Hemorrhoids are a common and frequently-occurring disease peculiar to humans. As the saying goes, "ten people have nine hemorrhoids", "ten women and ten hemorrhoids", the incidence of hemorrhoids is relatively high. According to the 769692 people surveyed in China from 1975 to 1977, anorectal diseases accounted for 59.1%, hemorrhoids accounted for 87.25% of all anorectal diseases, of which internal hemorrhoids accounted for the most, accounting for 53.9% of all anorectal diseases. The incidence of hemorrhoids investigated abroad is also 60% to 70%. Hemorrhoids can develop at any age, and the incidence gradually increases with age. People with "hemorrhoids" often have this question: Do hemorrhoids need surgery? What kind of hemorrhoids need surgery? So, let's first understand what is hemorrhoids.
According to the location where hemorrhoids occur, we clinically divide them into three categories, namely internal hemorrhoids, external hemorrhoids and mixed hemorrhoids. The current more authoritative definition of hemorrhoids is that internal hemorrhoids are masses formed by pathological hypertrophy or displacement of the supporting structure of the anal canal vascular liner, vascular plexus and arteriovenous anastomotic branches. External hemorrhoids are masses formed by pathological expansion, thrombosis or tissue hyperplasia in the subcutaneous vascular plexus distal to the dentate line of the anal canal. The clinical symptoms of internal hemorrhoids are mainly blood in the stool, blood in the stool when stool, blood dripping from the anus, linear ejection or jet-like bleeding, bright red, or prolapse of the hemorrhoids during defecation, coughing or weight bearing, and can return on its own after defecation. In severe cases, it needs to be pressed and repaid by hand. The clinical symptoms of external hemorrhoids are mainly anal foreign body sensation, anal discomfort or anal dampness, itching discomfort, etc. Anal pain may occur when thrombosis or inflammation. Knowing what hemorrhoids are, let’s take a look at the treatment of hemorrhoids. What are the ways to treat hemorrhoids? What kind of hemorrhoids need surgery?
The principle of treatment of hemorrhoids: asymptomatic hemorrhoids do not need treatment, only symptomatic hemorrhoids need treatment. Moreover, the purpose of treatment is to reduce and eliminate the main symptoms, not to cure them. Relieving the symptoms of hemorrhoids is more meaningful than changing the size of hemorrhoids. There is no cure for hemorrhoids, but timely treatment is necessary. The treatment of hemorrhoids is divided into general treatment, drug treatment and surgical treatment. General treatment is the basis of various therapies and has effects on all types of hemorrhoids. There are three main points: First, improve your diet, eat more vegetables and fruits, avoid chili, mustard, etc., and forbid alcohol. The second is to maintain unobstructed bowel movements, develop the habit of defecation regularly, do not hold back, avoid doing other things during defecation, such as playing mobile phones, reading newspapers, etc., after using warm water bath and dry, keep the anus clean, the toilet paper should be soft. The third is to have a regular life, a combination of work and rest, and it is not appropriate to stand for long periods of time or travel long distances with heavy loads. Medications can be treated with Chinese and Western medicines, which have a certain effect on early internal, external and mixed hemorrhoids. Through oral administration and external application, they can relieve and relieve symptoms and delay the development of hemorrhoids.
For the surgical treatment of hemorrhoids, there is a classic saying in the anorectal department, that is, "do not treat symptoms without symptoms, and do not treat symptoms without symptoms." Hemorrhoids are vasodilation and local connective tissue hyperplasia. If there are no symptoms such as blood in the stool, prolapse, and anal discomfort, surgery is generally not required. Because the operation is traumatic, it damages the local anal cushion and affects the closure function. A little carelessness will cause a certain degree of anal incontinence. For the early stage I and II internal hemorrhoids, conservative treatment can be considered when the blood volume in the stool is low. If the blood volume in the stool is large or the conservative treatment fails, internal hemorrhoid injection or internal hemorrhoid ligation is recommended. For internal hemorrhoids of degree III and IV, surgical treatment is recommended, and internal hemorrhoid ligation, PPH or TST operation can be considered for the operation method. For external hemorrhoids, when the symptoms are mild, conservative treatment can be temporarily given, and conservative is ineffective, and surgical treatment is feasible; for thrombotic external hemorrhoids, anal pain is generally severe, and early surgery can quickly and effectively relieve anal pain. Therefore, early surgical treatment is recommended. Mixed hemorrhoids are formed by fusion of internal hemorrhoids through abundant venous plexus anastomotic branches and corresponding external hemorrhoids. There are mainly internal hemorrhoids, external hemorrhoids mainly, and equal internal and external hemorrhoids. There are single and multiple shots, and some have a circular bulge around the anus. Mixed hemorrhoids are at an advanced stage, and internal and external hemorrhoids are fused together. It is difficult for internal and external drug treatments to work, so surgery should be performed. Single or multiple possible external stripping and internal ligation, external resection combined with internal hemorrhoid ligation, etc., circular mixed hemorrhoids with multiple external stripping and internal ligation or circular hemorrhoid segment ligation, PPH surgery, etc.
There are many treatment methods for hemorrhoids, and the corresponding treatment methods are adopted according to different types and different degrees. In short, if you have no symptoms, try not to operate. If you have symptoms, it should be based on specific conditions, or conservative treatment or surgical treatment. The operation method should also be based on the type and severity of hemorrhoids.