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A hemorrhoid is a disease that causes a lot of concern and interferes with the patients’ life, especially the physical pain, embarrassment to see the doctor and fear of treatment. However, today, there are many treatment options that can cure patients completely, with little pain and a quick recovery.
Dr.Teerasan Tantitemit, a colon and rectal surgeon at Phyathai 2 Hospital, recommends that patients should see a doctor to find the right treatment before the disease becomes more severe.
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<h2>Hemorrhoids, anyone can get it.</h2>
Hemorrhoids tissue consists of veins, highly elastic tissue at the end of the last intestine and the edge of the anus swells and protrudes. This disease can occur in people of all ages, but it is almost common in people at the aged of 30 and above. It is rare in teenagers, especially if it is internal hemorrhoids.
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<h2>Types of Hemorrhoids</h2>
<ol>
<li>Internal Type: This type occurs above approximately 1.5 – 2 cm. from the annus opening. Normally, it does not protrude and cannot be felt. It is usually covered by the distal colon membrane. It does not cause pain. While there are no complications, the main symptoms are bleeding and lumps.</li>
<li>External Type: Hemorrhoids that occur around the wrinkle of the annus. They can be seen and palpated. The swollen veins are covered by the skin. The patient will feel pain and bleeding</li>
</ol>
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<h2>The step of Hemorrhoids</h2>
It is divided for internal hemorrhoids only, the external is not divided.
<ul>
<li>Step 1: There are swollen veins in the annus but there are not many symptoms. However, there may be bleeding when straining to defecate or when having constipated.</li>
<li>Step 2: Hemorrhoids enlarged and to be felt while defecating. They start to protrude but are able to shrink back on their own. There may also be some bleeding.</li>
<li>Stage 3: Hemorrhoids become larger and protrude to the outside but are unable to go back in, by their own. Sometimes, it takes a long time to shrink back in by their own.</li>
<li>Step 4: Hemorrhoids are very severe and can be seen from the outside. There is inflammation, swelling, then, the patients cannot sit and cannot put it back in.</li>
</ul>
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<h2>Factors that cause hemorrhoids:</h2>
<ol>
<li>Chronic constipation</li>
<li>Diarrhea, frequent defecate</li>
<li>Habit of straining a lot the last feces</li>
<li>Habit of sitting for a long time when defecating, such as for a book reading while defecating.</li>
<li>In some cases where the cause is unknown, it may be found that some family member has hemorrhoids, so there is a higher chance of having this disease than normal.</li>
</ol>
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<h2>Treatment Guides for Internal Hemorrhoids:</h2>
Non-surgical:
<ol>
<li>Rubber band ligation is a treatment that is not very painful, however, patient will feel a dull sensation about 1- 3 days, like abdominal pain. The rubber band ligation can help the second and the third step of hemorrhoids shrink to the first step and it becomes a scar. After rubber band ligation, the rubber will fall off by it own. The wound where the rubber band was placed has retracted, there is no bleeding and the wound is not painful.</li>
<li>Injection of drugs to help the blood vessels harden and shrink. It is the same type of medicine use to treat varicose veins. When compared to rubber band ligation, the rubber band ligation provides more immediate and targeted results. In case the patients have several hemorrhoids heads, drug injected may be not cover all of hemorrhoids and does not provide good result as rubber band ligation method or surgical method. This method is suitable to cure the bleeding.</li>
</ol>
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Surgical:
<ol>
<li>Standard surgical: The tumor will be removed by the surgical and closing the wound. It takes about 1 hour or more. The patient has to admit and stay in the hospital about 1-2 days, after that staying at home for 1-2 weeks. The patient should avoid exercising, do not soak his annus in potassium permanganate or warm water. The normal water can be used to wash.</li>
<li>Laser treatment: it requires drilling into the wound to use the laser to destroy hemorrhoids. The drilling is done next to the wound, does not directly cutting to the annus. The size of the incision is about 2-3 millimeters. After the surgery, there is no need to stitch the wound and the patient can move normally. There is no need to rest for a long time and does not need to soak the annus in potassium permanganate.</li>
<li>Use an automatic sewing tool. It is a disposable tool and takes less time to operate. However, it must be done by a specialist because the position that need to be cut, is close to the vagina. This method can only be done for people with internal hemorrhoids. After the surgery, the recovery time is only 2-3 days and the recovery is fast.</li>
<li>Hemorrhoid suturing: This method is less painful, but requires spinal block and anesthesia. The surgery requires opening the wound to suturing the blood vessels that supply hemorrhoid to shrink.</li>
</ol>
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<h2>Treatment Guides for External Hemorrhoids:</h2>
<ol>
<li>Most external hemorrhoids will heal on their own and are not very dangerous. Common symptoms include flat bottom but when straining, the annus becomes sore and inflamed. This is called inflamed external hemorrhoids. It can happen to anyone who has the habit of straining to pass the stool. If it does not heal on its own, surgery is required to remove the blood clot.</li>
<li>When the lump grows bigger, surgery is necessary because the more often you defecate, the more painful becomes. Therefore, the patient should not wait until the symptoms are severe to go to see the doctor. He should come early, as there is no other way to treat it except surgery by the doctor who is experienced in rectal diseases. Surgery must be considered on a case-by-case basis.</li>
</ol>
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<h2 style="text-align: center;">Post – hemorrhoid surgery symptoms that require immediate medical attention:</h2>
<ol>
<li>Passing a large amount of blood clots in the stool but there is not much stool coming out.</li>
<li>The wound is very painful. It hurts every time, the symptoms do not improve.</li>
<li>A large amount of pus and lymph is flowing out.</li>
<li>High fever without exact cause.</li>
</ol>
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Make appointment with the doctor:
Dr.Theerasan Tantitemit
Colon and Rectal Diseases (Bowel Surgery and Others)
Phyathai 2 Hospital

A hemorrhoid is a disease that causes a lot of concern and interferes with the patients’ life, especially the physical pain

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Hemorrhoids is a common disease that can be treated. Don’t be afraid of the pain.

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