This article is professionally consulted by Dr. Nguyen Ngoc Thang, (M.D., MMed) Department of General Surgery - Vinmec International Hospital Da Nang.

Internal hemorrhoids are one of the problems that many people encounter. Not only does it seriously affect the quality of life, causing pain and suffering for the patient, but hemorrhoids also have many dangerous complications if not detected promptly. Hemorrhoids can lead to blood loss and severe infections if not treated promptly.

1. Symptoms of grade 4 hemorrhoids

At this stage, the hemorrhoids have become so enlarged that they protrude even when the individual is not having a defecation and cannot be reinserted. The patient experiences constant pain and bleeding at all times. Additionally, at this level, the individual is at an increased risk for various other health complications, including hemorrhoid infections, hemorrhoid necrosis, anal fissures, anal abscesses, and potentially rectal cancer.
 

2. Causes of grade 4 hemorrhoids

• Prolonged periods of sitting or standing, lifting heavy objects, and engaging in strenuous activities like weightlifting or tennis...

• Excessive consumption of stimulants, including alcoholic beverages, beer, chili.

• Inadequate intake of fiber-rich foods, particularly fruits and vegetables.

• Insufficient hydration leading to constipation.

• Obesity, pregnancy, and chronic coughing...

3. Effects of hemorrhoids

• Hemorrhoids can significantly disrupt daily routines, profoundly impacting the mental well-being and psychological state of the individual, particularly during defecation.

• Hemorrhoidal obstruction  can lead to pain and discomfort in the anal region, and in more severe cases, it may result in blood infections and varying degrees of inflammation, such as anal abscesses.

• Patients experiencing frequent episodes of bloody stools are more likely to suffer from severe anemia.

• Fissures and tears in the anal region become vulnerable to bacterial infection from fecal matter and urine, especially when hemorrhoids are persistently protruding. These bacteria and toxins can enter the systemic circulation again, leading to blood infections.

• The condition may pose risks to the nervous system, potentially resulting in headaches, cognitive impairments such as memory loss, lower back pain, and contributing to neurological disorders, mental strain, and even syncope.

• Additionally, hemorrhoids can interfere with intimate relationships and activities between couples.

• Women suffering from hemorrhoids are at an increased risk for gynecological infections, with particularly serious consequences during pregnancy and the postpartum period. Therefore, it is crucial for women to adopt preventive measures prior to conception and remain vigilant regarding the risks associated with hemorrhoids.

• Hemorrhoids can develop into rectal cancer if they are not treated early.

4. Is it possible to cure grade 4 hemorrhoids?

Vinmec International Hospital Da Nang has successfully conducted surgery and treated a 61-year-old patient suffering from severe grade 4 internal hemorrhoids. With surgery, grade 4 internal hemorrhoids can be totally resolved. Dr. Nguyen Ngoc Thang, a gastrointestinal surgeon at Vinmec International Hospital Da Nang, stated: "Patients experiencing severe hemorrhoids, particularly those with a prolonged history and inappropriate treatment, are at a heightened risk for anal stenosis. The Longo procedure pulls the hemorrhoids up and cuts off the blood supply of internal hemorrhoids, while the external hemorrhoids partial excision aims to prevent the potential risk of thrombosis in external hemorrhoids following the Longo procedure. The integration of both techniques will further reduce the likelihood of hemorrhoid recurrence."

5. How to prevent recurrence after surgery to remove grade 4 internal hemorrhoids

• Drink plenty of water: 2 liters of water per day will prevent dehydration and promoting waste removal.

• Enhance fiber intake: Incorporate a variety of foods such as sweet potato leaves, jute leaves, Malabar spinach, fish mint, dragon fruit, papaya, peeled and seeded guava, sweet potatoes, and bananas.

• Establish a daily routine for bowel movements at a consistent time, and avoid excessive straining or prolonged sitting during the process.

• Maintain hygiene in the anal region: It is recommended to soak the anal area in a 0.9% warm saline solution for 15 minutes, twice daily.

• Increase physical activity: Engage in gentle exercises such as walking, jogging, yoga, and anal contraction exercises. Minimize prolonged sitting during work.

• It is recommended to use products containing Meriva (curcuma phospholipid), fish mint, Angelica sinensis, Rutin, and magnesium both before and immediately after surgery. These products assist in preventing constipation while enhancing venous tone, protecting microcirculation, preventing thrombosis, reducing edema, and mitigating infection. To aid in stool softening, restore anal function, accelerate surgical wound healing, and effectively prevent recurrence post-surgery, it is advisable to use the product one week prior to surgery and continue for 2-3 months afterward.

• Refrain from consuming stimulants such as alcoholic beverages, beer, and excessive amounts of chili.

• Address any conditions that cause prolonged cough...

The Longo procedure is now a widely used treatment method in modern medicine. It is a modern technique that offers high efficiency, reduces post-operative complications, and speeds up patient recovery.

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