Hemorrhoids and Clinical Outcome for Hemorrhoid Surgery 2020

Hemorrhoids: An Early Detection Increases Chances of Being Successfully Cured.

Get to Know “Hemorrhoids”

Hemorrhoids are swollen veins in the anus and lower rectum. The veins around the anus tend to stretch under pressure, causing bulge or swelling. This condition can develop from increased pressure in the lower rectum. Hemorrhoids might develop in different locations at the same time. Classified by locations, there are 2 types of hemorrhoids:

1.) Internal hemorrhoids

Internal hemorrhoids lie inside the rectum which located above the pectinate line and are covered with cells that are the same as those that line the rest of the intestines. Internal hemorrhoids cannot be typically seen or felt. Only using anoscopy, proctoscopy and sigmoidoscopy allows gastroenterologists to examine the inner lining of the rectum. Internal hemorrhoids can be stratified into 4 grades:

  • Grade I: The internal hemorrhoid bulges into the canal but does not prolapse. These may cause rectal bleeding.
  • Grade II: The hemorrhoid protrudes through the rectum with straining during a bowel movement. But it spontaneously returns to their original position once the straining has subsided after bowel movements. 
  • Grade III: The hemorrhoid protrudes without any straining and requires the patient to push it inside manually.
  • Grade IV: The hemorrhoid protrudes and cannot be pushed back, causing discomfort and rectal pain. 

2.) External hemorrhoids 

External hemorrhoids are hemorrhoids that affect veins outside the anus. External hemorrhoids arise below the pectinate line and are covered with cells that resemble skin which are typically slightly less pink than the surrounding skin. External bulges can be seen and touched around the anal area. Symptoms might include itching or irritation in the anal region, pain or discomfort, swelling around the anus and rectal bleeding.

Risk Factors of Hemorrhoids

Hemorrhoids can develop from increased pressure in the lower rectum due to:

  • Straining during bowel movements
  • Frequent bowel movements
  • Sitting for long periods of time on the toilet
  • Having chronic diarrhea or constipation
  • Using laxative or rectal enema unnecessarily
  • Advanced age that makes tissues supporting the veins in rectum and anus become weak and stretch
  • Chronic cough 
  • Being obese
  • Regular heavy lifting
  • Cirrhosis that results in bulging veins in the anus area
  • Genetics with family history of hemorrhoids 
  • Being pregnant when baby puts pressure on the anal region

Clinical Outcome for Hemorrhoid Surgery


Diagnosis by ICD10

Day Surgery & IPD Procedure

Pain Score 1 Day After Surgery

Diagnosis by ICD9

0% Complication rates

Recurrence in 1 Year

Diagnosis of Hemorrhoids.

For external hemorrhoid, it is usually seen by the specialists. Diagnosing internal hemorrhoids might include examination of the anal canal and rectum. Tests and procedures are digital examination by inserting a gloved, lubricated finger into the rectum and identifying abnormal signs, visual inspection to examine the lower portion of the colon and rectum with an anoscope, proctoscope or sigmoidoscope and other tests such as computerized tomography scan (CT) and endoanal – endorectal ultrasonography. If colorectal cancer is potentially suspected, colonoscopy, the endoscopic examination of the large bowel and rectum might be considered to verify a confirmatory diagnosis, leading to appropriate treatment plans.


Home Remedies

In the majority of cases, simple measures will alleviate symptoms while the problem gets better on its own.

  • Eat high-fiber foods / Take high fiber diets.
  • Use topical treatments.
  • Soak regularly in warm bath.
  • Apply cold compress in your swelling anus.
  • Take oral pain relievers to help ease discomfort.
  • Exercise regularly.
  • Drink lots of fluid to keep stools soft and easier to pass.
  • Use a pillow in sitting hard surface.
  • Avoid using dry or rough toilet paper when you wipe after a bowel movement.

Medical Procedures

  • Rubber band ligation.
  • Injection (Sclerotherapy).
  • Coagulation or cauterization.

Surgical Procedures

  • Hemorrhoidectomy.
  • Stapled Hemorrhoidectomy.
  • TransanalHemorrhoidalDearterialization(THD).
  • Laser Hemorrhoidoplasty.
  • Radiofrequency Coagulation.

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