Hemorrhoids. A convenient solution to an inconvenient problem

According to the latest statistics gathered by the World Health Organisation, hemorrhoids affect one in every six people on earth. After giving birth, every third woman also experiences this issue.

Many patients postpone visiting a proctologist for later, which can lead to the need for surgical intervention due to exacerbation of the condition.

The most common causes of hemorrhoids are heredity, sedentary lifestyle and stress. Due to the war, the last reason is present in the life of almost every Ukrainian. So the MEDplus editorial team asked the surgeon of the highest category, proctologist Oleksandr Volodymyrovych Kornienko, and the proctologist, surgeon, and endoscopist Olena Serhiyivna Karbovnycha, about how to effectively reduce the risk of hemorrhoids and how should doctors act to quickly rid patients of this delicate problem.

Karbovnycha Olena Serhiivna

Proctologist, surgeon, endoscopist

Kornienko Oleksandr Volodymyrovych

Surgeon of the highest category, proctologist

Has the number of hemorrhoid patients increased in the last 2 years?

Oleksandr Volodymyrovych: Yes, there are more patients suffering from proctological illnesses than just hemorrhoids. All because stress causes a variety of non-specific large intestine inflammations to occur, including proctitis, sigmoiditis, colitis, etc. These illnesses develop against a backdrop of rising human fear. The intestine starts to function differently while under stress because all nerve endings turn to dealing with the stress issue. The intestine slows down, mobilizes, and experiences a kind of swelling in the bottom portion and rectum. This is how stagnation and disturbances in the regulation of the intestines, rectum, and pelvic organs occur. It is not necessary, of course, to generalize; this is more relevant to those who are prone to constipation due to stress. However, it should be noted that hemorrhoids can also develop in conjunction with diarrhea. In both instances, heredity and a tendency to hemorrhoids both play a major factor.

Olena Serhiivna: Hemorrhoids are really quite a common problem of the 21st century. All because most people do not properly monitor their health – have irregular and unbalanced diet, sedentary lifestyle, etc. Now patients have started to turn to doctors more. I think that it is related to exacerbations due to stress. And there is also more trust in doctors. Many private clinics have been opened, state clinics, thanks to the reform, can afford much more and hire more specialists. People began to contact and be examined more frequently. Therefore, there are more detected cases of the disease.

How to prevent hemorrhoids?

Olena Serhiivna: The most important thing is a healthy lifestyle. Be sure to move a lot. I understand that many people have a sedentary job where they need to sit down from call to call, but there are ways to move more, get up every hour, and at least warm up. Be sure to do sports. Balanced nutrition prevents constipation or diarrhea. Proctologists always recommend excluding spicy, fatty, fried, smoked, salty, alcohol, and coffee. You must follow the drinking regime: drink 1,5–2 liters of water per day. These are general recommendations, but each situation is individual.

Oleksandr Volodymyrovych: There should be regular preventive examinations with the participation of a proctologist. If a person has problems, it is recommended to visit a proctologist once a year. And in general, I advise everyone to visit a proctologist at least once to understand whether there are diseases of the rectum and how to treat them. Do not self-medicate under any circumstances! Hemorrhoids are one of the diseases that can affect the rectum; only a doctor can diagnose them and prescribe treatment. Such cases happen very often: patients put on suppositories after an exacerbation, then something does not work out for them, and then they already go to proctologists. Often, people read information on the Internet and think that a proctologist is some kind of terrible doctor, and only after receiving treatment from a specialist do they regret that they did not seek treatment from the beginning.

Olena Serhiivna: Just recently, a patient came and said, «I put potatoes on myself, and it helps me. Not for long, but it helps». By the way, such cases, especially during the war, became more frequent simply because people could not go to the doctor because of hostilities. I want to underline that the only realistic outcome that can be attained through one’s own efforts is remission. This means that for a while, you won’t be bothered by hemorrhoids’ symptoms, and this scenario is completely true. Diets, authorized physical activity, cleanliness advice, and other methods are used to achieve this. Google writes about it all. But it is unlikely to cure hemorrhoids without a proctologist, and you can definitely harm yourself.

But it is unlikely to cure hemorrhoids without a proctologist, and you can definitely harm yourself.

What are the methods of treatment for hemorrhoids? Which of them are the most effective?

Olena Serhiivna: Treatment methods are divided into conservative and operative. Most often, even now, patients choose a conservative method of treatment: suppositories, ointments, gels, and so on. All this relieves the symptoms quite well, but does not insure against relapse. Everything will depend on the patient’s further lifestyle. Of course, we give recommendations, but we have no control over whether the hemorrhoids will recur.

There are several operative methods of treatment:

• Open operations, which are quite traumatic but necessary. They are considered radical.
• Minimally traumatic operations, they are minimally invasive: there may be laser surgery, dearterialization, or even outpatient manipulation of latex rings. Everything depends on the specific case, the disease’s stage, and its manifestations. Let’s be realistic: it depends on the patient’s financial capabilities as well. The doctor also plays a role in how he will convey the information to the patient, but the patient decides.

I most often use the method of hemorrhoidal dearterialization. Because my contingent is mainly women, often young girls who have not yet given birth, I don’t see the point in injuring them with open surgery. Therefore, I believe that when young patients come to me, they should be offered the least invasive technique possible.

Oleksandr Volodymyrovych: I treat all stages of hemorrhoids. Transanal hemorrhoidal dearterialization by the HAL-RAR method is among the most popular surgical interventions, because it is the least invasive operation. Complete rehabilitation within a week or two.

I think it’s crucial to explain some basic truths to patients:

• The smaller the stage of the disease, the fewer surgical interventions and, accordingly, surgical trauma, and therefore faster rehabilitation.
• A proctologist should be visited once a year, like any other doctor. If there is already an initial stage of hemorrhoids — then twice a year. In our country, there are many cases of colorectal cancer (appear inrectum and colon), so I do not advise you to ignore preventive examinations.
• Every person should, firstly, take care of his health. There are opportunities for this in Ukraine; all you need is a desire.