Varicose veins of the anus (hemorrhoids) are one of the most common diseases of civilization. According to statistics, this problem may periodically affect nearly half of the adult population. This is a very embarrassing problem that can, and should be treated.
Aesthetic proctology is a branch of medicine dealing with the sensitive area of the anus and the last section of the large intestine, i.e. the rectum.
Hemorrhoids are the normal anatomical structure that every person has. They are located in the anal canal about 2 cm from the anal gap. Physiologically, they are an anatomical structure that has the sealing function. Most often there are three hemorrhoids, hidden inside the anus.
Hemorrhoidal disease is an inflammation of the hemorrhoids, which, due to pressure, increase and fill with blood, but do not empty completely. Excessive spasm of the anal sphincters leads to a pathophysiological condition causing discomfort and pain.
The first alarming symptoms, often underestimated are pruritus and burning sensations around the anus, which are often accompanied by mucosal irritation and oozing discharge and inflammation. Another disturbing symptom is the feeling of incomplete bowel movement, which forces the patient for extra pressure and blood on the stool. At advanced stages of the disease, haemorrhoids fall out of the anus. In that case patients fell pain and discomfort when sitting and due other daily activities.
Symptoms of hemorrhoidal disease:
- rectal bleeding
- itching
- mucous discharge
- prolapse of hemorrhoids from the anal canal outside the anus
- pain
Treatment of hemorrhoids begins after diagnosis. It is implemented through the use of preventive treatment, non-invasive treatment and in more advanced cases of surgical treatment. Most often, only advanced hemorrhoidal disease with haemorrhoids prolapse and / or anemia may require surgery. The treatment plan is set individually for the ailment, severity of the hemorrhoidal disease and other patient needs. The basis of modern therapy is the appropriate diagnosis of the stage of the disease and the use of least invasive, but also the most effective treatment tactics.
Diagnosis of hemorrhoidal disease always requires consultation with a doctor! The patient does not have to be prepared in any special way for the consultation. Depending on the result of the examination, the doctor recommends performing additional diagnostic tests.
Non-invasive treatments: obliteration of venous plexuses with sclerosant (a medication that causes their fibrosis), use of the Nd:Yag laser to close dilated blood vessels of hemorrhoids or other less frequently used methods.
Surgical treatment: excision of enlarged, falling out hemorrhoids, occasionally also to treat bleeding that causes anemia.
Both less-invasive and surgical treatments require anesthesia as well as an adequate preparation for the planned surgery, which is discussed and determined during the visit preceding its execution.
In the postoperative and surgical period, the healing process is constantly monitored during series of postoperative consultations.
Types of treatments
Sclerotherapy of anal varices
Sclerotherapy is one of the methods of varicose veins treatment eliminating blood flow in varicose veins by injecting medicinal substances into them. Polidocanol in various concentrations is used for this purpose. Sclerotherapy procedures do not require anesthesia or the use of pain medications. Usually, after surgery there are no contraindications for the patient’s immediate return to full activity and daily duties. Sclerotherapy can be carried out completely safely as an outpatient procedure.
The primary goal of sclerotherapy is to obtain a limited area of fibrosis of the hemorrhoids without surgical resection. This does not eliminate hemorrhoids, but causes their fixation within the rectal canal while maintaining their physiological functions.
Contraindications:
- pregnancy and breastfeeding
- cancer
- acute viral infection, HIV infection
- autoimmune diseases
- use of immunosuppressive medications
- blood coagulation disorders and use of medications that increase bleeding time (anticoagulants)
Post-surgery recommendations are individually set to the patient’s needs, type of disease and method of administration, however common points are:
- easily digestible diet,
- avoiding long sitting position,
- avoiding direct exposure of the treated areas to UV radiation.
- Anal fissure treatment with botulinum toxin
Botul. tox. is used for medical purposes and belongs to the group of muscle relaxants. Its way of working is based on blocking nerve impulses to the muscles into which it has been injected. This prevents these muscles from contracting.
Botul. tox. can be used for treating several conditions. Anal fissure is one of them.
Contraindications:
- pregnancy and breastfeeding
- use of some specific medications (antibiotic therapy, anticoagulation),
- some neurological diseases
- blood coagulation disorders
- intolerance of the active ingredients of the preparation.
During the procedure, doctor injects toxin with a thin needle- patient may feel a slight prick, but the procedure itself is quick and painless. Using botulinum toxin by an experienced doctor is completely safe. After the procedure, the patient immediately returns to his daily duties. Post-surgery recommendations are set individually for each patient.
Correction of anodermal folds
Anoderma is the skin in the final segment of the anal canal. It is devoid of glands and very poorly supplied with blood, but at the same time has a rich pain innervation. It is covered with a multi-layered epithelium. In anal diseases such as varicose veins, anodermal hypertrophy in the form of perianal skin folds may occur, causing discomfort and negative aesthetic sensations.
Contraindications:
- pregnancy and breastfeeding
- cancer
- acute viral infection, HIV infection
- autoimmune diseases
- use of immunosuppressive drugs
- blood coagulation disorders and taking medications (relative contraindication) that increase bleeding time (anticoagulants)
Perianal anodermal folds are removed surgically. If the disease does not recur, it is not necessary to repeat the treatment. The procedure performed correctly by an experienced proctologist is safe. Return to daily activities is possible quite quickly. Transient pain may occur in the operated area of the body. There is a risk of local inflammation and itching may also appear.
Recommendations after the procedure:
- a high-fiber diet
- regular meals
- regular bowel movements
- use of individually prescribed medications
Laser treatment of rectal varices
Laser varicose vein treatment is a minimally invasive proctology procedure that allows you to effectively get rid of the problem of hemorrhoids regardless of their stage. Laser therapy can be used in the treatment of varicose veins of both I, II and III and IV degree, thanks to which this technique is very popular..
One of the most modern methods of treating anal varicose veins is laser therapy, which consists in irradiating the affected hemorrhoids with an optical fiber powered by laser light inserted into them. Currently, hemorrhoids are treated with two types of equipment: a CO2 laser and a neodymium-yag laser (Nd: YAG). The first system works by evaporating the outer parts of the nodule outside the anus, while the Nd: YAG laser is used to induce photocoagulation at the base of the hemorrhoid and cause its necrosis.
Thanks to the laser treatment you can get rid of hemorrhoids of different sizes. The procedure is safe for the patient, and compared to the others, more invasive methods of treatments, it has much lower risk of causing damage to the anal sphincter – this is due to the fact that the laser technique is very precise, thanks to the use of a focused light beam. This type of treatment is carried out as a one-day surgery, because it usually does not require hospitalization. The advantages of this method also include low postoperative pain and very high effectiveness.
