Causes and Treatment of Hemorrhoids

My name is Brian DaCosta Gill,I’m an MD and I’m a board certified general surgeon,and I practice in Utah County at Timpanogos Regional Hospital. General surgery also includes care of a problem that a lot of people like not to talk about, and that’s hemorrhoids. And this problem affects many different age groups. We see it in the elderly and we see it in the young, healthy females as they’re having their children. It’s a common complication of pregnancy and the immediate postpartum period for these young women.

Hemorrhoids, of course, are basically like dilated, or varicose veins in the rectum. And the common symptoms include;prolapse, or protrusion, of the hemorrhoidal tissue, the veins and the tissue overlying them outside of the anus. This is bothersome to the patient. It can cause pain, it can cause itching,and it can cause bleeding. And, frankly, it’s just difficult to take care of your bottom, down there,as you go through the normal passage of bowel movements. So, it’s a problem for a lot of people every single day. And, a lot of people don’t know where to go to talk about that. There have been many procedures designed to help people with different grades of hemorrhoids.

We typically grade hemorrhoids in four categories,grade one through grade four. Most of us have grade one, it’s normal,where they might become dilated if you’re, specifically, constipated, or maybe you even have diarrhea for a while, or you have an illness that affects your G. I. tract. That’s not usually a problem. Grade two hemorrhoids, though, are ones that consistently protrude out, consistently bleed, almost on a daily basis and cause problems or symptoms to the patient at least weekly. Those are hemorrhoids, grade two hemorrhoids, that we can treat successfully with new technologies.

I’ve been a surgeon for a long time and there was a period, about a decade of my practice, where I didn’t even like to see,or treat, hemorrhoid patients. Because the surgeries that I had to offer them were so painful that I hated to submit my patients to that. That type of excisional procedure. Now we have new technology where we have a special plastic anus scope, or a little tiny five inch scope, that just goes inside the bottom, when the patient’s asleep under anesthesia. That’s attached to a computer and an ultrasound machine. Using this, we can painlessly find where the hemorrhoid arterial inflow comes from the heart, where the main pressure going into that venus, or vascular, structure comes from.

The vascular ultrasound helps us identify the exact spot of the inflow of the artery, and allows us through a special channel to tie off the artery before it gets into the hemorrhoid. Tying off an artery is not resecting it, so the pain afterwards is much less. Additionally, then, with the tags of that stitch that we used to tie off the artery, we use the tail of that to come down and get the redundant tissue, that tends to hang out of the bottom, and stitch that, and tie that, or lift that back up two inches, or so, internally so that it doesn’t come out any longer for the patient.

This type of hemorrhoid surgery, I’ve been really excited about because it doesn’t have the same pain complications the older surgeries did, where we actually excise the tissue and there was raw tissue for patients to have to deal with on a daily basis,whether they were passing stool, or passing just their gas.