Haemorrhoids

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Treatment :

Medical:

a. high fibre diet
b. increased water intake
c. encouragng gentle exercise
d. sitz bath 10 to 20 minutes twice aday
e. suppositries and ointments no known value expect for anaesthetic and astringent affect
f. for prolapsed edematous internal heamorrhoids gentle reduction local compression (witch hazel) and warm sitz bath.

Non operative:

a) Rubber Band Ligation : safe and effective for 2nd and 3rd degree heamorrhoids. Rubber band is placed snugly around mucosa and heamorrhoidal plexus ischemic necrosis occurs leading to slough necrosis fibrosis



The acutely inflamed prostategland is swollen, tender, and often somewheat asymmetrical.

The gland of chronic prostatitis is variable; it may (1) feel normal, (2) be somewhat enlarged, tender, and boggy, or (3) contain scattered firm areas of fibrosis. and fixation.

Complications : Pain severe enough to remove the band due to low application of the band bleeding may occur at the time of sloughing. Pelvic cellulitis is the other
complication

b) Injection treatment: Effective in Grade 1 & 2. Substances used include phenol, vegetable oil, sodium morrhuate and sodium tetra decyl sulphate. One or two injections are given into the symptomatic quadrant. Injection is done with a special syringe called the Gabriel syringe above the muco cutaneous junction This causes inflamation, fibrosis and scarring.

Complications: include sloughing of mucosa, infection, acute prostatitis and sensitivity reactions to injected material.

c) Cryosurgery: Heamorrhoids can be treated with a cryo probe using CO2 or N20


Complications: include uncontrolled slough of mucosa, foul smelling discharge and delayed wound healing

d) Infrared Photocoagulation: Infrared beam applied to the

heamorrhoids through a proctoscope can produce an area of fibrosis equal to banding Grade 1 & 2

e) Bipolar Contact Diathermy (bicap 2 device): may be applied to the base of internal heamorrhoids, coagulating the feeding vessels

f) Galvanic Generator And Probe:

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