Treatment with a cream

There is a variety of hemorrhoid creams and ointments that are used for the brief symptomatic treatment of hemorrhoids. They are intended to relieve itching and burning, but cannot eliminate the cause. Such ointments contain anti-inflammatory substances, local anesthetics and astringents.

These so-called astringents have anti-inflammatory, haemostatic and drying effects. This is an advantage, as creams of such a composition help well with itching, weeping and burning inflammations. For more severe complaints there are also ointments containing cortisone.

Pain-relieving components of hemorrhoid ointments include lidocaine and benzocaine. All these active ingredients are mixed with lubricants and vasoconstrictors (dilate vessels). The latter also lead significantly to hemostasis. All available ointments and creams serve the local symptomatic treatment of a mild to moderate ailment, but they cannot replace surgical therapy for more severe ailments. You can find additional information here: Home remedy for hemorrhoids or Tannolact fat cream

The surgery for hemorrhoids

Very advanced and severe hemorrhoidal diseases cannot be treated in an outpatient and conservative manner. In such a case a surgical intervention is unavoidable. The aim of such surgical interventions is to restore the normal anatomical conditions of the anus as far as possible.

Under no circumstances should the entire hemorroidal cushion be removed, as this would lead to a loss of fine continence. There are now various surgical procedures that can be considered for the treatment of particularly severe hemorrhoidal conditions. A very important classical procedure is the hemorrhoidectomy.

This procedure is mainly used for prolapsed, no longer reducible tissue. This procedure entails an inpatient stay in hospital and a painful healing process lasting several weeks. The procedure is generally performed under general or spinal anesthesia.

Before surgery, hemorrhoids in the acute stage are first treated conservatively.Hemorrhoidectomy can be subdivided into different aspects: First of all, a distinction is made between circular and segmental, and between open and closed procedures. Circular and segmental are terms that describe the extent of the prolapsed (prolapsed) tissue. A circular prolapse means that the entire hemorrhoidal cushion has prolapsed.

Segmental procedures include, for example, the Milligan-Morgan open hemorrhoidectomy or the Ferguson closed procedure. An example of a circular procedure is the reconstructive hemorrhoidectomy according to Fansler-Arnold. The various procedures differ in their exact surgical course and are each named after their discoverers.

What they have in common, however, is a very low recurrence rate, i.e. there are usually no new cases after the operation. Furthermore, all these procedures involve a lengthy healing process, which sometimes has to be accompanied by pain therapy. In any case, after such an operation the patient is first of all incapacitated for work.

Apart from these classic procedures, there are also modern procedures, which are sometimes less painful. However, they are only used for less severe hemorrhoidal disorders. The stacker hemorrhoidopexy should be mentioned, in which the anal skin is lifted with the help of a special surgical device, the stacker.

Thus, in contrast to hemorrhoidectomy, a large part of the hemorrhoidal cushion is preserved. This method is often used for third degree hemorrhoids. However, the procedure is contraindicated for fourth-degree hemorrhoids, as it can lead to a renewed prolapse.

There are also minimally invasive procedures in which the arteries leading to the hemorrhoidal nodes are tied off, thus shrinking the hemorrhoids. By clamping the arteries, the blood supply to the hemorrhoids is cut off. There are different procedures depending on the exact procedure.

What happens after the operation? Patients are usually taken ill one to three weeks after the operation. In the first few days, there may be reduced stool continence, but this improves automatically over time. Risks of an operation are scarring and an associated anal stenosis (tightness of the sphincter muscles), which can lead to stool retention. Very often, especially in patients with spinal anesthesia, urinary retention occurs.