Hemorrhoids: Causes, Treatment and Prevention

. They contribute to the maintenance of continence as they can swell and deflate as needed.

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Under normal conditions, hemorrhoids are not perceived in the least by the individual, but the discourse changes when problems arise that cause these pads to slide down (both internal and external hemorrhoids) thus causing the characteristic symptoms of hemorrhoidal disease.

In common parlance, however, the term "hemorrhoids" is misused to refer to the aforementioned condition. For simplicity, the use of this term - although improper - will also be made in the course of this article to indicate the aforementioned pathological condition.

For further information: Hemorrhoids ;

Drastic increase in intra-abdominal pressure during delivery.

Hemorrhoids occur mainly between the ages of 45 and 65 and tend to worsen over time. At the origin of the disease there are also predisposing factors such as familiarity, lifestyle and eating habits.

Among the main risk factors, the most influential is linked to the presence of intestinal dysfunctions, such as constipation or chronic diarrhea. Other factors that can trigger or aggravate haemorrhoidal disorders include:

Sedentary lifestyle;
Excessive effort;
Abuse of laxatives;
Prolonged standing;
Abuse of alcohol / or nicotine;
Incorrect feeding.

Speaking of dietary habits, it is important to emphasize that a healthy body is perfectly capable of handling any food, including those considered to be at risk for hemorrhoids. Obviously, a massive and prolonged use of these particular foods could, in the long run, determine the appearance of the disease or other proctological pathologies.

In light of what has been said so far, therefore, it is not possible to determine a "single specific cause at the origin of the hemorrhoids as the pathology in question may be the result of a set of factors that concur with each other in the onset. of the problem.

and alcohol. Sports such as jogging, dancing, walking or gentle gymnastics for the elderly are just a few examples of motor activities that can improve body functions while strengthening the pelvic region.

At the same time, "careful personal hygiene can not only be useful for preventing hemorrhoids but also other very annoying diseases, such as anal fissures or fistulas. The choice of underwear is also very important since permeable fabrics such as cotton contribute to avoid stagnation of heat and humidity.

What to eat?

Nutrition plays a very important role in both primary and secondary prevention (after the appearance of hemorrhoids). A balanced diet, rich in water and fiber, helps to regulate intestinal functions, removing one of the main risk factors.

In truth, as mentioned above, a healthy organism is capable of managing even the foods considered "risky" for hemorrhoids, although their excessive and too frequent intake can still favor the onset of the disease. Therefore, moderation and the adoption of a balanced diet are essential.

If you already suffer from hemorrhoids, all those foods that can irritate the anal mucosa will be abolished, or at least limited, such as:

Chili pepper;
Sausages;
Alcohol;
Chocolate;
Spicy spices.

To learn more, read also:

Diet and Nutrition for Hemorrhoids Example Diet for Hemorrhoids varies according to the severity of the disease. If in milder cases a little exercise and correct dietary habits are sufficient to promote healing, in particularly severe cases the only effective solution is surgery.

Between these two extremes there are a whole series of other types of treatments, such as the use of drugs or the execution of outpatient operations carried out under local anesthesia such as photocoagulation and elastic ligation. The result of these interventions solves in most cases the problem at the first attempt (about 60%), while in the most unfortunate ones it is necessary to repeat the treatment.

Behavioral interventions

In the initial stage, the treatment of hemorrhoids takes place thanks to a series of measures capable of reducing inflammation and restoring elasticity to the venous walls.

In this regard, the diet must be rich in water and fibers, in order to favor intestinal evacuation; at the same time, all those situations that cause an increase in pressure on the hemorrhoids, such as lifting heavy loads or excessive effort during defecation, must be avoided.

Hygiene and correct washing with lukewarm water and a suitable detergent are also very important, as they accelerate healing and remove the risk of infection. On the other hand, washing with cold water should be avoided as the consequent spasm of the anal muscles could cause loosening. throttling of hemorrhoidal nodules.

Finally, ointments and suppositories with a decongestant, anesthetic and / or disinfectant action represent the "conservative" remedies useful for treating hemorrhoids in the initial stage and relieving their symptoms.

For more information: Hemorrhoid Remedies: Do's and Don'ts

Medicines for the treatment of hemorrhoids

Also in this case, as is the case for many other pathologies, the drugs that can be used in the presence of hemorrhoids relieve the symptoms but do not act on the causes that gave rise to the problem.

The active ingredients usually used are local anesthetics and corticosteroids (powerful anti-inflammatories). The medicines that contain them used in the treatment of hemorrhoids are for topical and local use; hence, they are generally formulated in the form of creams or ointments.

It should also be noted that some medicinal products for the symptomatic treatment of hemorrhoids contain plant extracts or cell extracts of Saccharomyces cerevisiae.

For further information: Hemorrhoid ointment

However, it should be noted that the use of any type of drug for the treatment of hemorrhoids should only take place after consulting your doctor and - especially (but not exclusively) in the case of corticosteroids - under his strict control.

For more information: Hemorrhoid Medication

If pharmacological treatments do not have the desired effect and / or there is a worsening of the symptoms that cannot be resolved by outpatient techniques, surgery should be considered as the only truly effective alternative. Of course, the decision to resort to this type or not. of approach is up to the doctor.

Surgical Treatment of Hemorrhoids

The surgical removal operation (haemorrhoidectomy) which is necessary for haemorrhoids of a higher degree than the first associated with heavy bleeding, frequent thrombi or complete prolapse (IV degree) has undergone numerous evolutions over the years.

There are three main types of surgery:

The classic one also known as Milligan and Morgan traditional open hemorrhoidectomy;
The method based on the technique developed by Dr. Longo (Longo method);
The THD method.

The first technique, certainly not without side effects, is based on the surgical removal of hemorrhoids thanks to the removal of the excess tissue responsible for bleeding and prolapse. The other methods, however, will be briefly described below. Before proceeding, however, it should be noted that the choice of the most suitable intervention is made by the specialist based on the results of the proctological examination. If the diagnosis is correct, about 96% of patients can definitively solve the annoying problem of hemorrhoids. .

Longo method

The Longo method is based on the repositioning of prolapsed hemorrhoids (prolassectomy and hemorrhoidopexy surgery). This device allows the patient a faster recovery (generally within 10-15 days, compared to the 4-6 weeks foreseen with the traditional intervention), relieves painful symptoms and has an efficacy comparable to the traditional method.

THD method

The THD method consists of suturing the terminal branches of the superior rectal artery (this is the artery that carries blood to the hemorrhoids). In case of prolapse, the suture is associated with the repositioning of the mucosa in its natural location. This type of intervention also has faster recovery times than the traditional method (7-10 days) because it does not require tissue removal, relieves painful symptoms and has a low rate of relapses.