Causes of Haemorrhoids
Haemorrhoids, sometimes called piles, are swollen veins in your anus and rectum. Common symptoms of hemorrhoids can include pain, itching, and rectal bleeding. They can develop inside or outside of the anus and rectum, called internal and external hemorrhoids, respectively. Haemorrhoids can develop from increased pressure in the lower rectum due to:
- Straining during bowel movements.
- Sitting for long periods of time on the toilet.
- Chronic diarrhea or constipation.
- Low-fiber diet.
Treatment for Haemorrhoids
Haemorrhoids often go away after a few days without any special treatment. In many cases Mr Karametos will recommend measures to relieve constipation, if it’s present. This can involve:
- eating more fibre
- drinking plenty of water every day
- warm baths, cold compresses for pain relief
- taking a mild laxative to soften your bowel movements
- avoiding medicines (such as codeine) that can cause constipation
- going to the toilet as soon as possible when you feel the urge
Treatment for haemorrhoids depends on your specific circumstances. If, for example, you are pregnant, they should settle after you have given birth, so you will probably not need any treatment other than symptom control. If the condition is more severe or is recurring, you may eventually need surgery.
In some cases, minor surgery may be needed. Common procedures include:
- Rubber band ligation, where a very tight elastic band is placed around the haemorrhoid to cut off the blood supply. This causes the haemorrhoid to fall off and be passed out of the body within seven to ten days. This procedure can be performed under sedation.
- Haemorrhoidectomy, excising the haemorrhoid completely including the internal, external components and anal skin tags. It is reserved for larger haemorrhoids. It requires a general anaesthetic and a short stay in hospital. Pain around the anus is common for a few days after the procedure.
- The HALO procedure, Haemorrhoidal artery ligation also known as HALO (Haemorrhoidal Artery Ligation Operation) or THD (Transanal Haemorrhoidal Dearterialisation). The procedure reduces the blood flow to your haemorrhoids. You will be put under general anaesthetic and Mr Karametos will use an ultrasound to identify arteries (blood vessels) supplying blood to a haemorrhoid. Stitches or sutures are sewn in to cut off this blood supply and shrink the haemorrhoids. The recovery after HALO procedure is virtually painless. Read more about this advanced treatment for haemorrhoids in the next paragraph.
The Halo Procedure
The Haemorrhoidal Artery Ligation Operation (HALO) is a new operation designed to eradicate haemorrhoids/ piles without the need for cutting. The Halo procedure is now available in Melbourne Australia. It is performed by Mr Steven Karametos, who is one of the highly trained surgeons in Melbourne with a specialist interest in haemorrhoids.
The operation uses a miniature Doppler ultrasound device to locate all the arteries supplying the haemorrhoids as they come down from the rectum under the lining of the bowel. The device also has a small window which allows a stitch to be placed around the artery thus cutting off the blood supply to the pile. During the course of the procedure all the arteries supplying the piles are located (up to 3) and tied off. Over the next few days and weeks the pile shrinks away and the symptoms resolve.
Because the stitch is placed in the lower rectum, where there are virtually no pain nerves, rather than in the anus, the HALO procedure is virtually painless. Because all of the blood vessels to the piles are accurately located the operation is more successful than injection; and as the blood vessels are properly ligated rather than just looped with a band they will not dislodge, producing a better response with far less risk of bleeding after the procedure.
Most patients are back to work after 24-48 hours with only a minimum of discomfort, which if there is any, is no more than a mild a throbbing in the rectum. You may drive the next day.
This procedure has been performed in Europe and North America now for a few years with excellent results. 85% of patients have a complete resolution of their symptoms and over 90% are thoroughly pleased with the result even if there are some very minor residual symptoms. This is due to the relative ease of recovery from the operation compared to more conventional treatments.
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