Minimally Invasive


Minimally Invasive Procedure for Haemorrhoid

Hemorrhoids are one of the most commonly occurring ailments, affecting both men and women. One reason people do not talk about haemorrhoid problems with their doctors is because they anticipate a painful, traditional haemorrhoid surgery. But the fact is that better understanding of the disease process along with new technological improvements have enabled more procedures to be performed as day care procedure.

Piles or Hemorrhoids can occur at any age. Many experts believe that they are caused by continuous high pressure in the veins of the body, which occurs because human beings stand upright. The causes of haemorrhoids include constipation and excessive straining during bowel movements. Persistent diarrhoea and loose stool movements are also causes of haemorrhoids, and some people inherit a family tendency to develop piles. Women are more susceptible to haemorrhoids during pregnancy, as pressure from the growing uterus restricts blood flow in the pelvic area. Lifestyle factors can also contribute to hemorrhoid development.

Hemorrhoids may be internal or external. Both types of hemorrhoids can be present at the same time. Internal hemorrhoids are classified further based upon the degree to which they protrude from the anal canal. This grading system is important since the grade in part determines which type of treatment is best. But no widely used grading system exists for external hemorrhoids. According to this grading system:

  • Grade I hemorrhoids may bulge into the anal canal but do not protrude through the anus.
  • Grade II hemorrhoids protrude through the anus during straining and defecation, but return spontaneously.
  • Grade III hemorrhoids protrude through the anus with defecation or straining but do not return spontaneously, requiring the patient to gently push it back into its normal position with a finger.
  • Grade IV hemorrhoids cannot be manually returned to their normal position.

The symptoms of piles can come and go. There are five main symptoms:

  • Itching and irritation
  • Aching pain and discomfort
  • Bleeding
  • A lump, which may be tender
  • Soiling of pants or knickers with slime or faeces ('skid marks').

Itching and irritation probably occur because the lumpy piles stop acting as soft pads to keep the mucus in instead, a little mucus leaks out and irritates the area around the anus. Pain and discomfort comes from swelling around the pile, and from scratching of the lining of the anal canal by faeces as they pass over the lumpy area. The scratching also causes bleeding, which is a fresh bright red colour and may be seen on faeces or toilet paper or dripping in the pan. A pile that has been pushed down (a second- or third-degree pile) may be felt as a lump at the anus. Internal haemorrhoids cannot cause cutaneous pain, but they can bleed and prolapse. Prolapse of internal haemorrhoids can cause perianal pain by causing a spasm of the sphincter complex. This spasm results in discomfort while the prolapsed haemorrhoids are exposed. The discomfort is relieved with reduction. Internal hemorrhoids can also cause acute pain when incarcerated and strangulated. Again, the pain is related to the sphincter complex spasm.