Over time, hemorrhoids / hemorrhoids / hemorrhoids are increasingly found in society. Most likely this is due to the habit of eating instant food and low in fiber. This is common in developing countries like Indonesia. In fact, more and more clinics and health centers that offer both medical and herbal treatment. Then which one will we choose?
The development of science and technology ushered us into the digital era. Many treatment methods that can be selected at this time. Among them are:
- Medikamentosa
This method uses only drugs and ointments. Usually health facilities 1 or herbal clinics use this method. Apart from being safe, the cost is cheaper and of course painless because no action is taken. However, the results and effectiveness for large hemorrhoids are relatively lower.
- Conventional without incision
Medical science has progressed more and more, in this method ligation and injections with sclerotherapy agents are carried out. Usually done locally and on relatively small hemorrhoids.
- Conventional with an incision
This method is often used because it is cost-effective and the results are good. But the level of pain and complications is still quite high.
- Conventional with tools
This method is an alternative to conventional measures. Examples of tools used in this method, such as a stapler, are quite effective in reducing pain and complications.
- Laser Hemorrhoids
The laser method is currently very developed and popular because of the patient's comfort level in undergoing therapy compared to the end result which is better when compared to other methods.
Patients often come for treatment when they are experiencing severe symptoms. Symptoms that are often found in hemorrhoid patients include itching and pain in the anal area, and even bleeding during defecation. If left unchecked, the lump will grow bigger and can't go back into the anus and even bleeding.
Causes of Hemorrhoids / Hemorrhoids
Hemorrhoids occur due to increased pressure on the veins in the anus, which occurs when straining during bowel movements, urinating, lifting heavy loads, and pregnancy. Factors triggering hemorrhoids are a lack of fibrous food, frequent consumption of processed foods, fried foods and not drinking enough water. Besides making constipation, this will dilate local blood vessels. Then there will be thrombosis. Occurrence of a blood clot/clothing in the hemmoroidal vein results in obstruction of blood circulation and causes severe pain and active bleeding when injured.
Based on its location, hemorrhoids / hemorrhoids can be divided into 2 types, namely:
- Internal (inside the anus)
- External (outside the anus).
Apart from its location, hemorrhoids / hemorrhoids can also be divided based on the degree of severity, namely:
- Hemorrhoids / hemorrhoids degree 1 (one) has not protruded from the anus.
- Degree 2 (two) if the lump can go back on its own.
- Degree 3 (three) if the lump protrudes from the anus, but can be put back in but often comes out.
- Hemorrhoids / hemorrhoids are said to be grade 4 when they can no longer enter the anus. Therefore, the sooner hemorrhoids are treated, the more satisfying the healing process and the results will be.
Do all hemorrhoids/hemorroids need surgery?
Of course not. In degrees 1 and 2, surgery does not always have to be done. However, you should first consult a surgeon as the first step in dealing with the problem of hemorrhoids. The next step is to change lifestyles, both for prevention and improvement of our quality of life. Things that can be done are:
- Consume high-fiber foods.
- Consume lots of water.
- Avoid processed foods.
- Avoid excessive straining during bowel movements.
- Avoid sitting too long on the toilet.
- Exercise in moderation
The laser hemorrhoid method or Laser Hemorrhoidoplasty (LHP) is a minimally invasive method without incisions, where laser coagulation aims to stop blood flow to the hemorrhoids. The laser causes the hemorrhoid veins to close and the hemorrhoid to shrink in size. Reduced hemorrhoids will then fall off on their own during defecation 1-2 weeks after surgery. What are the advantages of the laser method? Here's the answer.
- The level of pain is lighter than other methods. It was stated in the journal that the pain level assessed by the Visual Analogue Scale , the VAS level on the laser method was 2 units lower. This is similar to the author's experience in the field. It was also found that the patient's stay with laser surgery only took 1 day after surgery and was often carried out as a one day surgery center. This shows that the patient feels comfortable in undergoing the laser therapy.
- Less postoperative bleeding. In the journal it is stated that the laser method can reduce an average of 16.83 ml of intraoperative bleeding. This is similar to what the author feels in treating patients with the laser method. Most bleeding occurs 2-3 days after the procedure with an almost always decreasing intensity, directly proportional to the level of pain. In severe cases, this condition is followed by swelling of the laser area and will decrease according to the wound healing phase.
- Mobility after surgery is very good. Especially when compared to conventional methods where patients will feel relatively high pain. In patients with lasers, if they choose to use general anesthesia, after being fully conscious the patient can immediately practice mobilization and continue activities. Then the use of pain medication can be minimal.
- Smaller wound. The laser method does not require an incision, only a very small puncture wound for the laser probe to enter. With small wounds, fewer anatomical complications are expected compared to other methods. The most feared complication is stricture / narrowing of the anal canal. So with the development of laser techniques this can be minimized. Sometimes a mucopex suture is added in the laser method. This aims to maintain the fixation of dilation of blood vessels that have been lasered. The risk of infection is also smaller because the resulting wound is smaller.
MYTH
- Laser treatment is only intended for hemorrhoids with a low degree/small size
With the development of laser technology, it is now possible to perform laser therapy on large hemorrhoids. In accordance with several studies, the results obtained are relatively better.
- Laser treatment is expensive
Indeed, in some places, laser technology is still more expensive than other methods. However, many medical centers offer laser treatment at more economical prices because of the high treatment quota.
- Laser treatment often relapses
Many studies say the recurrence rate of hemorrhoids with good lifestyle changes is very low. Many factors influence the recurrence of hemorrhoids. If we suppress these risk factors, then the results of treatment can be more positive. Consult with your doctor what are the risk factors for hemorrhoids.
With the development of hemorrhoid treatment technology, it is currently very enthusiastic in Indonesia. As a community/patient, it is not recommended to force yourself to get the most modern treatment. The most important thing is the right diagnosis and treatment by a doctor with the right competence. Methods other than lasers can indeed provide positive results. However, currently the laser provides several advantages in terms of pain, fast healing, recurrence and length of stay. Hopefully with this article, we can prevent hemorrhoids and get appropriate treatment with minimal complications. Let's improve the quality of life without hemorrhoids.
Article written by dr. Clement Dewanto, Sp.B (General Surgeon Specialist at EMC Tangerang Hospital).