Treatment of combined haemorrhoids of grade 4

Combined haemorrhoids in proctology – the simultaneous formation and enlargement of internal and external haemorrhoids.
The mechanism of the combined pathology is due to chronic circulatory disorders in the rectum and anus, dystrophy of the nodal ligamentous apparatus, including the anal sphincter.
Treatment of stage 4 haemorrhoids primarily involves surgical treatment along with medication support. In the proctology medical center in Ukraine, a wide range of diagnostic and therapeutic services for haemorrhoidal disease is offered.

Symptoms – how fourth-degree combined haemorrhoids progress

The symptoms of grade 4 combined haemorrhoids are distinguished by the severity and combination of manifestations of acute and chronic processes. The main symptom is pain. The pain syndrome accompanies the patient almost constantly: at rest, during bowel movements, and with sudden changes in body position. Other manifestations of combined haemorrhoids include:

• blood on the tissue after using the toilet;
• traces of blood in the stool;
• itching;
• moisture in the anus;
• redness and swelling in the anal opening.

Grade 4 combined haemorrhoids are often accompanied by rectal bleeding, characteristic of the rupture of pathological nodes.

Treatment

Treatment for grade 4 combined haemorrhoids should be urgent. Inflamed internal nodes may bleed, while external ones may prolapse and provoke acute complications such as strangulation and chronic infections.

Combined haemorrhoids of grade 4 in men – treatment principles

There are no significant differences in the treatment of haemorrhoids in men and women. During consultation and diagnosis, the clinical history is clarified, as well as risk factors:

• excessive physical exertion (including heavy labor activities);
• physical inactivity, sedentary lifestyle;
• overweight, obesity;
• bad habits.

The difficulty in treating haemorrhoids at any stage in men lies in psychological aspects. Men cannot be called disciplined patients, especially regarding the recommendations of a proctologist. Men usually visit a doctor at an advanced stage, when they can no longer endure. We understand this feature and guarantee an individual approach to each patient.

Features of haemorrhoid treatment in women

Women of childbearing and elderly age are at special risk. Most often, the first problems start after childbirth. Without treatment, haemorrhoids become chronic, complicating with internal and external haemorrhoidal nodules. The clinical situation is worsened by the following factors:

• each subsequent birth;
• excessive physical activity;
• obesity;
• hormonal disorders;
• active practice of anal sex;
• varicose veins.

Age-related changes lead to a weakening of the anal sphincter tone – another factor in the development of combined haemorrhoids.

Medication therapy – is it worthwhile at stage 4

Monotherapy with medications is effective only in the early stages of haemorrhoidal disease. The prescription of drugs is dictated by the following goals:

• relieving acute symptoms;
• preventing complications;
• preparation for surgery and postoperative rehabilitation.

Medications commonly used include both local and systemic treatments (tablets, rectal suppositories, ointments).
Modern suppositories such as Proctosan, Ultraprоct, Aurobin, Empa, Posterisan, Relief, and Nefluan are effective for pain. Ketoprofen and Xefocam can also help reduce pain.
For those at risk of thrombosis, anticoagulants based on heparin and troxerutin (both local and systemic) are prescribed. If complications involve inflammation, Heparin, Aurobin, Proctosedyl, Procto-Glyvenol, Proctosan, and others are recommended.
Bleeding can be managed with well-known over-the-counter drugs like Natalsid, Relief, Tronexan, and Etamsylate.
Among alternative treatments, local baths with strong chamomile, celandine, or eucalyptus decoctions can help.
Unfortunately, at stage 4 haemorrhoids, it is impossible to relieve symptoms and completely solve the problem using only conservative methods.

Effective and quick treatment

Proctologists of the medical center in Ukraine offer treatment for combined grade 4 haemorrhoids using minimally invasive surgical methods. We suggest paying attention to laser removal of haemorrhoids. The principle of laser action is based on the thermal effect of the laser beam and the following effects:

• tissue destruction;
• non-inflammatory burn;
• limited necrosis with connective tissue formation;
• scarring.

Laser surgeries in proctology are used in classic haemorrhoidectomy (including submucosal), interstitial laser coagulation of nodes, and combined treatment methods.

What We Can Offer

Our medical center offers a wide range of proctological services from diagnostics to surgical intervention. We use the following methods:

• HAR-LAR method surgeries;
• laser thrombectomy for grade 1-2 haemorrhoids;
• Longo procedure for advanced pathology;
• transanal Doppler-controlled dearterialization of nodes;
• Morgan-Milligan operation.

All operations are performed under spinal-epidural anesthesia with epidural catheter placement. We manage the treatment of pararectal fistulas, anal and chronic fissures, presacral cysts.
We guarantee pain control and high therapeutic results. Submit a request for consultation (check the cost when booking) – we know how to help you.