Treatment prognosis and risk of recurrence after hemorrhoid treatment

This is an automatically translated article.

The article was professionally consulted by Dr. CKII Phan Phi Tuan - Head of General Surgery Department, Vinmec Phu Quoc International General Hospital.

The nature of hemorrhoids is the vascular plexus in the anal canal, causing blood not to circulate, stagnation forming hemorrhoids. Depending on the type of hemorrhoids, the extent and health of the patient, the doctor will predict the appropriate treatment.

1. Measures to treat hemorrhoids


Usually grade 1, grade 2 hemorrhoids only use drugs and change lifestyle, eating and drinking to treat symptoms, prevent disease recurrence and progression without the need for surgical intervention. With heavier and more complicated hemorrhoids, it is often necessary to use surgical procedures to remove the hemorrhoids, then restore function and reduce complications.
Tie the hemorrhoid with an elastic band The doctor uses a rubber band, inserts it into the neck of the hemorrhoid and then tightens it so that the blood can't reach the hemorrhoid, the hemorrhoid will atrophy and fall off by itself.

Medical treatment of mild hemorrhoids are often used for medical treatment. There are many types of Western medicine as well as traditional medicine that work well in the treatment of hemorrhoids. Western medicine statistics have about 100 types of drugs including ointments, pills, suppositories are marketed to treat hemorrhoids. However, before using any drug, it is necessary to consider and consult with a doctor for high effectiveness, avoiding side effects.
Traditional medicine applies many remedies to treat hemorrhoids using herbs that are quite effective, easy to find, and cheap. However, most of the remedies are only effective for hemorrhoids grade 1 - 2, while heavier and more complicated hemorrhoids cannot be completely treated.
In general, medical treatment only works to treat symptoms or acute treatment to help reduce burning pain, bleeding, prolapsed hemorrhoids ... but difficult to treat.

Trĩ cấp độ nhẹ thường dùng điều trị nội khoa
Trĩ cấp độ nhẹ thường dùng điều trị nội khoa

Burning - cutting hemorrhoids Some methods such as infrared coagulation therapy; electrocautery with bipolar ablation, monopole or direct current, cryotherapy, DOPPLER ultrasound hemorrhoid ablation, internal sphincterectomy...
The advantages of these methods are painless, Patients can recover and go home in a short time, but there is a weakness that is very easy to relapse.
Hemorrhoidectomy Surgery Hemorrhoidectomy is an effective method for severe hemorrhoids grade 3, 4, famous for being the Milligan-Morgan method of cutting hemorrhoids and the stalk is sutured. If hemorrhoids are ring, it is necessary to cut additional submucosal hemorrhoids to avoid anal narrowing later. There are also methods Ferguson, Mazier...
Treatment with hemorrhoidectomy is the most thorough method, with high efficiency and low risk of recurrence. Surgery can cure all types of hemorrhoids, but the disadvantage is that patients after surgery have a long pain, very painful because the anus is concentrated with many nerves.
Hemorrhoidectomy is an effective and thorough method. In addition, the wound in the anal position for a long time is in contact with feces, so it is easy to become infected. Every time you defecate, the anus must stretch, so it usually takes 2-3 months for the wound to heal completely.
Longo hemorrhoidectomy Longo hemorrhoidectomy is based on the principle of pulling the hemorrhoid back to its normal position, at the same time cutting and suturing the acute blood vessel to make the hemorrhoid shrink. The cuts and sutures are located in the less sensitive area of ​​the anal canal, which greatly reduces pain for the patient.
After surgery, patients usually only need to stay in the hospital for 3-4 days to be able to return to normal activities. Postoperative pain and bowel movements are significantly reduced compared to other surgeries, patients only need to use oral pain relievers and only feel slight discomfort in the anal area.
However, this method uses one-time instruments, so the cost of treatment is high, moreover, if the doctor is inexperienced, the error rate is not small.

Phẫu thuật Longo
Phẫu thuật Longo
This is the procedure of injecting chemical fibers into the hemorrhoids to lose the hemorrhoids, the fibers in the hemorrhoids make it impossible for blood to feed the hemorrhoids, the hemorrhoids will atrophy by themselves.
This method is currently being performed at many medical facilities across the country with different drugs and sclerotherapy techniques. The method of sclerotherapy of hemorrhoids is often used to treat internal hemorrhoids, bleeding hemorrhoids with good results. However, with severe internal hemorrhoids and mucosal prolapse, external hemorrhoids, mixed hemorrhoids, and ring hemorrhoids are usually not indicated due to fear of patients suffering from injection pain or complications.
Hemorrhoid sclerotherapy has a low recurrence rate This method is highly effective (99 - 100% cured), the recurrence rate is low, only 2% from 2 to 5 years. After relapse, only 1-2 injections are required.

2. Risk of recurrence after hemorrhoid treatment


Each treatment method has a different recurrence rate after treatment, in addition, it also depends on the skill of the doctor performing and the patient's abstinence.
Most of the cases of recurrence after hemorrhoid treatment are caused by not completely eliminating the cause of hemorrhoids such as: living indiscriminately, drinking alcohol, pregnancy, chronic colitis,...
Methods Treatment methods all help relieve symptoms of hemorrhoids but the recurrence rate is also common, some people relapse after 1 year, some people relapse after 10 years, depending a lot on the patient's relapse prevention.

3. The role of lifestyle in preventing recurrence after hemorrhoid treatment


To prevent recurrence after hemorrhoid treatment, a healthy lifestyle plays a decisive role. Patients need:
Drink lots of water: drink 2 liters of water per day to help avoid constipation and better excrete waste. After hemorrhoid treatment, patients should drink a lot of water. Increase fiber: Eat a lot of fiber-rich fruits and vegetables such as sweet potatoes, jute vegetables, lettuce, papaya, sweet potatoes, bananas.. Practice bowel habits. every day at a certain time, do not try to push or sit for too long to defecate. Keep the anal area clean: soak the anus in warm water diluted with salt twice a day, 15 minutes each time. Increase exercise: gentle exercise such as slow running, walking, yoga. Limit sitting too much.

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