Hemorrhoids – Causes, Symptoms, and Modern Treatment Options
What are hemorrhoids?
Hemorrhoids are vascular cushions made up of arteries and veins located in the lower rectum. They function like a valve that seals the anal canal and contribute to approximately 15% of continence control.
How do enlarged hemorrhoids develop?
Repeated or prolonged increases in abdominal pressure often lead to the enlargement of hemorrhoids. Common causes include excessive straining during bowel movements, pregnancy, or chronic coughing. The enlargement typically occurs gradually over several years and is classified into different stages (grades), which affect both symptoms and treatment options.
Typical symptoms:
- Traces of blood on toilet paper or in the stool
- Pain during bowel movements
- Itching, pressure, or a sensation of a foreign body
- Symptoms may change as the condition progresses
Preventing hemorrhoids – keeping your bowels healthy:
A healthy lifestyle is the best prevention:
- A fiber-rich diet and adequate fluid intake help maintain soft stool consistency
- Proper toilet habits: only go when you feel the natural urge and avoid straining
- Regular exercise supports digestion and promotes healthy bowel movements
Individualized Care in My Practice:
Hemorrhoids are nothing to be ashamed of. In my practice, I take the time for a thorough evaluation of your symptoms. Depending on the diagnosis, I offer personalized care – from one-on-one consultations and conservative treatments to surgical procedures. In many cases, surgery can be avoided.
If surgery is necessary, I rely on minimally invasive techniques that are both gentle and highly effective. With over 2,700 procedures performed, the training of more than 500 proctologists, and the leadership of numerous international workshops, I bring extensive experience in treating even advanced hemorrhoids.
Modern Treatment Method: HAL/RAR
HAL/RAR (Hemorrhoidal Artery Ligation and Recto-Anal Repair) is a proven, minimally invasive technique:
Using a Doppler signal, the supplying arteries are located and then ligated. This reduces blood flow to the hemorrhoids, causing them to shrink. In addition, the hemorrhoids are fixed back in place with anchoring stitches and reshaped using a special spiral suture (pexy technique).
Advantages:
- Preserves hemorrhoidal function, helping maintain continence
- No open wounds, resulting in faster healing
- Anal canal sensitivity remains unaffected
- Usually only a few days of pain medication needed
Hemorrhoids play a vital role in continence – these 15% are something we want to preserve, both in youth and in older age!
Post-Operative Recommendations:
For a smooth and quick recovery, I recommend the following:
- Pain Management: Mexalen 500 mg or Novalgin 500 mg (up to 4×1 tablet daily if needed)
- Local Treatment: Anal Plus ointment (Dr. Freitas) or Xylocaine 5% for pain, possibly applied a few minutes before bowel movements
- Nutrition & Digestion: High-fiber diet, adequate fluid intake, Optifibre (1–3 scoops daily in a large glass of water)
- Hygiene: Use baby wipes and/or water; avoid dry toilet paper
- During Bowel Movements: Avoid straining to support the healing process
- Exercise & Lifting: No heavy lifting (> 20 kg) during the first two weeks after surgery
Important Notes for the First Weeks After Surgery
- Occasional bleeding may occur within the first 6 weeks, especially between weeks 2–4 (due to suture dissolution)
- Follow-up appointment: approximately 3 weeks after the procedure
Thanks to these modern treatment methods and individualized care, we can gently and effectively treat even advanced hemorrhoids – improving your quality of life for the long term. 🌿
