What are Hemorrhoids

WHAT ARE HEMORRHOIDS?

Hemorrhoids, also known as piles, are natural cushions of tissue and tiny blood vessels located at the junction of rectum and anus. Along with the sphincter, this normal tissue is responsible for complete closure of the anus and prevents any leakage. During a bowel movement, these cushions become smaller to allow stool to pass through. Everyone has them and, in most cases, problems only arise when they become larger than they should. Hemorrhoids are classified grade I-IV according to size, location and degree of prolapse.

Why do people get hemorrhoids?

According to the National Institute of Health, millions of people suffer from hemorrhoids in the United States annually, and half of those will suffer from hemorrhoids by the age of fifty. There are many different factors that may cause hemorrhoids to enlarge, and the exact reason is not always obvious for every patient. However, there is no doubt that straining during bowel movements or very hard stool, pregnancy, weakening of the tissue in old age, an unhealthy lifestyle (lack of exercise, bad eating habits, alcohol, etc.), and diarrhea or overuse of laxatives can all lead to hemorrhoidal disease.

What are the symptoms?

Hemorrhoids may often be quite painless and can even go quite unnoticed by the person affected. Other sufferers may experience any or all of these symptoms:

• Bleeding during bowel movements.
• Swelling protruding from the anus. In some cases, the hemorrhoids might
feel like small lumps in the anus and project from the back passage only
after straining on the toilet; in severe cases, the swellings will be
constantly visible.
• Itching, discharge or dull pain.

What treatments are available?

Hemorrhoid treatments range from topical medications and self-care (i.e. sitz baths, dietary changes) for mild hemorrhoid symptoms to minimally-invasive procedures and surgery for moderate to severe conditions. The most common methods for treating protruding hemorrhoids involve either ligation (reducing/stopping blood flow) or surgical removal of the hemorrhoid.

Surgical treatments:

• Rubber band ligation
Minimally-invasive procedure (not open surgery) usually done in the doctor's
office. Often requires multiple treatments.

• Circular stapled hemorrhoidectomy
Excision (removal) of a band of circumferential rectal tissue and stapling together
the sides adjacent to the excision, thereby reducing the blood flow and lifting the
tissue. Usually requires general anesthesia, moderate post-operative pain reported,
low rate of complications, but some severe adverse effects have also been
reported.1

• Hemorrhoidectomy
Surgical procedure to remove hemorrhoids, usually requires general anesthesia.
Patients report a significantly higher degree of pain after surgery for as long as
seven days.

Because treatment and the consequences are often extremely uncomfortable, many patients previously preferred to live with the problem rather than seek treatment with their doctor.

Non-Surgical Treatments

Now, there is another option. The HAL/RAR is a minimally invasive non-surgical procesure. Instead of painful operations, the Doppler-Guided Hemorrhoidal Artery Ligation and Recto Anal Repair - (DG) HAL/RAR® System provides a minimally-invasive treatment that is particularly effective for grade II to IV hemorrhoids.

How Does HAL/RAR Work?

HAL/RAR enables surgeons to identify the blood flow that feeds hemorrhoids by using a doppler device (a type of ultrasound). Once the problematic artery is identified with the doppler, the surgeon simply ties it off with a suture. The stitch helps bring the blood flow back to normal thereby reducing the swelling, and sometimes even the prolapsed tissue. If the prolapsed tissue does not shrink, another suture is used to bring it back into place so it does not stick out or easily refill.

How Long is Recovery from HAL/RAR?

The suture dissolves in weeks and the patient's anal orifice reverts back to its natural state. Since the procedure is performed through the anus and the stitches are placed far enough up the anal canal (above what is called the dentate line), patients experience less pain and can often get back to work in a couple of days.