Treatment of combined haemorrhoids

Combined type – the most common form of the disease. The condition is characterized by the formation of haemorrhoids both inside the rectum and directly under the skin in the walls of the anus. The patient experiences discomfort, which sometimes intensifies, causing sharp pain.
Combined haemorrhoids, both in chronic and acute forms, are treatable. Modern proctology methods allow the problem to be resolved. A patient who experiences not only physical pain but also emotional distress should know that our clinic specialists use spinal-epidural anesthesia with an epidural block, which allows all procedures to be carried out with individually tailored pain relief. The treatment plan is developed individually for each patient, taking into account the severity of the disease, overall health, and other factors.

Symptoms of combined haemorrhoids

Patients experience noticeable symptoms of combined haemorrhoids at the early stages of the disease. Even the presence of just one of the listed symptoms is a reason to see a doctor. The patient experiences the following symptoms:

• discomfort and pain during defecation;
• blood found on the stool or during bathing;
• swelling, itching, and burning in the anal area.

Since in combined haemorrhoids the nodes form directly in the walls of the anus, they can be felt by the patient during self-palpation. Gentle care can help relieve symptoms: instead of cleaning with toilet paper, rinsing with cool water using delicate products specifically designed for intimate hygiene should be used. However, this does not eliminate the need to see a doctor and will not remove the symptoms, it only alleviates them.

Stages of combined haemorrhoids

At first, the disease may not cause discomfort and may not manifest itself. Because of this, the patient does not always suspect a problem. Four stages of the disease are distinguished.

• Stage I is characterized by the fact that the patient does not yet feel the nodes during palpation, but experiences itching, pain, and burning during the process of defecation. After the defecation process, there is a sensation that the intestines have not fully emptied, and sometimes blood is noticeable on the tissue.
• In Stage II, pain intensifies, and the amount of bleeding increases. The patient feels the prolapse of haemorrhoids and can reposition them independently. This can happen during sudden lifting of heavy objects, sneezing, and other abrupt actions.
• Stage III brings even more negative sensations, especially during bowel movements. Pain causes fear, which further complicates the process and leads to a deterioration of the condition. The nodes become larger, making it difficult and painful to push them back. Bleeding accompanies almost every act of defecation.
• By Stage IV, the patient understands that they cannot push the nodes back on their own, and medical assistance is necessary. Bowel movements are painful and accompanied by bleeding. Cases of fecal incontinence are possible, as sphincter closure is difficult due to the bulky nodes. Some nodes are irreducible.

Features of treating combined haemorrhoids in men

Men are 3-5 times more likely than women to face the disease. Doctors cannot say for sure why the disease is related to gender, but they name a number of complicating factors:

• men more often have bad habits that negatively affect blood vessels;
• men are much more often required to perform heavy physical labor;
• men are more often embarrassed to see a doctor at the first signs of the disease, which makes treatment more difficult and symptoms manifest more severely;
• the female body, naturally designed to handle childbirth-related stress, is more resistant to vascular problems.

Along with conservative and invasive treatment, lifestyle is important. The risk of developing haemorrhoids in patients without excess weight is lower, as is the course of the disease. It is also important to form a proper diet: it should contain fiber and roughage, a sufficient amount of trace elements and vitamins. Male-type obesity is a problem that needs to be addressed first. Among the doctor’s recommendations will be those related to physical activity: for those with sedentary work – to do warm-ups, for men whose work involves lifting heavy loads – to reduce physical strain if possible.

Features of treating combined haemorrhoids in women

The period of pregnancy increases the risks of developing haemorrhoids. This is due to the fact that the growing uterus presses on the internal organs and causes increased abdominal pressure. The period of carrying a child is also associated with relatively rapid weight gain.
The only specific recommendation for women is strict monitoring of health during pregnancy and the postpartum period. Otherwise, the therapy does not differ from that used to treat men.

Treatment of combined haemorrhoids with medications

At the initial stage of the disease, folk medicine methods can significantly relieve symptoms. It should be understood that these remedies are not an alternative to traditional treatment and should be used only after consulting a doctor.

Soothing itching and pain is helped by baths with chamomile, knotweed, calendula, and belladonna decoctions. With particular caution and strictly following the dosage, celandine should be used for baths.

Enemas with medicinal herb decoctions are also widely used. For some patients, the procedure causes discomfort, and it should not be used in case of severe pain.

Local preparations have a positive effect:

• suppositories (“Posterisan”, “Relief”, “Proctosedyl”);
• ointments (“Relief”, “Procto-Glyvenol”, “Proctosan”).

The composition includes not only active components for reducing inflammation and eliminating swelling, but also pain-relieving substances.
The use of topical medications is part of a comprehensive therapy, which is selected by a proctologist. Self-treatment can lead to worsening of well-being and complicate the situation.

Effective and fast treatment of combined haemorrhoids

Surgery using the HAL-RAR method is considered one of the most advanced for treating haemorrhoids and can be used to eliminate the disease at any stage. Its effectiveness is significantly higher than that of more traditional and common techniques, such as ligation of nodes and infrared coagulation. The essence involves ligating the arteries in the rectal wall, combined with mucosectomy (lifting the node) and proctoplasty. Laser thrombectomy is used for stages I-II of the disease. Using laser equipment, the doctor delicately removes the nodes, barely affecting the surrounding tissues. Rehabilitation after the surgery is not required, as the laser beam “burns out” the node, which promotes the rapid formation of neat, thin scars. The Longo procedure is used in serious cases, including stage VI. It is indicated for rectocele, massive nodes, in cases of rectal prolapse and other complicating factors. It involves circular excision of a section of the intestine followed by knot tightening. Laser surgery shows effectiveness in 97% of cases. The absolute majority manage to get rid of the problem permanently. Its advantages are as follows:

• relatively short procedure time;
• no subsequent hospitalization required;
• safety, minimal number of contraindications;
• quick recovery, no pain during healing;
• pain control.

It should be noted that the surgery does not eliminate the need to choose a proper diet and learn to lead a balanced lifestyle.