Treatment of chronic combined haemorrhoids

Haemorrhoids are considered one of the most unpleasant diseases that can affect a person. This happens because of a combination of many factors, so it is impossible to name a single cause. Fortunately for patients, doctors have long learned how to deal with already aggravated haemorrhoids, which significantly makes life easier for many people. It is worth learning in advance about the symptoms, causes, and possible treatment methods for chronic combined haemorrhoids.

What Are the Symptoms of Chronic Combined Haemorrhoids

Combined haemorrhoids involve the enlargement of two types of nodes at once: external and internal. Symptoms can vary among patients, but in most cases, the affected person experiences:

• the appearance of burning and itching in the anus;
• mucous discharge, atypical for this area;
• appearance of lumps near the anus – they can be easily felt by self-palpation;
• haemorrhoids start to prolapse;
• blood appears during defecation;
• there is a constant feeling of incomplete bowel emptying.

If at least two symptoms occur, you should immediately consult a specialist.

Main stages

If the patient does not see a doctor or does not want to be treated, haemorrhoids will go through 4 stages before reaching the most severe point. Each stage is distinguished by its symptoms and overall severity.

Stage 1

The first stage progresses the easiest, with no pronounced symptoms. The nodes are slightly enlarged, which does not affect the patient’s normal life. Discomfort during defecation may occur. At this stage, 90% of people are still unaware of the problem.

Stage 2

At this stage, internal nodes begin to protrude beyond the anal opening. External nodes become more noticeable and pronounced, and can be felt upon palpation. Bleeding and painful sensations appear.

Stage 3

The onset of the third stage is characterized by the inability to manually reposition a prolapsed internal node. Pain becomes a constant companion, along with burning and itching.

Stage 4

The most severe period, during which the pain is so intense that a person lives on painkillers. In the fourth stage of chronic combined haemorrhoids, complications often appear in the form of anemia, thrombosis, and very severe bleeding.

Treatment features in men

Suppressing the disease in men is more difficult than in women. This is due to the fact that the male half of the population is more susceptible to this pathology. They often lead an unhealthy lifestyle, eat on the go, are sedentary, smoke, and drink alcohol. Moreover, in women, blood vessels and veins are better adapted to possible changes and loads. Before starting treatment, a more comprehensive examination and an individual approach are required.

Treatment features in women

Women are less likely than men to develop the disease before severe symptoms appear. Therefore, in 80% of cases, conservative treatment and lifestyle adjustments are sufficient, without surgical intervention.
Women also adapt more easily to the changes that need to be made in their lives for further prevention of chronic haemorrhoids.

Conservative treatment

For the treatment of chronic combined haemorrhoids, a whole range of local medications can be used:

• ointments;
• rectal suppositories;
• baths.

All medications contain several active components that have a complex effect on the focus of inflammation. The reduction of symptom severity occurs extremely quickly, swelling decreases, pain and itching are reduced. In chronic haemorrhoids, it is important to prevent the progression of the disease and the occurrence of side effects. In most cases, drug therapy only has a temporary effect, and the disease returns later.

Effective and fast treatment

It is possible to get rid of the pathology permanently only with minimally invasive surgery. Some procedures, such as laser thrombectomy, are permissible to use already at stages 1 and 2. In modern medicine, there is a whole range of possible procedures that can help cure chronic combined haemorrhoids. The main ones are:

1. Thrombectomy is used in certain cases of haemorrhoidal node thrombosis, mainly external. It is not a universal treatment for stage I–II internal haemorrhoids. The method of intervention and anesthesia are chosen after examination; pain, bleeding, and recurrent thrombosis are possible.
2. The Longo operation is used in selected patients with internal prolapse. The stapler removes a ring of mucosal and submucosal tissue above the dentate line, lifting the internal haemorrhoidal tissues. The external component is not removed in this procedure. Postoperative pain, complications, and recurrence are possible; recovery times vary individually. The method is compared with alternatives, as it is not a universal first surgical choice.
3. Milligan-Morgan Haemorrhoidectomy (stage 3-4 of the disease). This is a comprehensive removal of haemorrhoids, differing from minimally invasive methods in that all nodes are completely removed at once.
4. Dearterialization of haemorrhoids with Doppler control (stage 3-4). This is the tying off of arteries under the control of an ultrasound device. During the operation, the proctologist ties off 3 to 7 vessels.
5. HAL-RAR surgery (stage 3-4). This involves ligation (tying off) of haemorrhoidal arteries.

In the presence of stage 3-4 chronic combined haemorrhoids, minimally invasive procedures are prescribed in 99% of cases.
These methods have many advantages:

• no long recovery period; in most cases, patients return to normal life just 3-4 days after the procedure;
• pain relief is selected individually; an epidural catheter is placed if indicated, not necessarily for everyone, and postoperative pain may require treatment adjustment;
• the likelihood of disease recurrence is extremely low, only if external factors do not have a significant impact;
• Minimally invasive and surgical treatment is available to people of any age, weight, and body type.

If even barely noticeable symptoms are present, you should consult a doctor for advice and further examination. In our center, consultations are completely free. To do this, you just need to leave a request. Treating haemorrhoids at an early stage is much easier than trying to cure a severe stage complicated by side effects.