HEMORRHOIDS

Modern hemorrhoid treatment in Vienna

Every healthy human being has three inner hemorrhoids. They are swollen veins in the anus or rectum, similar to varicose veins. They only become a condition when they enlarge or grow deeper.
Hemorrhoids can have a number of causes, although often the exact cause is unknown. It can be a low-fiber diet, long periods of sitting, straining during bowel movement, weakness of the connective tissue or other causes.

About half the people of over 50 have hemorrhoids, categorized into 4 stages. Men are more affected than women.

“Nowadays, hemorrhoids are not a condition you must endure. There are a number of surgical options.”

In Dr. Kissers Practice in Vienna, we will gladly inform you about the different ways of treatment.

Symptoms

Typical symptoms are bleeding, itchiness or irritation of the anal region, a feeling of pressure and in later stages even fecal incontinence.

 

Treatment options

Non-surgical treatment is possible at stage 1 and 2 of hemorrhoids. High fiber diet, mild stool softeners, lukewarm sitz baths, salves, and suppositories can help.

Sclerotherapy:
Small hemorrhoids can be shrunk through a special injection that stops the local circulation. Usually three treatments, one every 4-6 weeks are necessary. The treatment is done ambulatorily.

Rubber band ligation:
Inner hemorrhoids can be treated with a rubber band ligation. Via rectoscopy (link), a rubber band is placed around the hemorrhoids. The hemorrhoids will then shrink and fall off a few days later.
Usually, 3-5 sessions with an interval of 4-6 weeks are necessary.

 

Surgical measures

The classical surgery is to remove the hemorrhoids. The downside to this though is the remaining wound in a very sensitive region. Those procedures are usually performed under general anesthesia or epidural anesthesia.

 New ways of Hemorrhoid surgery

Stapled hemorrhoidectomy:
This method brings hemorrhoids back to their original place, through shortening the hemorrhoidal tissue with a stapler, without incisions at the sensitive anus.

Transanal hemorrhoidal dearterialization:
After locating the superior rectal arteries via ultrasound, a suture ligation is performed. This procedure can be done under conscious sedation, with an additional medication of Dormicum.
There is no risk of fecal incontinence.

Risks and long-term results:
After the classic surgery, pain during bowel movement is common in the first few days. Very rarely, tightness of the sphincter, impaired control over bowel movement or newly enlarged hemorrhoids can occur.

HEMORRHOIDS

Hemorrhoids are blood filled cushions under the skin in the lower rectum, that help with stool control. Every human has hemorrhoids. Only when they are swollen or inflamed the become a disease.
Symptoms can be a light red bleeding from the anus, itchiness, burning, wetness or secretion from the anus or a feeling of pressure. Seldomly they also come with pain.

Hemorrhoids are divided into 4 stages:

Stage 1: The hemorrhoids cannot be felt but seen with the proctoscope.

Stage 2: When pushing, the hemorrhoids can shortly bulge out of the anal canal but return on their own.

Stage 3: The hemorrhoids come out of the anal canal but can be pushed back with a finger.

Stage 4: The hemorrhoids are permanently outside of the anus and cannot be pushed back in.

We treat each patient according to their individual medical needs. In stage 1 and 2 we recommend dietary changes, stool regulation, as well as suppositories and salves. Patients with stage 2 hemorrhoids can additionally have a rubber band ligation and/or sclerotherapy.
In stage 3 and 4, a surgery is necessary. There are several types of surgery: removing the hemorrhoids, stapled hemorrhoidectomy and the trans anal hemorrhoidal ligation.

Rectal diseases:

 

ANAL ABSCESS:
An anal abscess is a pus developing inflammation in the anal area. Typical symptoms are swelling, local pressure and increased chronic pain, especially when sitting down. Surgical treatment of anal abscess is opening the abscess cave. Should a fistula be found, it can be treated as well or must have an additional surgery, depending on its course.

ANAL EXCEMA:
An anal eczema is the most common disease in proctology and is very often a result of a different disease, for example, enlarged hemorrhoids. In the early stages, it is good to additionally treat it with sitz baths and salves as well. It is important to have the correct anal hygiene, using only water and no soap or perfume on your anus.
Allergies or skin conditions can also be the cause of anal eczema.

ANAL FISSURE:
Anal fissures are very painful cracks in the skin of the anal canal. There are acute anal fissures (a shallow crack on the surface of the skin) and a chronic fissure (deep fissure with additional skin changes). Symptoms are strong stinging pain during bowel movements that can last up to a few hours.
Often there can be blood stains on the toilet paper, or striped bloody streaks on the stool.
Often an examination is enough for a diagnosis.
The treatment depends on the kind of anal fissure.

ANAL FISTULA:

An anal fistula is a small tunnel between the end of the bowel and the skin near the anus. Diagnosing anal fistulas begins with checking the anal region for possible fistula openings. In most case, and examination under full anesthesia is needed in order to probe the fistula tunnel.
We offer all surgical options and use sphincter friendly procedures.

ANAL BARNACLES:
Barnacles are skin flaps in the anus. The shape and size of them can vary, but they are harmless in most cases.
Surgical removal of barnacles is only necessary when they disturb anal hygiene. Cosmetic reasons can also be a motive for surgery.

ANAL THROMBOSIS:
Acute pain and swelling on the anus can be an indicator of anal vein thrombosis. When inspected, one or several blue colored knots can be found.
Depending on the symptoms, a therapy with painkillers and anti-inflammatories can be tried. If this does not help, or if the patient has strong pain the anal vein thrombose should be removed surgically, under local anesthesia or conscious sedation.

ANAL ITCHINESS:
Chronic, uncomfortable itchiness or burning in the anal region.
Itching is an often-heard ailment in proctology, but it is not a disease by itself. There can be many possible causes for it.
Diagnosis and treatment will tackle the cause of itchiness.