anal-masses, Anorectal diseases, بیماری های مقعد

Five treatment options for hemorrhoids or piles

hemorrhoid treatment types

Based on the type of hemorrhoids and the patient’s clinical conditions, various methods can be used for treating hemorrhoids. The main enemy of hemorrhoids or piles is a healthy and high-fiber diet. Note that all home remedies for hemorrhoids do not always work. Here we introduce some of the best and worst home remedies for hemorrhoids. It is noteworthy that home remedies are among the main principles of hemorrhoid treatments even after hemorrhoid surgery or hemorrhoid laser. In fact, home remedies are the first step to treating hemorrhoids.

Other treatments for hemorrhoids are medication and, in more advanced cases, conventional surgery and laser surgery. You are recommended to visit an experienced general surgeon and laser surgery specialist to suggest you the best and fastest treatment. You can also visit a skilled and knowledgeable surgeon to introduce you the outpatient treatments for different types of hemorrhoids.

The image of a protruding hemorrhoid that was treated with a high-power laser without pain and bleeding and without recurrence or return of the laser

Hemorrhoid treatment at home

The first step to treating hemorrhoids at home is to control constipation by changing eating and behavioral habits. Laxatives and other medicines cannot permanently control constipation, and you have no choice but to add more fiber-containing foods to your diet and do regular exercise. Individuals with constipation usually suffer from dehydration and obesity.

Having 30 to 60 grams of fiber, equivalent to 12 medium-sized fruits, every day greatly helps to control constipation. Other solutions to control constipation are as follows:

  • Drink 8 to 10 glasses of water and juice every day
  • Do a sports activity such as yoga or walking every day

Miraculous hemorrhoid treatment with aloe vera at home

You can use the pure gel of aloe vera as a home remedy for hemorrhoids. This is known as a miraculous treatment of hemorrhoids at home. Some individuals are allergic to aloe vera, especially those who are allergic to garlic or onions. Apply a small amount of aloe vera gel on your forearm and wait for 24-48 hours; if you observed no allergic reaction, you can use it as a home remedy. The following video describes a simple method for preparing aloe vera gel.

The best home remedies for hemorrhoids are as follows

  • Sit in a basin of warm water to facilitate blood circulation, relieve pain, and clean the anal area
  • Apply restorative gels such as aloe vera gel to the area
  • Go to the toilet as soon as you feel you need to defecate in order to prevent constipation
  • Set a specific time every day, e.g. after a meal, for sitting on the toilet to stimulate bowel movements
  • Avoid drying the anal area with rough towels to prevent any damage to the skin
  • Put an ice pack on the area to reduce swelling
  • Avoid sitting on hard surfaces or put a soft pillow on them

The worst home remedies for hemorrhoids

One of the worst home remedies for hemorrhoids is the frequent use of suppositories and ointments without a doctor’s prescription. Some chemicals and even natural substances may thin and irritate the anal area skin and gradually cause ulcers and bleeding. Vinegar, which is commonly used in home remedies for hemorrhoids, can cause these complications because of its acidic properties. In addition, the repeated application of betadine to the anal area leads to the dryness and sensitivity of the skin in this area and reduces resistance and immunity.

Medicines and capsules for the treatment of hemorrhoids

Medication for hemorrhoids

Medications for hemorrhoids include tablets or special ointments. This treatment option is usually prescribed for internal hemorrhoids of Grade 1 and sometimes Grade 2 and also mild external hemorrhoids. The physician may prescribe the patient to take hemorrhoid medications for a period to treat other diseases and then recommends other treatment options.

The medications commonly prescribed for hemorrhoids can be divided into 3 general categories:

  • Ointments, pills, and suppositories for relieving inflammation and pain
  • Restorative ointments for accelerating skin healing and removing hemorrhoid paques
  • Anesthetic ointments for temporary relief of spasms and pain

These medications may include lidocaine, zinc cream to protect the skin, and a variety of ointments and anti-hemorrhoid suppositories. The incorrect administration of steroidal anti-inflammatory drugs can cause complications such as atrophy and thin the skin. If the general surgeon prescribes you administer a hemorrhoid treatment for one to two weeks, avoid extending the medication period. If hemorrhoids do not improve within this period, the general surgeon will prescribe other treatments.

A child with hemorrhoids sitting on the toilet

Home remedies of hemorrhoids for children

There is no suitable cream or ointment available in pharmacies for treating piles in children. The best way to reduce pain is to take ibuprofen. Children with hemorrhoids or piles should sit in a basin of warm water for 20-30 minutes several times a day; adding oat powder to water can increase the soothing effects of this method. To reduce anal itching, it is recommended to apply some cornstarch to the anus. A good solution to relieve anal pain is to put an ice pack wrapped with a towel on the area for 5 minutes.

2-Laser treatment of hemorrhoids:

The second and most effective treatment of hemorrhoids is the use of laser equipment. Different types of lasers are employed in the treatment of hemorrhoids, the most efficient of which for hemorrhoid laser are 1- infrared coagulation of hemorrhoids (IRC) and 2- high-power CO2 laser for removing hemorrhoid paques or piles without pain and bleeding.

2.1-Hemorrhoid laser therapy:

Laser therapy is another treatment of hemorrhoids or piles in the early stages of the disease when the hemorrhoid is not too big or has caused no other complication. In this treatment, a special tool is inserted into the rectum to emit laser light in different directions to reduce the symptoms of hemorrhoids. The laser light actually reduces both the pain and size of hemorrhoid paques. This treatment is not suitable for very large hemorrhoids that have caused other complications. Note that laser therapy, as an outpatient treatment, is different from laser surgery.

Infrared (IR)

IR can be used for treating hemorrhoids in two ways:

  • The laser probe is placed on the internal hemorrhoid, and IR is emitted to the area to turn the area white. This wavelength is highly absorbed by hemoglobin and causes the coagulation of the blood vessels inside the hemorrhoid paque. Therefore, the hemorrhoid paque will shrink and disappear after a few days. This method is only used for internal hemorrhoids without the need for general or even local anesthesia.
  • A fiber diode carrying the laser light is inserted into the hemorrhoid paque to clot the blood vessels and remove the hemorrhoid paque. This method is usually very expensive.

Schematic of three degrees of internal hemorrhoids

High-power CO2 laser for definitive treatment of hemorrhoids or piles

High-power CO2 laser is currently the newest and best treatment for all types of hemorrhoids. This high-power laser can completely remove the hemorrhoid paque. In fact, this laser serves as a surgical knife and definitively treats piles.

Compared to conventional methods, laser has caused a revolution in the treatment of diseases, especially anorectal diseases. Since previous methods were associated with severe pain and bleeding and very long recovery periods, patients with such diseases were not very willing to visit a physician. In other words, people may never visit a physician or do so very late for hemorrhoids or other anorectal diseases because they assume that the treatments for such conditions are long and painful. If you know the advantages of laser surgery, you will no longer feel embarrassed about visiting a physician for treating your disease.

These images show a case of hemorrhoids before and after surgery with high-power laser

These images show a case of hemorrhoids before and after surgery with high-power laser

3-Treatment of hemorrhoids or piles by open surgery

There are several surgical procedures for the removal of symptomatic hemorrhoids. All these methods are based on reducing the blood flow of hemorrhoid networks and removing excess mucus and endoderm.

Hemorrhoid open surgery is performed under local anesthesia or general anesthesia. The surgical wound is either closed with absorbable sutures or left open to heal secondarily. Although all 3 hemorrhoid veins can be removed in a single session by this method, a large area of skin around the anus should not be removed in order to prevent anal stenosis.

Common complications of hemorrhoid open surgery are bleeding, infections, anal stenosis, urinary retention, and anal incontinence.

The picture of Dr. Zahra Saadati writing prescription for hemorrhoid treatment

Treatment of thrombosed external hemorrhoids

Thrombosed external hemorrhoids are generally characterized by severe pain and a palpable mass around the anus during the first 24-72 hours after thrombosis. Thrombosed hemorrhoids can be removed under local anesthesia in a doctor’s office. Since the blood clot inside the hemorrhoid is hollow, making a simple incision for draining the hemorrhoid is not effective in most cases and it is necessary to completely remove hemorrhoid. The thrombosed hemorrhoid begins to reabsorb after 72 hours and the pain reduces on its own. If the pain is completely relieved after 72 hours, it is not necessary to remove hemorrhoid; instead, the patient is prescribed to take painkillers and sit in a basin of warm water several times a day.

4-Doppler Guided Hemorrhoidal Artery Ligation (DG-HAL)

This method affects the hemorrhoid paques (veins) indirectly. In fact, the operation aims to cut off the blood supply to the piles in order to reduce swelling, shrink the piles, and alleviate the symptoms. However, this is not a definitive treatment for piles and takes a relatively long time.

5-Rubber band ligation of hemorrhoids or piles:

This treatment of hemorrhoids or piles was formerly popular. This outpatient treatment does not require local or general anesthesia and can be performed in a doctor’s office for treating hemorrhoids or piles of grades 2 and 3. However, this is not a definitive treatment for hemorrhoids or piles and cannot be used for external or mixed hemorrhoids or piles because it causes intolerable pain. The success rate of this method is 87% and its risk of compilation is 3%.

Frequently asked questions (FAQs) about hemorrhoid treatments:

1-What is the best treatment for hemorrhoids?

As soon as you suspect hemorrhoids, you should make changes in your lifestyle; you should eat more fiber-rich foods, vegetables, fruits, and water. If you are overweight, try to lose weight and increase your daily activity. If you do not take the necessary actions, you may have to undergo hemorrhoid surgery. The best treatment in such cases is hemorrhoid laser with high-power laser because it requires a very short recovery period and minimizes the risk of recurrence. Consult a general surgeon and laser surgery specialist about hemorrhoid laser surgery.

2-Can hemorrhoids be excreted with stool?

Some patients with thrombosed hemorrhoids may wrongly assume that the bleeding and drainage of the hemorrhoid paque mean the excretion of hemorrhoids. But only the blood clot has drained and the hemorrhoid paque still exists. Hemorrhoids do not heal and drain spontaneously, and you need to visit a general surgeon to treat your hemorrhoids.

3-How can we reduce hemorrhoid inflammation?

Since warm water can dilate blood vessels, it improves vascular contractions, spasms, and inflammation. Therefore, a way to reduce hemorrhoid inflammation is to sit in a basin of warm water because it creates a sense of relaxation and relief in the area.

4-Which one is better for the treatment of hemorrhoids: laser-based methods or conventional methods?

It is not difficult to treat hemorrhoids in the early stages without the need for surgery or laser therapy. However, laser surgery is the best option for treating chronic hemorrhoids that do not respond to medication. It is possible to treat different types of hemorrhoids and other anorectal diseases, such as anal abscesses, fissures, and fistula in a single session by using high-power laser.

5-What are the treatments for mild hemorrhoids or piles?

Note that only specialists can diagnose mild hemorrhoids or piles; some patients may have painless hemorrhoids or piles that are not mild and are noticed when they are protruded. You can easily treat mild hemorrhoids or piles by following a healthy and fiber-rich diet, drinking enough water and liquids, and taking some medications prescribed by a specialist.

6-What is the strongest medication for hemorrhoids?

A variety of medications are prescribed for treating hemorrhoids depending on the type and cause of hemorrhoids. Nevertheless, herbal anti-inflammatory and restorative drugs are the strongest medications for hemorrhoids. Specialists may prescribe anti-hemorrhoid ointments, Anaheal, Daflon, and so on for a period of 7 to 10 days.

7-Why do some people believe that hemorrhoids should not be treated?

Some uneducated individuals who are unaware of the complications of hemorrhoids believe this disease should not be treated. However, when you visit a physician, you will find that untreated hemorrhoids or piles may lead to anal abscesses and infections, painful fissures, and even anal fistula.

8-How is the thread ligation of hemorrhoids or piles at home?

The thread ligation of hemorrhoids or piles at home can cause infections and exacerbate the disease. This method is similar to rubber band ligation of hemorrhoids that was formerly performed by specialists. Anal appendages and skin tags and piles are recommended to be removed by using high-power laser.


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