Hemorrhoids or Piles
Hemorrhoids or Piles
Rubber Band Ligation
What are hemorrhoids or Piles?
Hemorrhoids – represents a dilation of the veins in the area (anus and rectum) and surrounding tissue. it is similar to varicose veins that can occur in the lower limbs.
Hemorrhoids or piles, involves two distinct vascular structures, namely: -external hemorrhoidal plexus -internal hemorrhoidal plexus.Thus hemorrhoids or piles can be internal (inside the anus) or external (around the anus).
- Constipation or diarrhea
- Sedentary life
- Premenstrual phase, pregnancy, childbirth
- Certain sports: horse riding, cycling
- Spicy diet, alcohol consumption
Signs and symptoms in hemorrhoidal or piles disease
External hemorrhoids or piles are visible around the anus, internal hemorrhoids or piles are not visible outside. They are seen only during the Proctoscopy.
Hemorrhoidal disease can be asymptomatic, with discrete symptomatology (itching, irritation, discomfort, sero-mucopurulent secretions) or can be clinically translated into three types of signs that are already complications of the disease:
- Lumpy feel at the anal level
When you don't treat piles, complications can occur
Without treatment may occur a
- chronic anaemia due to blood loss
- both internal and external hemorrhoids or piles may thrombose causing severe pain.
Stages of Piles Formation
Stage I – hemorrhoids or piles that do not externalize
Stage II – hemorrhoids or piles that externalize on straining but spontaneously go inside the anus.
Stage III – hemorrhoids or piles that externalize on straining (sneezing, coughing, defecation) and that need to be pushed inside manually.
Stage IV – internal hemorrhoids or piles, which are not reduced inside the anus and remain outside permanently
Anal Fistula Surgery
An anal fistula is an abnormal connection between the inside of your anal canal (back passage) and the skin near your anus.
Most anal fistulas are caused by an abscess (a collection of pus) which has developed in your anal canal. The pus can drain away onto the skin on its own or by an operation. A fistula happens when pus drains outside without surgery
What are the benefits of anal fistula surgery?
If the operation is successful, you should no longer have any infection or pain.
Are there any alternatives to Fistula surgery?
Most anal fistulas do not heal on their own. Surgery is usually needed to treat the problem. Anal mucosal LIFT procedure is a new technique for fistula surgery
What happens during anal fistula surgery?
Surgery for anal fistula is usually performed under a general or regional anaesthetic. The operation usually takes between a quarter of an hour and half an hour.
To lessen the risk of bowel incontinence (when you pass a motion without wanting to) your treatment may involve several operations over a number of months. The type of surgery you need will depend on where and the type of fistula .
If the fistula is below or crosses the lower part of the sphincter muscles, your surgeon will cut it open to the skin and leave the wound open so that it can heal with healthy tissue.
If the fistula has branches that pass through the upper part of the sphincter muscles, your surgeon may place a special stitch (called a seton stitch) in the fistula to allow pus to drain easily.
Your surgeon will not need to make a cut in the skin or the sphincter muscle.
If the fistula reaches above your sphincter muscles, you may need to have a temporary colostomy (bowel opening onto the skin). However, this is not common.
What complications can happen?
General complications of any operation:
- Unsightly scarring
Specific complications of this operation:
Difficulty passing urine Involuntarily passing wind or loose faeces Bowel incontinence
How soon will I recover from this surgery?
You should be able to go home the 1-3 days after. You should rest for the first few days, walking as little as possible, to help the wound to heal. The wound often takes several weeks to heal completely and you may need to wear a pad until then. Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, you should ask your dictor for advice. In a small number of cases, the fistula can come back.
Anal fistula surgery summary
An anal fistula can cause continued infection and pain. Symptoms usually get worse without an operation.
Pilonidal Sinus Surgery
What is pilonidal sinus surgery?
A pilonidal sinus is an infection, almost always in the natal cleft (between buttock cheeks) caused by ingrowing hairs. It may present as an abscess which requires drainage or as a more chronic discharging opening associated with pain and swelling.
What does the operation involve?
Surgery usually involves excising the abnormal skin/fat with the sinus. The resulting hole can be left open and packed with a dressing, closed with just a suture, or with a ‘flap’ of nearby tissue.
What are the benefits of pilonidal sinus surgery?
The benefits of surgery are to remove the sinus with its associated leakage, pain and infection. In minor cases it can sometimes be ‘managed’ (not cured) with antibiotics.
Are there any risks?
The risks of surgery are predominantly infection and failure of the wound to heal. This can result in the need for a prolonged period of renewing dressings or further surgery which can be disruptive but rarely serious. There is also a risk that the sinus will recur.
Your treating consultant will discuss all risks in full with you prior to the surgery.