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Medical treatment - Medical treatment includes a diet rich with fibers, intake of oral fluids to maintain hydration and sitz baths.
Office Procedure (Treatment) - A number of office-based procedures may be performed. While generally safe, rare serious side effects such as perianal sepsis may occur. Blood tests to measure your blood counts, your risk of bleeding or infection, how well your liver and kidneys are working and blood grouping, in case you need a blood transfusion.
Chest x-ray and ECG (electrocardiogram) to check your lungs and your hearts electrical system. Rubber band ligation is typically recommended as the first line treatment in those with grade 1 to 3 disease. It is a procedure in which elastic bands are applied on to internal hemorrhoid at least 1 cm above the dentate line to cut off its blood supply. Within 5"7 days, withered hemorrhoid falls off. Cure rate has been found to be about 87% with a complication rate of up to 3%.
Sclerotherapy involves the injection of a sclerosing agent, such as phenol, into hemorrhoid. This causes the vein walls to collapse and the hemorrhoids to shrivel up. The success rate four years after treatment is ~70% which is higher than that with rubber band ligation.
Cauterization methods: A number of cauterization methods have been shown to be effective for hemorrhoids, but are usually only used when other methods fail. This procedure can be done using electrocautery, infrared radiation, laser surgery or cryosurgery. These methods may be an option for grade 1 or 2 diseases. In those with grade 3 or 4 disease re-occurrence rates are high. Rubber band ligation and Sclerotherapy.
Excisional hemorrhoidectomy is a surgical excision of hemorrhoid used primarily only in severe cases. It is associated with significant post-operative pain and usually requires 2"4 weeks for recovery. However, there is a greater long-term benefit in those with grade 3 hemorrhoids as compared to rubber band ligation. It is the recommended treatment in those with a thrombosed external hemorrhoid if carried out within 24"72 hours.
Doppler-guided, transanal hemorrhoidal dearterialization is a minimally invasive treatment using an ultrasound doppler to accurately locate the arterial blood inflow. These arteries are then "tied off" and the prolapsed tissue is sutured back to its normal position. It has a slightly higher recurrence rate, but fewer complications compared to a hemorrhoidectomy.
Stapled hemorrhoidectomy (stapled hemorrhoid epoxy), is a procedure that involves the removal of much of the abnormally enlarged hemorrhoidal tissue, followed by a repositioning of the remaining hemorrhoidal tissue back to its normal anatomic position. It is generally less painful and is associated with faster healing compared to complete removal of hemorrhoids. However, the chance of symptomatic hemorrhoids returning is greater than for conventional hemorrhoidectomy and thus it is typically only recommended for grade 2 or 3 diseases. Exceptionally rare but potentially devastating complications include anovaginal fistula, substantial hemorrhage, and rectal perforation and/or retroperitoneal sepsis.
Stapled haemorrhoidopexy is a new alternative available for individuals with significant haemorrhoidal prolapse. It involves a mucosal and submucosal, circular resection of the haemorrhoidal columns at their apex. In addition, the blood supply is interrupted and haemorrhoids are fixed to the distal rectal muscular wall. This is all accomplished by a single firing of a modified, circular anastomotic stapler.
Our expert team members shall help you to prepare you for surgery. Pre-operative testing 1in most cases, you will need some tests before your surgery. The tests routinely used include:
Blood tests to measure your blood counts, your risk of bleeding or infection, how well your liver and kidneys are working and blood grouping, in case you need a blood transfusion.
Our expert team members shall help you to prepare you for surgery. Pre-operative testing 1in most cases, you will need some tests before your surgery. The tests routinely used include:
Our expert team of Anaesthetist will ask you questions pertaining to your health and to assess your fitness for surgery. You are requested to tell them in detail about your current and past medical ailments, allergic reactions you've had in the past and current medicines that you are taking like blood thinning medicine. This medicine should be stopped prior to surgery to minimize the risk of bleeding during /after surgery.
Anaesthesia is the use of drugs to make the body unable to feel pain for a period of time. General anesthesia puts you into a deep sleep for the surgery. It is often started by having you breathe into a face mask or by putting a drug into a vein in your arm. Once you are asleep, an endotracheal or ET tube is put in your throat to make it easy for you to breathe. Your heart rate, breathing rate, and blood pressure (vital signs) will be closely watched during the surgery. A doctor watches you throughout the procedure and until you wake up. They also take out the ET tube when the operation is over. You will be taken to the recovery room to be watched closely while the effects of the drugs wear off. This may take hours. People waking up from general anesthesia often feel "out of it" for some time. Things may seem hazy or dream-like for a while. Your throat may be sore for a while from the endotracheal (ET) tube.
RECOVERY FROM SURGERY - Pain You may feel pain at the site of surgery. We aim to keep you pain-free after surgery with the help of latest and most effective technique or analgesic (pain relieving medicine).
Eating and Drinking - You will be allowed orally liquids once you recover from an effect of anesthesia medicine and you don't have nausea or vomiting. Gradually you can add soft to a normal diet.
Activity - Our healthcare team will try to have you move around as soon as possible after surgery. You are encouraged to get out of bed and walk the same day. While this may be hard at first, it helps speed your recovery. It also helps your circulation and helps prevent blood clots from forming in your legs.
Going home - Once you are eating and walking, and then you are ready to go home, in most case in next day following surgery. Before leaving for home or health care team shall give you detailed guidance regarding diet, activities, medications & further plan of treatment.
There are risks that go with any type of medical procedure and surgery is no longer an exception. Success of surgery depends upon 3 factors: type of disease/surgery, experience of surgeon and overall health of patients. What's important is whether the expected benefits outweigh the possible risks.
Complications in major surgical procedures include: Complications related to Anaesthesia: Reactions to drugs used (anesthesia) or other medicines. Although rare, these can be serious because they can cause dangerously low blood pressures. Complications related to underlying medical illness like heart disease, diabetes, kidney disease, obesity, malnutrition. Complications related to Specific Operations: bleeding, rectal perforation & sepsis, recto-vaginal fistula.
Nutrition Our health care team shall advise you in detail regarding dietary habits, Briefly, your diet begins with liquids followed by gradual advance to solid foods.Exercise Patients are encouraged to engage in light activity while at home. You will be able to get back to your normal activities within a short amount of time (week). Follow up You may be advised to see our healthcare team after 1 week to assess your progress and to address your problems.