How to cure hemorrhoid (part 2)
Are there effective ways to cure hemorrhoid? Most of the sick associate treatment with the necessity of painful surgery. However proctology is a dynamically developing branch of medicine. And at present it has both highly effective drugs and spare efficient remedies for hemorrhoid treatment in its arsenal.
According to one of the versions, Napoleon had lost Battle of Waterloo due to an acute fit of hemorrhoid. It is said he was not able to sit on his horse and control army moves. Maybe this fact gives rise to doubt. However one can be sure that such disease ad hemorrhoid can instantly and misfortunately unhorse anybody.
Conservative treatment methods (medicinal preparation)
Hemorrhoid is usually treated by local preparations (rectal suppositories and ointments). As a rule they are all complex – contain several active components. The preparations lower tissues edema and inflammation as well as deaden pain and itch. Heparin which is included in all of them promotes blood supply improvement and thrombi liquefaction. Now the market of hemorrhoid remedies is represented by a wide range of drugs: Proctozone, Ultraproct, Hepatrombin, Proctosedyl etc. But all the preparations have nuances of application in each particular case; therefore adequate medication can be prescribed only by proctologist.
In order to improve the effectiveness of local preparations remedies, ameliorating vascular tone and impeding blood clot organization (Detralex, Troxevasin), should be taken internally.
Medicamental treatment methods are exceptionally symptomatic – that is do not radically cure hemorrhoid. However they allow coping temporarily with annoying hemorrhoid signs. It has been proven that if a patient follows doctor’s recommendations on prophylaxis of hemorrhoid relapses he can avoid surgical therapy. Though as practice shows most people are not willing to change their lifestyle, their job – in general to remove those risk factors that provoke hemorrhoid development. That is why it is reasonable to solve hemorrhoid problem once and for all – with the help of radical surgical therapy.
Semisurgical operations (spare methods)
Sclerotherapy
A special substance which promotes sticking of cavernous vessels walls is injected into hemorrhoidal bolus. As a result the bolus ceases to exist (is substituted for connective tissue).
The operation is performed it conditions of clinic, do not require central and local anesthesia. Sclerosing agent (e.g., etoxisclerol) after detecting rectum lumen is injected into hemorrhoidal bolus peduncle. The manipulation requires extremely high precision and proctologist’s experience.
Extreme temperatures exposure
Cryodestruction (by extremely low temperature) and focused infrared coagulation (by extremely high one) are used. At the same time hemmoroidal boluses are subject to necrosis. If hemmorhoidal boluses are big the operation may take several sessions. It is considered to be reasonably effective remedy of hemorrhoid cure at initial and middle stages of development.
Boluses ligation with the help of latex rings
Stretched rings are put on the base of hemorrhoidal bolus by special apparatus: nourishment of bolus is discontinued and its necrotization takes place. At the end of the process the bolus is rejected together with the ring.
All these operations are scarcely traumatic, painless and easily taken by patients. In some cases patients are disturbed by discomfort while the intervention is performed. In rare cases patients mention pain, but it is not intensive and can be cut off by anesthetic preparations.
Minor surgery in hemorrhoid cure may be applied at all the stages of the disease with the exception of acute forms. However on later stages of hemorrhoid (III-IV) these methods are mostly used as a preparation for performing radical surgery. But these methods have significant disadvantage – they do not remove the cause of hemorrhoid, namely blood supply disturbance of hemorrhoidal boluses. Therefore the symptoms can reoccur (relapse) on the average in 3-5 years. Recurrence rate with these methods is from 15% to 45% (the earlier the stage at which the operation is done, the lower the probability).
Radical operations – eliminate hemorrhoid causes
Longo procedure
The most popular type of surgical hemorrhoid treatment. It is comparatively short procedure, and that is important if there are contraindications to traditional hemorrhoidectomy. Operative intervention implies excision of rectum mucous membrane above hemorrhoidal bolus. However patients often experience pain during postoperative period. In addition the method may be applied only on early stages of hemorrhoid (I-II).
Boluses excision
A traditional operation – hemorrhoidectomy (boluses excision) is still a successful practice. The operation is quite traumatic, is performed under general anesthetic. Postoperative period is long and requires thorough rectum care and usage of painkillers. At present many world’s leading proctologists consider hemorrhoid disarterization to be the most preferable method.
Disarterization
It is the cutting-edge procedure of surgical hemorrhoid cure. Its idea is to cut the artery which feeds blood to the enlarged bolus. To perform transanal hemorroid disarterization a special equipment (ultrasound apparatus with dopplerometry function) is needed. This allows proctologist not to work “blindly”, as, for example, in sclerotherapy. The equipment gives an opportunity to accurately find artery which supplies blood to the hemorrhoidal bolus and accurately cut it under vision control. The procedure may be done in the outpatient setting and does not require painkillers usage during postoperative period.
The main advantages of the method are minimal operation duration (15 min), absence of blood, high effectiveness, applicability on all stages of hemorrhoid. The operation is scarcely traumatic, that a patient does not need a medical certificate and is able to proceed with his regular daily duties the next day.
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