Hemorrhoids is an extremely common disease, and it has even developed to a situation of “ten people with nine hemorrhoids”. Clinically, it has been shown that the incidence of hemorrhoids in adults is as high as 50%, and with age, the incidence of hemorrhoids will be obvious. Promote. Hemorrhoids are still a very tormenting disease. Many patients cannot sit or stand when they are sick. Even lying down is unbearable pain. Some people say that hemorrhoids need surgery and the treatment is more thorough, but others say that hemorrhoids surgery is very painful and will recur after surgery. So, should hemorrhoids undergo surgery? Please listen to me slowly analyze it for you.
Internal hemorrhoids are divided into 4 stages
In the past, clinical experts believed that hemorrhoids are soft venous clusters formed by the expansion and flexion of the venous plexus under the epithelium of the rectum and anal canal. However, treating hemorrhoids according to this theory cannot solve the problem of high postoperative recurrence rate. In recent years, some foreign scholars have put forward the modern concept of hemorrhoids—the theory of downward movement of the anal cushion. The anal cushion is a lip-shaped fleshy on the lower end of the rectum. It is a ring-shaped spongy tissue band about 1.5 cm above the tooth line. It is a normal anatomical structure that everyone has. It acts as an anal gasket and helps the sphincter to close the anus. . Long-term drinking and eating a large amount of irritating food can cause local congestion; perianal infection can cause perivenous inflammation and thicken the anal cushion; long-term sitting, constipation, pregnancy, and prostatic hypertrophy can cause the anal cushion to shift downward. The pathological hypertrophy and displacement of the anal cushion form hemorrhoids. When the patient goes to the hospital, the doctor can confirm the diagnosis through anoscope and digital anal examination.
Hemorrhoids are clinically divided into three categories: internal hemorrhoids, external hemorrhoids and mixed hemorrhoids. It can be understood from the literal meaning that internal hemorrhoids are lumps that exist inside the anus; external hemorrhoids occur outside the anus; when internal and external hemorrhoids exist at the same time, they are mixed hemorrhoids. Among them, internal hemorrhoids are divided into 4 stages according to their severity: Stage 1 only bleeds during defecation, and the hemorrhoids do not come out of the anus; stage 2 hemorrhoids come out during defecation and are repaid by themselves after defecation; stage 3 hemorrhoids need to be repaid by hand after prolapse; Stage 4 hemorrhoids are outside the anus for a long time and cannot be repaid with hands.
Surgery is considered for stage 3 and 4
If you feel a foreign body sensation in the anus, prolapse of anal swelling during defecation, or even anal pain, intermittent red blood in the stool, anal itching, etc., you may have hemorrhoids. The purpose of treatment of hemorrhoids is to relieve the suffering of patients. There are three principles in the clinical treatment of hemorrhoids: one is that no treatment is necessary if there is no symptom; the other is symptomatic, focusing on reducing or eliminating symptoms; the third is non-surgical treatment.
If hemorrhoids only reach stage 1 or stage 2, the patient can control and improve hemorrhoids by paying attention to diet, avoiding spicy food and drinking, eating more fruits and vegetables, maintaining smooth stools, avoiding sitting for a long time, and doing more levator anal movements. But when hemorrhoids reach stage 3 or stage 4, surgery should be considered. In addition, if the following symptoms occur, surgical treatment is also required: repeated heavy bleeding; thrombotic external hemorrhoids, the pain is very severe; the symptoms of external hemorrhoids gradually aggravate, the skin tags continue to increase, the patient often has inflammation, there is obvious pain, redness, or itching symptom.
Surgical methods are constantly updated
In the past, hemorrhoid surgery mainly used sclerosing agent injection, rubber band ligation, infrared cautery or cryogenic freezing. Nowadays, ligation resection surgery, PPH surgery, HAL hemorrhoid artery atresia, HCPT ablation are more commonly used. Among them, PPH surgery is more widely used. It is also called “circumcision of hemorrhoids”. It uses a surgical instrument called a PPH stapler to perform circular resection of the rectal mucosa above the hemorrhoids, which can block the supply of hemorrhoids. The blood flow of the blood vessels can also suspend and fix the prolapsed rectal and anal canal tissues. Compared with traditional surgery, PPH surgery has the advantages of less postoperative pain, shorter hospital stay, faster recovery time, lower postoperative complications and recurrence rate, and can effectively improve the quality of life of hemorrhoid patients.
Within one week after the operation, since the wound is relatively delicate, it is necessary to avoid forceful stool or excessive stool frequency at this stage, otherwise it may cause wound bleeding; as the exit of feces, the anus is naturally a place where dirt and dirt are contained. Pay attention to the cleanliness of the anus. You can take a bath in warm water for 3 to 5 minutes before going to bed every night. There is no need to add salt or potassium permanganate to avoid excessive stimulation; whether it is PPH surgery or other surgical methods, the wound will be edema for a period of time after surgery Therefore, you should avoid standing and walking too much after the operation. Lying more often will help reduce swelling.