With its general definition, hemorrhoids is a health problem that occurs with the dilation of the vessels in the anus region. This health problem, which is also known by names such as hemorrhoids or chilblain, may affect the daily life of patients negatively. This problem occurs when the rectum located at the end of the large intestine and the veins in the anus form various sacs. We can say that hemorrhoids, which is an extremely common problem, can occur in almost half of the society. We will also touch on how the hemorrhoid problem is treated or its causes. But first, let’s review the symptoms.

What are the Symptoms of Hemorrhoids?

First of all, let us state that the symptoms of hemorrhoids may show different symptoms in patients. Symptoms can also vary depending on which type of hemorrhoids you have. However, it should be noted that the severity of the symptoms seen in patients is not the same.

We can give the following examples of external hemorrhoid symptoms:

  • Severe itching and discomfort around the anus
  • A painful lump or swelling near the anus
  • Increased pain in this area in sitting position
  • Blood in stool

Factors such as rubbing this area or cleaning it for a long time can increase the pain experienced by the patients. At the same time, we can say that staying in a sitting position for a long time increases the pain.

The symptoms experienced in internal hemorrhoids are as follows:

  • Bright red blood in the stool
  • Prolapse and palpation of hemorrhoids from the anus region

We can state that hemorrhoids, which are usually drooping, cause pain. In the absence of sagging, complaints of pain are also extremely rare. Of course, when these symptoms are observed, a doctor should be consulted without wasting time.

What Causes Hemorrhoids?

what causes hemorrhoids

We can say that the chronic constipation problem is the leading cause of hemorrhoids. In case of frequent constipation problems, it is also important to investigate the causes and treat them, in order to prevent hemorrhoids in the future. Long stay in the toilet is also on the list of reasons. However, uneasiness during defecation is another cause of hemorrhoids. All of these are factors that negatively affect the blood flow in the area. If the blood flow is affected negatively, it causes the vessels to form a pool over time. It should be noted that hemorrhoids are common during pregnancy. The reason is that the uterus expands and starts to put pressure on the vessels. Therefore, even only pregnancy can become a factor that can cause hemorrhoids.

What are the Types of Hemorrhoids?

In general, hemorrhoids problem is examined in 4 different categories. These;

  • Internal
  • External
  • Prolapse
  • Thrombosis

This classification is made according to the location of hemorrhoids and the symptoms. The part where stool is temporarily stored is called the rectum. When there is a venous enlargement in the lower part of the rectum, this situation is evaluated in the internal class. We can state that this type of hemorrhoids is not very sensitive to external factors such as pain, stretching or temperature. A grading of 1 to 4 is made, depending on how much the overhang occurs.

We can state that external hemorrhoids occur in the outer part of the anus area. It often has a blue color and sometimes patients may complain of itching and pain. Slouching of the internal hemorrhoids from the anus is considered as prolapse. Thrombosis occurs when there is a blood clot in the hemorrhoids.

What are the stages of hemorrhoids?

The degrees of internal hemorrhoids commonly seen in the society are between 1 and 4.

First Degree

Hemorrhoids are prominent, but there is no protrusion from the anal canal. However, bleeding can also be seen.

Second Degree

Only during bowel movements the hemorrhoid protrudes outward and then returns spontaneously.

Third Degree

Hemorrhoids protrude from the anus during some body movements, exercise, and bowel movements. However, in third degree internal hemorrhoids, this protrusion does not go in by itself, it is necessary to push with a finger.

Fourth Degree

Hemorrhoids are completely ptotic. It cannot go in and cannot be pushed with a finger.

How Is Hemorrhoids Diagnosed?

hemorroid diagnosed

Studies show that the vast majority of people with hemorrhoids do not go to a doctor because they are embarrassed. It is observed that 4% of the patients consult a doctor when the complaints start, and the remaining part prefer to go to the doctor when the disease is very difficult. However, diagnosis by examination is very important in terms of starting treatment before the disease progresses. We can say that external hemorrhoids can be easily detected and diagnosed by examination. Anal canal and rectum examinations are required for the diagnosis of internal hemorrhoids. Rectum examination can also be done by the doctor with a finger.

In rare cases, your doctor may request some further examinations. Sometimes it may be necessary to examine the large intestine by colonoscopy. We can explain in what situations this examination, made with a device with a micro camera at the tip, is needed as follows:

  • Finding that there is a different digestive system disease
  • Large bowel cancer suspected
  • The patient is of middle age and has not had a colonoscopy recently.

As a result, one should not think that a colonoscopy will be required for diagnosis. This procedure is done only when deemed necessary by the doctor. Apart from this, it is also possible to diagnose only by examination.

How to Treat Hemorrhoids?

Of course, patients may also wonder how hemorrhoids are treated. If there is an internal hemorrhoid and its degree is low, a drug treatment option is considered. In such cases, there is no need for surgical intervention. If different complications develop or if drug therapy is not successful, surgery options should be considered. In external hemorrhoids, if the patient does not have any complaints, an intervention may not be performed.

The main purpose of drug therapy in this condition is not to cure hemorrhoids, but to control the complaints. Because it is not possible to completely cure hemorrhoids by using medication alone. It is a treatment method applied only to relax the patients. In addition to the pill form of the drugs, there are also those in the form of wipes, creams or bougies. Medicines that the patient can use comfortably are prescribed by the doctor.

How is Surgical Treatment Performed in Hemorrhoids?

Closed surgery (Longo) (stapled hemorrhoidopexy)

It is an operation performed by the Italian Antonio Longo with the help of an instrument found in 1997.

In 1999, we also started to do this operation in Turkey .

The most important feature of a successful surgery in our series is that there is no postoperative pain and the long-term success rate is high.

Laser hemorrhoidectomy

It is a method that always happens.

Sometimes they used radiofrequency and called laser, but now it is the process of laser burning the inside of the hemorrhoid pack with the help of a probe.

Suitable for Grade 1-2 hemorrhoids.

Band Hemorrhoidectomy

Again, with the help of a tool, the hemorrhoid nozzle is wrapped with a rubber and gangrene is opened and the hemorrhoid nozzle is dropped.

Ligasure Hemorroidectomia

We generally do not recommend it. The reason is that the hemorrhoid nozzle is cut with the help of heat.

Since the problem is with the help of heat, burns occur and recovery is long.

Ferguson hemorrhoidectomy

Sutures are placed by going through the anus, going to the very back part of the hemorrhoid, and the hemorrhoid is removed as a flap and stitched to the end.

Parks surgery (submucosal hemorrhoidectomy)

A more superficial suture is placed and the wound is not closed.

Milligan and Morgan hemorrhoidectomy

Only the tip of the hemorrhoid is sutured, the hemorrhoid is removed and the wound is left open.

Whitehead hemorrhoidectomy

It is the type in which all pouches are removed and often causes stenosis  and constipation problems in patients.

For this reason, it is rarely used today.

It was my teacher Kazım Sarı’s favorite surgery, and he recently started doing longo.

Ultrasonic-harmonic scalpel hemorrhoidectomy

Using ultrasound, the vascular structure of the hemorrhoids is found and stitches are made. The aim is for the hemorrhoids to die without blood. This method has also emerged as a miracle, but its use is low today due to its high price and low efficiency.

What Is Good For Hemorrhoids?

First of all, we should state that patients with hemorrhoids should go through some changes in their diet and lifestyle. At this point, the answer to the question of what is good for hemorrhoids is also important. If you want to reduce hemorrhoid complaints, you should pay attention to each element listed below.

  • Olive oil dishes should be consumed.
  • Fibrous foods should be consumed during the day.
  • It is necessary to never hinder the consumption of 2 – 3 liters of water a day.
  • Should not stay in the toilet for a long time.
  • Red meat consumption should be severely limited.
  • Avoid foods with high carbohydrate content such as pastries and rice varieties.
  • Avoid sitting position for a long time.
  • Those who have chronic constipation problems should definitely consult a doctor and ensure that treatment is done before they develop unexpectedly.
  • Spice varieties and hot peppers irritate the area of ​​hemorrhoids, so you should not consume hot pepper and spice varieties.
  • Consuming fruits and vegetables that are in season and focusing on pulp foods at meals reduce the complaints of patients.
  • It is beneficial to go to the toilet without waiting for the need to defecate.

Hemorrhoids in pregnancy

The main reason for the development of hemorrhoids during pregnancy is the increase in the pressure in the abdomen of the patient due to the growth of the baby, the slow work of the veins coming from the legs causes the blood to pool and as a result of the increase in constipation, it causes both hemorrhoids and varicose veins.

Another reason may be the relaxing effect of the progesterone hormone on smooth muscles during pregnancy.

Also, iron preparates used during pregnancy can cause constipation.

Finally, as the uterus grows, blood flow accelerates and increases the pressure on the vein, causing hemorrhoids.

It is more common in the last three months of pregnancy.

Hemorrhoids during pregnancy appear as a very troublesome process. The good situation here is hemorrhoids disappear when pregnancy ends.

What can be done to prevent hemorrhoids during pregnancy?

The aim during pregnancy is not to be constipated.

In addition to eating plenty of liquid fiber foods, it is necessary not to wait for the toilet.

Do hemorrhoids during pregnancy harm the child?

Especially in the last trimester (last three months), if hemorrhoids are very troublesome, they can even be operated, but the main thing is to treat them with drugs

Hemorrhoids during pregnancy do not cause any harm to the child.

How should a person with hemorrhoids during pregnancy give birth?

Although this decision should be given by the doctor, we usually recommend a cesarean section. Because there will be excessive straining, hemorrhoids may progress, so CAESAREAN is recommended for pregnant women with hemorrhoids.

What happens after hemorrhoid surgery?

In fact, postoperative pain varies according to the surgeon performing the surgery and the type of surgery performed.

After closed surgery

If you have had a closed surgery (LONGO-STAPLED HEMORRHOIDOPEXY), you may have very little pain, the first toilet may come out with blood.

In this surgery, the outer pouches may remain and these will pass over time.

There are two important factors in this surgery:

  • The first is the experience of the doctor, if the doctor performs the procedure from the outside sufficiently in closed surgery, there will be a lot of postoperative pain.
  • The second is the use of materials that do not have FDA and CE approval for the tool used. This situation creates a life-threatening risk, especially causing bleeding.

The patient must see the tool used.

After open surgery

Pain and bleeding are inevitable, but it is expected that it will decrease over time.

Hemorrhoids and Nutrition

Hemorrhoids disease is closely related to eating habits. If there are hemorrhoids, it is very important to create a suitable diet in order to prevent the disease from progressing to advanced dimensions and reduce the quality of life of the person.

In order for the defecation to be comfortable, at least 2.5-3 liters of water should be consumed per day and a diet rich in fiber should be adopted. The consumption of bitter, spicy foods is more common in some populations, resulting in a burning and pain sensation in the anus and increases the risk of hemorrhoids during defecation.

There is a diet that should be followed in order to prevent the occurrence of hemorrhoid disease, to prevent the progression of hemorrhoids and to reduce the complaints caused by hemorrhoid disease. We can divide the foods here into two as should be consumed and those that should not be consumed.

Recommended foods to be consumed:

Whole-grain and cereal foods: A high-fiber diet should be preferred. The daily fiber amount in the diets of people in the 20-50 age group should be around 40 grams for men and 25 grams for women. In order not to cause some nutritional irregularities, the amount of fiber in the diet should not exceed 50 grams per day. Consuming whole wheat or rye products provides great benefits for digestion. In addition to these, it is important to consume oats and wheat bran.

Vegetables: It should be consumed at every meal as possible, prevents constipation, provides comfortable functioning of the intestine. Foods such as broccoli, spinach, cabbage, celery, cauliflower, artichokes, leeks, Brussels sprouts, okra and peas should be included in the diet.

Fruits: Fruits should be consumed without pare it, fruits provide a smooth functioning of the intestine and prevent constipation. Fruits such as apples, grapes, pears, figs, and apricots can also be consumed dried or in the form of compote. Vegetables and fruits are of great importance in increasing body resistance. Fruits such as apple (shelled), apricot, blueberry (tea grape), melon, watermelon, cherry, sour cherry, grape, peach, pear, plum, raspberry, strawberry can be preferred. Lemon, grapefruit and orange contain both fiber and vitamin C, but may increase complaints, especially in patients with rectal burning problems.Legumes: Legumes, a food group rich in vegetable protein and fiber, are useful in preventing hemorrhoids. Foods such as lentils, bulgur, chickpeas, broad beans, and dry beans should also be included.

Nuts and dried fruits: Walnuts, hazelnuts, almonds, raisins, dried apricots, dried figs and prunes are among the foods that should be included in the nutrition program.

Foods that should not be consumed:

Hot, sour, spicy foods: red pepper, black pepper, chili pepper, isot etc. When bitter spices are eaten, it may cause a burning sensation and causes strain more in the toilet, or to stay longer on the toilet, and this may increase the complaints of hemorrhoids.

Foods that can cause irritation in the rectal area: Tomato, eggplant and spices can cause complaints. In such cases, it is necessary to determine which food it is and stay away from it.

Foods that can cause irritation:

  • Excessive use of alcohol, fermented drinks such as wine and beer
  • Fast-food style foods
  • Refined foods (fast foods)
  • Pastries: cake, cake, white bread
  • Consuming too much salt
  • Citrus fruits (such as lemon, tangerine, orange, grapefruit)
  • Drinks containing caffeine, such as coffee, cola, and tea
  • Drinks: energy drinks, fizzy drinks
  • Ketchup
  • Chocolate
  • Foods cooked by the frying method
  • When high-fat dairy products are consumed excessively, itching occurs in the anus region and this causes constipation.
  • Iron medications can also cause constipation. If you are looking for an alternative to iron supplements, you should definitely consult your doctor.

It is directly related to hemorrhoids and nutrition. Being aware of the benefits of the foods we eat and drink, on our body will help us prevent not only hemorrhoids but also many diseases. It should be our main goal to gain conscious eating habits. By consuming protein, fat and carbohydrates in a balanced way; We should aim to increase our quality of life by eating healthy, consciously and selectively.