Hemorrhoids, commonly known as piles, are a prevalent condition characterized by symptoms such as bleeding, prolapse, and itching around the anus. According to statistics from abroad, the incidence of hemorrhoids in individuals over 50 years old is approximately 50%. In Vietnam, although there isn’t a large-scale study available, many experienced healthcare professionals suggest that the prevalence is significantly high, indicating that nearly everyone will experience hemorrhoids at some point in their life. As a famous professor in the medical field once stated, “Out of ten people, nine suffer from hemorrhoids.”
Who is Most Likely to Suffer from Hemorrhoids?
To date, there hasn’t been a comprehensive study identifying specific groups more prone to hemorrhoids. If someone in a family has hemorrhoids, do other family members also have a higher risk? There is no definitive answer, but several important factors have been identified in numerous studies around the world, including Vietnam, as the underlying causes of hemorrhoids:
– Individuals who stand for long periods, sit for extended durations, or have a sedentary lifestyle, such as sales staff, tailors, and secretaries.
– Patients suffering from chronic constipation, who exert excessive pressure during bowel movements, increasing the pressure in the anal canal, which leads to the enlargement and prolapse of hemorrhoids.
– Patients with dysentery: Frequent bowel movements increase abdominal pressure and expand the size of hemorrhoids.
– Additionally, hemorrhoids can also occur in patients with other conditions such as Irritable Bowel Syndrome, increased abdominal pressure, tumors in the anal and rectal area, and surrounding regions.
The impact of hemorrhoids on the quality of life for sufferers can be severe. Symptoms like rectal bleeding, painful thrombosed hemorrhoids, and difficulty in bowel movements can cause significant distress, leaving patients in an uncomfortable mental state throughout the day. Furthermore, patients often delay seeking medical attention, as hemorrhoids are a sensitive issue that tends to be concealed, causing embarrassment, especially among women. Some may carry the burden of this condition for decades in silence, suffering in secret, and by the time they consult a doctor, the damage is often too extensive, necessitating more invasive treatments with increased pain.
Treatment: Medication or Surgery?
There are various treatment methods available for hemorrhoids. The first line of treatment involves conservative management with several types of medication and methods of administration, including oral medications to strengthen vascular walls, antibiotics, anti-inflammatory drugs, pain relievers for acute pain, as well as suppositories and topical creams. This approach is the starting point for all other treatment modalities. However, conservative treatment is only suitable for small hemorrhoids that are not heavily bleeding and are in the acute phase causing pain and inflammation.
To achieve a complete resolution of hemorrhoids, intervention on the hemorrhoids themselves is necessary through procedures such as sclerotherapy, cryotherapy, rubber band ligation, bipolar electrocoagulation, infrared coagulation, or surgical excision of the hemorrhoids. Advanced techniques like the Longo procedure and its modifications have shown promising results, including shorter hospital stays and significantly reduced postoperative pain.
To accurately assess the severity of the condition, patients should be examined by a specialist and undergo a rectal examination to determine the grade of hemorrhoids accurately. The choice of treatment method depends on the severity of the hemorrhoids.
For Grade 1 hemorrhoids, patients may be treated with conservative methods, using oral medications, suppositories, or topical creams without the need for hospitalization. For Grade 2 and Grade 3 hemorrhoids that are still small, procedures like sclerotherapy or infrared coagulation can be utilized. Surgery is reserved for patients with Grade 3 hemorrhoids with large masses, Grade 4 hemorrhoids, or those with thrombosed hemorrhoids causing acute obstruction and significant bleeding and pain.
Associate Professor Dr. Nguyen Hoai Nam
(University of Medicine and Pharmacy Hospital, Ho Chi Minh City)
