{"id":20074,"date":"2024-06-10T13:34:03","date_gmt":"2024-06-10T06:34:03","guid":{"rendered":"https:\/\/abdiwaluyo.com\/?p=20074"},"modified":"2024-10-10T10:25:44","modified_gmt":"2024-10-10T03:25:44","slug":"understanding-treatment-options-for-persistent-hemorrhoids","status":"publish","type":"post","link":"https:\/\/abdiwaluyo.com\/en\/health-info\/understanding-treatment-options-for-persistent-hemorrhoids\/","title":{"rendered":"Understanding Treatment Options for Persistent Hemorrhoids"},"content":{"rendered":"<p><span style=\"font-size: 13px;\"><em><strong>By:\u00a0 Thalia Kaylyn Averil<\/strong><\/em><\/span><\/p>\n<hr \/>\n<p><span style=\"font-weight: 400;\">Hemorrhoids are enlarged and swollen blood vessels that form inside or outside the rectum and anus, causing pain, discomfort and bleeding. Initially, hemorrhoidal cushions are normal anatomical structures that contain blood vessels and can be found in the anal canal. However, hemorrhoid pads can become swollen and stretched, resulting in prolapse of the tissue.Over time, the support system of these structures weakens, causing the tissue to protrude from the anal canal and become more susceptible to injury. This disease affects individuals of all ages and genders, but increasing age can increase the risk of developing hemorrhoids.Hemorrhoids can also be influenced by an unhealthy diet, such as frequently consuming low-fiber, high-fat foods. Hemorrhoids can be classified based on their location.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>External hemorrhoids<\/b><span style=\"font-weight: 400;\">: Hemorrhoids that form inside the anus. Patients with external hemorrhoids may experience itching, pain, and sometimes bleeding.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Internal hemorrhoids<\/b><span style=\"font-weight: 400;\">: Hemorrhoids that form inside the rectum or the part of the digestive system that connects the large intestine to the anus. In general, internal hemorrhoids cause bleeding, but do not cause pain.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Prolapsed hemorrhoids<\/b><span style=\"font-weight: 400;\">: External and internal hemorrhoids can prolapse, protruding outside the anus. This can cause bleeding or pain.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Hemorrhoids can also be classified based on their progression from their normal internal position to their prolapsed external position. This classification will also determine the appropriate treatment for the patient.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Stage 1<\/b><span style=\"font-weight: 400;\">: Hemorrhoids enlarge and may bleed. Treatment options include fiber supplementation, cortisone suppositories, and sclerotherapy.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Stage 2<\/b><span style=\"font-weight: 400;\">: Hemorrhoids protrude and can reduce on their own. Treatment options include fiber supplementation and cortisone suppositories.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Stage 3<\/b><span style=\"font-weight: 400;\">: Hemorrhoids protrude and require manual reduction. Treatment options include fiber supplementation, cortisone suppositories, ligation, and operative hemorrhoidectomy.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Stage 4<\/b><span style=\"font-weight: 400;\">: Hemorrhoids cannot be reduced. Treatment options include fiber supplementation, cortisone suppositories, and operative hemorrhoidectomy.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">There is no best treatment for hemorrhoids because each patient&#8217;s needs are different. In addition to hemorrhoid classification, treatment options are also based on a thorough history and physical examination performed by a doctor. The effectiveness of each treatment may vary depending on the severity of the lesion and other factors.<\/span><\/p>\n<ul>\n<li aria-level=\"1\"><b>Rubber band ligation<\/b><\/li>\n<\/ul>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ligation is one method of treating hemorrhoids using a small instrument called a ligator and rubber band. The ligator is inserted through a tube called a scope into the anal canal. Then, the doctor will hold the hemorrhoid with forceps and slide the ligator upwards to remove the rubber band right around the base of the hemorrhoid. This rubber band will cut off the blood supply to the hemorrhoids resulting in necrosis (death of the cells in the hemorrhoids) which leads to the hemorrhoids decreasing in size and then falling off. The advantage of this method is that it causes little pain and can be used to treat recurring hemorrhoids.<\/span><\/li>\n<\/ul>\n<div id=\"attachment_20075\" style=\"width: 361px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-20075\" class=\"wp-image-20075 size-full\" src=\"https:\/\/abdiwaluyo.com\/wp-content\/uploads\/2024\/06\/Screenshot-2024-06-10-132629.png\" alt=\"\" width=\"351\" height=\"373\" srcset=\"https:\/\/abdiwaluyo.com\/wp-content\/uploads\/2024\/06\/Screenshot-2024-06-10-132629.png 351w, https:\/\/abdiwaluyo.com\/wp-content\/uploads\/2024\/06\/Screenshot-2024-06-10-132629-282x300.png 282w, https:\/\/abdiwaluyo.com\/wp-content\/uploads\/2024\/06\/Screenshot-2024-06-10-132629-188x200.png 188w\" sizes=\"auto, (max-width: 351px) 100vw, 351px\" \/><p id=\"caption-attachment-20075\" class=\"wp-caption-text\">Figure 1. Rubber band ligation<\/p><\/div>\n<ul>\n<li aria-level=\"1\"><b>Sclerotherapy<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Sclerotherapy is a procedure that involves injecting a sclerosing agent into the hemorrhoid, which causes an inflammatory reaction that eventually forms fibrotic tissue, cutting off blood flow to the hemorrhoid. Sclerotic agents that can be used are 5% phenol in almond oil or vegetable oil, quinine, ethanolamine, and hypertonic salt solution. After undergoing this therapy, patients may experience pain and fever.<\/span><\/p>\n<div id=\"attachment_20077\" style=\"width: 330px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-20077\" class=\"wp-image-20077 size-full\" src=\"https:\/\/abdiwaluyo.com\/wp-content\/uploads\/2024\/06\/Screenshot-2024-06-10-132900.png\" alt=\"\" width=\"320\" height=\"243\" srcset=\"https:\/\/abdiwaluyo.com\/wp-content\/uploads\/2024\/06\/Screenshot-2024-06-10-132900.png 320w, https:\/\/abdiwaluyo.com\/wp-content\/uploads\/2024\/06\/Screenshot-2024-06-10-132900-300x228.png 300w, https:\/\/abdiwaluyo.com\/wp-content\/uploads\/2024\/06\/Screenshot-2024-06-10-132900-200x152.png 200w\" sizes=\"auto, (max-width: 320px) 100vw, 320px\" \/><p id=\"caption-attachment-20077\" class=\"wp-caption-text\">Figure 2. Sclerotherapy.<\/p><\/div>\n<ul>\n<li aria-level=\"1\"><b>Stapled hemorrhoidopexy<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">In this procedure, the prolapsed hemorrhoid tissue will be repositioned by connecting it to the rectal wall located directly above the hemorrhoid. First, a special tool is inserted into the anal canal, then the excess tissue is cut and removed, then the remaining tissue is pulled to its normal position. This method causes less pain than other surgical procedures for hemorrhoids.<\/span><\/p>\n<div id=\"attachment_20079\" style=\"width: 423px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-20079\" class=\"wp-image-20079 size-full\" src=\"https:\/\/abdiwaluyo.com\/wp-content\/uploads\/2024\/06\/Screenshot-2024-06-10-133043.png\" alt=\"\" width=\"413\" height=\"360\" srcset=\"https:\/\/abdiwaluyo.com\/wp-content\/uploads\/2024\/06\/Screenshot-2024-06-10-133043.png 413w, https:\/\/abdiwaluyo.com\/wp-content\/uploads\/2024\/06\/Screenshot-2024-06-10-133043-300x262.png 300w, https:\/\/abdiwaluyo.com\/wp-content\/uploads\/2024\/06\/Screenshot-2024-06-10-133043-200x174.png 200w\" sizes=\"auto, (max-width: 413px) 100vw, 413px\" \/><p id=\"caption-attachment-20079\" class=\"wp-caption-text\">Figure 3. Stapled hemorrhoidopexy.<\/p><\/div>\n<ul>\n<li aria-level=\"1\"><b>Laser hemorrhoidoplasty<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Laser hemorrhoidoplasty is a minimally invasive procedure used to treat hemorrhoids. To identify the arteries to be targeted, doctors may use a transducer that will be inserted into the rectum. Once the artery is found, doctors will insert a laser probe into the hemorrhoid, then this laser targets hemoglobin (protein inside the red blood cells) and closes the artery around the hemorrhoid. Lasers can cut off the blood supply to hemorrhoids causing the surrounding tissue to shrink. This method can minimize the risk of bleeding during and after the procedure. A study found that laser hemorrhoidoplasty resulted in low levels of postoperative pain and reduced recurrence rates in the long term.<\/span><\/p>\n<div id=\"attachment_20081\" style=\"width: 451px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-20081\" class=\"wp-image-20081 size-full\" src=\"https:\/\/abdiwaluyo.com\/wp-content\/uploads\/2024\/06\/Screenshot-2024-06-10-133149.png\" alt=\"\" width=\"441\" height=\"207\" srcset=\"https:\/\/abdiwaluyo.com\/wp-content\/uploads\/2024\/06\/Screenshot-2024-06-10-133149.png 441w, https:\/\/abdiwaluyo.com\/wp-content\/uploads\/2024\/06\/Screenshot-2024-06-10-133149-300x141.png 300w, https:\/\/abdiwaluyo.com\/wp-content\/uploads\/2024\/06\/Screenshot-2024-06-10-133149-200x94.png 200w\" sizes=\"auto, (max-width: 441px) 100vw, 441px\" \/><p id=\"caption-attachment-20081\" class=\"wp-caption-text\">Figure 4. Laser hemorrhoidoplasty.<\/p><\/div>\n<hr \/>\n<p><strong>Resources<\/strong><\/p>\n<ol>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Cleveland Clinic. Hemorrhoids [Internet]. Cleveland: Cleveland Clinic; date of publication unknown [reviewed 2021 Jan 18] [cited 2024 May 28]. Available from: <\/span><a href=\"https:\/\/my.clevelandclinic.org\/health\/diseases\/15120-hemorrhoids\"><span style=\"font-weight: 400;\">https:\/\/my.clevelandclinic.org\/health\/diseases\/15120-hemorrhoids<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Longo DL, Fauci AS, Kasper DL, Braunwald E, Hauser SL, Jameson JL, Loscalzo J. Harrison\u2019s gastroenterology and hepatology. 17th ed. New York: McGraw-Hill; 2010.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Cengiz TB, Gorgun E. Hemorrhoids: a range of treatments. CCJM. 2019 Sep;86(9):612-20. doi: 10.3949\/ccjm.86a.18079. Available from: <\/span><a href=\"https:\/\/www.ccjm.org\/content\/86\/9\/612\"><span style=\"font-weight: 400;\">https:\/\/www.ccjm.org\/content\/86\/9\/612<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">IBI Healthcare. Laser hemorrhoidoplasty (LHP) &#8211; IBI Healthcare Institute [YouTube video]. Georgia: IBI Healthcare; 2023 Jan 25. Available from: <\/span><a href=\"https:\/\/youtu.be\/o3YhMZIvx3s?si=2bmslz5ZyIh4neqa\"><span style=\"font-weight: 400;\">https:\/\/youtu.be\/o3YhMZIvx3s?si=2bmslz5ZyIh4neqa<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\">Torrinha G, Goncalves T, Sousa M, Hogemann G, Goulart A, Carvalho AF, Leao P. The effects of laser procedure in symptomatic patients with haemorrhoids: a systematic review. Frontiers. 2022 Dec 12;9. doi: 10.3389\/fsurg.2022.1050515. Available from: <a href=\"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.1050515\/full\">https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2022.1050515\/full<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>By:\u00a0 Thalia Kaylyn Averil Hemorrhoids are enlarged and swollen blood vessels that form inside or outside the rectum and anus, causing pain, discomfort and bleeding. Initially, hemorrhoidal cushions are normal anatomical structures that contain blood vessels and can be found in the anal canal. However, hemorrhoid pads can become swollen and stretched, resulting in prolapse <a href=\"https:\/\/abdiwaluyo.com\/en\/health-info\/understanding-treatment-options-for-persistent-hemorrhoids\/\" class=\"more-link\">&#8230;<span class=\"screen-reader-text\">  Understanding Treatment Options for Persistent Hemorrhoids<\/span><\/a><\/p>\n","protected":false},"author":19,"featured_media":20506,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[4],"tags":[],"class_list":["post-20074","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-info"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v21.8.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Understanding Treatment Options for Persistent Hemorrhoids - Abdi Waluyo Hospital<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/abdiwaluyo.com\/en\/health-info\/understanding-treatment-options-for-persistent-hemorrhoids\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Understanding Treatment Options for Persistent Hemorrhoids - Abdi Waluyo Hospital\" \/>\n<meta property=\"og:description\" content=\"By:\u00a0 Thalia Kaylyn Averil Hemorrhoids are enlarged and swollen blood vessels that form inside or outside the rectum and anus, causing pain, discomfort and bleeding. 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