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Hemorrhoids: Treatment and Surgery

Treatment

Medical treatment of hemorrhoids is aimed initially at relieving symptoms. Measures to reduce symptoms include:

• Warm tub baths several times a day in plain, warm water for about 10 minutes
• Application of a cream or suppository to the affected area
•  Relieving the pressure and straining of constipation.
Bathing in a tub with warm water eases painful perianal conditions as this produces relaxation of the spasm of the sphincter mechanism.  Application of ice also relieves the pain of thrombosed piles.

Cream is good for hemorrhoids that are sticking out from the anus
(prolapsed hemorrhoids), while suppositories (which are tablets pushed up inside the anus where they dissolve) are better suited to hemorrhoids which are still inside. Both methods shrink the hemorrhoids and are often sufficient.

Decreasing straining and treating constipation shrinks internal hemorrhoids and decreases their symptoms; thus, the first-line treatment for all hemorrhoids should include measures to decrease straining and constipation.

Fiber and fluids should be increased in the diet.  Eating the right amount of fiber and drinking six to eight glasses of fluid (not alcohol) result in softer, bulkier stools. Psyllium seed and methylcellulose are the most commonly used fibre supplements. A softer stool makes emptying the bowels easier and lessens the pressure on hemorrhoids caused by straining. Eliminating
straining also helps prevent the hemorrhoids from protruding.

Many hemorrhoid symptoms resolve when treated only with dietary alterations. Toilet training involves reminding patients that the lavatory is not the library.  Patients should sit on the toilet only long enough to evacuate the lower intestines.  Persistent straining or prolonged sitting can lead to engorged hemorrhoids.

Many patients get complete resolution of their symptoms with the above
conservative measures. Aggressive therapy is reserved for patients who have persistent symptoms after one month of conservative therapy.

Numerous methods are available to destroy internal haemorrhoids.
These are – rubber band ligation, sclerotherapy injection, infrared
photocoagulation, laser ablation, carbon dioxide freezing and surgical resection.

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