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What are haemorrhoids?
Haemorrhoids, also known as piles, are blood vessels and these are part of the normal anatomy of the anorectum. Everybody has haemorrhoids; however, when these get dilated and engorged may cause several symptoms and problems.
Anyone saying that he/she does not have haemorrhoids is a liar (Prof R. J. Nicholls).
Where do they occur?
You can have piles internally in the anal canal (internal haemorrhoids) or more externally, around the anus (external haemorrhoids).
Why do we have haemorrhoids?
The haemorrhoids normally act as cushions and they provide a fine closure of the anal canal (back passage). They act as a plug. If these are particularly swollen and inflamed may cause important dysfunction.
What are the symptoms of inflamed haemorrhoids?
The most frequent symptom of haemorrhoidal disease is bleeding, normally reported as fresh and bright in colour. Other symptoms may include the presence and the feeling of one or more lumps prolapsing from the anal canal. You can also experience mucous discharge, itching, anal pain, discomfort.
How can we classify the severity of haemorrhoidal disease?
Here are several scores that physicians and surgeons use to classify this disease. However, the most common and most used as well as the most recognised by the scientific community, is the following:
Grade 1: The haemorrhoids may bleed but do not prolapse;
Grade 2: The haemorrhoids prolapse through the anus on straining but these reduce spontaneously;
Grade 3: The haemorrhoids prolapse through the anus on straining or exertion and require manual reduction into the anal canal;
Grade 4: The haemorrhoids are constantly prolapsed;
How can we manage the haemorrhoidal disease?
Most of patients with early stages of haemorrhoids can respond to a conservative approach, therefore avoiding surgery. This include lifestyle and dietary changes. The surgeon may explain you this better during your consultation depending on the individual case.
Those categories of patients who fail a conservative treatment may need a minimally invasive surgery. These ranges of treatments include rubber banding ligation, injection sclerotherapy, and laser. For more advanced cases, especially for those patients who score 3 and 4, a surgical treatment is recommended. This can vary from a more conventional treatment such as haemorrhoidectomy to more advanced techniques such as THD TM procedure. The latter avoids the procedure of piles removal and instead corrects them cutting off the blood supply using a few absorbable sutures on the piles.
Every patient is different from one another and the treatment is usually tailored to their needs (Mr A. Leo).