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Medical Diagnosis -treating Hemorrhoids - How to Choose the Least Painful and Most Suitable Option
Treating hemorrhoids - how to choose the least painful and most suitable option
After consulting various specialists, each recommending his own pet method of treatment, a hemorrhoid sufferer gets online medical advice for choosing the least painful and most suitable treatment option.
After being diagnosed with 'hemorrhoidal pathology" (3rd degree hemorrhoids, polyp in the anal canal), the 37 year-old male patient consulted various medical services and specialists, who each suggested different medical treatment methods:
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1. Rubber band ligation;
2. Milligan-Morgan technique;
3. Cryotherapy;
4. Stapler.
The patient specified that each specialist consulted only practices the technique that he personally deems most efficient. The problem raised, therefore, is that each specialist believes his technique (stapler, cryotherapy, ligation, etc.) to be the best, strongly advising against other techniques (without, however, clarifying the reasons for this). Purely based on acquaintances' experiences with the treatment, and the excellent results obtained, the patient would tend towards opting for cryotherapy (which would appear to be the least invasive, cheapest, and simplest technique, as it is generally carried out as an outpatient, with no particular preparation or hospital stay required).
Online Doctor Consultation - Medical Questions:
1) Will any of the techniques mentioned provide a definitive solution to the medical problem?
2) If so, which of the previously specified techniques can be considered best in terms of least sufferance during and post surgery? And which technique would allow the patient to return to normal activity (including non-competitive sports) the quickest?
The expert´s opinion
First of all I must emphasis that I have some doubt concerning the medical diagnosis and that some important details are missing. The medical report did not describe the physical rectal examination regarding the external anal component. This is important for choosing the best surgical technique and I will assume that there is no external component.
Options of treatment
Cryotherapy: (the option the patient mentioned he was leaning toward) this is a painful procedure, frequently associated with a profuse discharge and at least a week off work. Only about 50% of patients are well satisfied with the treatment. In terms of morbidity and time off work it is slightly better than hemorrhoidectomy, but the long term results are less predictable. It has more complications than does rubber-band ligation. Most proctologists have abandoned this technique.
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Rubber-band ligation: complications are infrequent with rubber-band ligation. Pain is usually mild and can be managed with analgesics. Return to work can be immediately or the day after treatment. The results of rubber-band ligation have been excellent with patient satisfaction of 80 to 91%. It must be emphasized that optimal treatment consist of 2-4 sessions with at least two weeks interval and depends on the number of hemorrhoids to be treated.
Milligan-Morgan operation: This is one of the most frequent techniques practiced. The operation is usually performed under general anesthesia, but spinal anesthesia can be used. The long term results are over 90% patient satisfaction. Pain is considered to be the main reason that patients resist the operation. It is evident that pain experienced after the operation is patient dependent. Hospital stay is about 1-2 days, but return to work is not for at least two weeks.
Stapled hemorrhoidectomy: This is relatively a new technique and is in practice for ten years. In all aspects it is an operation and must take place in the hospital. Patients report on less post operative pain compared to Milligan-Morgan operation and hospital stay is usually 1 day. The success rate is about the same as the former but there is one exception: the stapler technique is not effective for treatment of Hemorrhoids with an external component.
Conclusion: according to the information provided by the patient the most suitable technique of treatment is stapled hemorrhoidectomy since it is most effective and less painful than Milligan-Morgan operation. Rubber-band ligation, though excellent, is not indicated in this case. The rectal polyp should be excised in any case.
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Learn More about Hemorrhoid Treatments
Hemorrhoids have two types: the internal and the external hemorrhoids. Unlike internal hemorrhoids that have grown inside the anal canal, external hemorrhoids occur outside of the anal verge. This sac-like protrusion found outside the anus is often characterized by itchiness (pruritus ani), pain, irritation and swelling.
Normally, tissues that bulge and protrude outside the anus is... 
Lots of things such as bills, bosses, parking tickets are a pain in the butt. But having a hemorrhoid is really just a varicose vein that sprouts where the sun don't shine. Are you likely to get them? Well, people who have chronic constipation or who habitually strain to move their bowels are susceptible. So are pregnant women, as the expanding uterus compresses the veins and obstructs the return... 
Not all anal irritations are hemorrhoids. Some could be fissures, some could be an abscess or fistula, some could be just an itch. Hemorrhoids could occur inside the anus or just outside. All they are, happen to be blood vessels in this area that swell up. Though they are not dangerous, they could be uncomfortable or painful.
Why do blood vessels in the anus and lower rectum swell up and... 
Hemorrhoids occur when your body is chemically unbalanced. Under these conditions, the veins in your anus become weak and when blood pressure increases in this area the veins will bulge out. When you strain and push to have a bowel movement, you increase the blood pressure in the anus veins. This is a situation you want to avoid.
If you are constipated and have been for a long time, then... 
To relieve hemorrhoids first look for ways to get your bowels moving easier and more frequently so they produce softer stools. I have suggestion ways, in other articles, to do this by changing your diet.
Any straining and puffing you do to push hard or even soft stools out during a bowel movement will aggravate your hemorrhoids and can lead to bleeding and pain.
When completing a bowel... 
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pregnant with hemroids, please help!? I'm 32 weeks pregnant ...
Tucks pads. And if you can stand it....an ice pack....Ask your doctor if proto-foam HC (hydro-cortisone) is safe during pregnancy...it is a "god send" Best of Luck!
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