Severe hemorrhoids include grade Ⅲ and Ⅳ circular internal hemorrhoids, and grade Ⅲ and Ⅳ circular mixed hemorrhoids (varicose veins or skin tags).
Cause: There is a chronic history of internal hemorrhoids or mixed hemorrhoids. Common inducements are fatigue, spicy food, constipation, diarrhea, long-distance walking, heavy load, coughing, sneezing, squatting and other conditions such as increased abdominal pressure.
Symptoms: blood in the stool, prolapsed lumps, pain, itching, weakness in bowel movements, difficulty in defecation, and other symptoms.
Signs: Perianal external hemorrhoids show varicose veins or bulging skin tags, external hemorrhoids and rectal mucosa, swelling and congestion, which may be accompanied by thrombus, partial mucosal necrosis, erosion, bleeding, infection, etc. Even hemorrhoids are ulcerated, swelling and painful, pus, perianal eczema, etc.
It is necessary to treat severe hemorrhoids, but also to protect the anal cushion tissue; it is necessary to relieve other complications and achieve the effect of correction and smoothing. Therefore, the principle of individualized comprehensive treatment is generally advocated in order to achieve a reasonable design, simultaneous operation, avoid postoperative complications, improve short-term and long-term efficacy, and reduce the recurrence rate.
1 General treatment: bed rest in side lying position and maintain anal hygiene.
2 Diet: It is suitable to eat light food: fresh vegetables, fruits, etc.; avoid spicy and fatty products, avoid overeating, quit smoking and alcohol.
3 Symptomatic support treatment.
4 Application of antibiotics.
5 Surgical treatment: Milligan-Morgan surgery (external stripping and internal ligation), PPH surgery and hemorrhoid circumcision can be used.
Circular mixed hemorrhoids are one of the three internationally recognized refractory anal diseases