Treating hemorrhoids
Often a sense of shame ensures that many patients do not seek medical treatment until very late in the disease's course, which is far advanced. Courage! The sooner you see a doctor or proctologist, the better. The examination can determine the severity of the disease and select a suitable treatment method.
Treatment options
1st degree
- Diet for stool regulation
- Ointments and suppositories
- Sclerosis/band ligation (see below Other methods)
- or HeLP®
2nd degree
- Diet for stool regulation
- Sclerosis/band ligation
- Surgery
- or HeLP® / LHP®
3rd degree
- Diet for stool regulation
- Stapled hemorrhoidectomy (see below Other methods)
- Sclerosis/band ligation
- Surgery
- or LHP® / HeLP®
4th degree
- Diet for stool regulation
- Surgery
- or LHP®
Other methods
Band ligation
Diseased Hemorrhoids are disconnected by a rubber band (ligature) and decrease in the following days.
Sclerotherapy
Sclerosis by injection
Surgery
The affected area is removed with a scalpel; convalescence time amounts to 2 to 3 weeks. Patients must expect severe pain.
Open hemorrhoidectomy using the Milligan-Morgan technique
- For severe pain with 3rd degree, less commonly also 4th degree hemorrhoids.
- The three hemorrhoidal swellings are pulled out through the anus with a clamp and prepared there.
- The method should not necessarily be used for all the swellings. It is just as suitable for treating individual segments.
- The surgeon decides where to situate skin bridges and cuts the hemorrhoid tissue from the underlying sphincter.
- After the swelling has been sutured, the supplying artery is also tied off to prevent postoperative bleeding.
- The swelling is then removed with a scalpel.
- The triangular wounds that remain between intact bridges of skin and anal mucosa of at least 2 cm width are not sewn up but are left open to heal. Therefore, this is also referred to as an "open method".
Stapled hemorrhoidectomy using Longo's technique
- The operation is carried out on prolapsed 3rd degree hemorrhoids under regional or general anesthetic.
- The stapler is brought to the enlarged hemorrhoidal cushions.
- The prolapsed tissue is partially removed.
- The remaining hemorrhoidal cushions are fixed in their original positions with staples.
- After the operation, bleeding from the stapled suture can occur. This risk can be minimized by resuturing even smaller points of bleeding immediately at the end of the operation.
- There is the possibility that too much muscle tissue is drawn into the device and as a result the wall of the rectum, and possibly also the wall of the vagina in women, is damaged.
- A constant urge to defecate can occur, especially if the staple suture is situated too deep.
- There is much less pain after the operation than in classical hemorrhoidectomy methods.
Who pays for it?
The costs for the minimally invasive treatment and the stay in hospital are generally borne by statutory health insurance.