Monday, October 14, 2013



 

 Hemorrhoids? Ouch! 
    About ten million people in the U.S. suffer from hemorrhoids. During the fourteen to fifteen hundreds, this malady was known as “Saint Fiacre’s Curse.”  

    In 2004, the National Institutes of Health noted that a diagnosis of hemorrhoids was associated with three million clinic visits, three hundred thousand hospitalizations, and two million prescriptions. Repeated straining during bowel movements can cause hemorrhoids. Symptoms include blood on the toilet paper, itching, pain, and a lump of soft tissue at the anus. 

Conservative Treatment: Increased dietary fiber, avoidance of straining during bowel movements, moist heat, and soothing sitz baths alleviate symptoms. A dietary supplement, flavonoids, can improve bowel elimination and control anal inflammation. However, their widespread use isn’t recommended till more research verifies their effectiveness.Sitting in warm water a tub or sitz bath reduces itching and pain. Fiber supplements, such as psyllium and unprocessed bran, reduce symptoms. 

Rubber Band Ligation is an effective, nonsurgical office treatment. Its success rate in is eighty to ninety nine percent. Side effects include temporary bleeding and pain. It is not recommended for people who are on long-term blood thinners.
 
Sclerotherapy involves injection of a medicine into the hemorrhoid. This causes a soft tissue reaction that shrinks underlying blood vessels. Possible side effects include urine retention and abscess. Serious complications are rare.  

Infrared Coagulation is a technique that delivers infrared energy to the hemorrhoid tissue using a tungsten halogen lamp. This scars and shrinks the underlying tissue. Repeat treatments might be needed every two to four weeks. Although thrombosed (clotted) hemorrhoids cause unbearable pain, they might resolve in one or two weeks without surgery. 

Doppler Ultrasound-guided hemorrhoid artery ligation could be considered. This procedure involves ligating (suturing shut) the blood vessels that connect to the hemorrhoids. It is less invasive than other procedures. It might not work for severe hemorrhoids. Long term benefit isn’t clear, and it isn’t widely available in the U.S.. 

Finally, surgical removal of the hemorrhoid clot under local anesthesia is the most effective treatment. Most people resume normal activities in two to three weeks. 

 “Why are hemorrhoids called hemorrhoids and asteroids called asteroids? Wouldn`t it make more sense if it was the other way around? But if that was true, then a proctologist would be an astronaut.” Robert Schimmel

 Source: Consumer Reports on Health; Vol. 25, Number 9.
 http://www.medscape.com/viewarticle/805040_7



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