron saint of gardeners and hemorrhoidal sufferers. This discussion should guide the practitioner in a more humane approach to hemorrhoidal disease with an emphasis on cost effectiveness and minimal complications.

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Posted in Hemorrhoids

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