Colorectal Surgeon Explains Hemorrhoid Treatment Options

Medically reviewed by: Gary H. Hoffman, MD

Video Transcription:

There’s no one particular age patient who is afflicted by hemorrhoids, however most commonly hemorrhoidal disease begins to manifest itself beginning at around age forty and extends through adult life.  Why do patients get hemorrhoids?  We don’t know.  But. we can fix them however when they become symptomatic and are no longer responsive to local medical measures such as creams, stool softeners, and the like.  The way to fix these things is to remove them, which is a traditional hemorrhoidectomy and is extremely painful.  A hemorrhoidectomy involves intense recovery time.  But, with some of the newer techniques such as PPH, which is procedure for prolapse and hemorrhoids, the postoperative period is lessened.  THD, which is Transarterial Hemorrhoidal Dearterialization, is another, less invasive way of removing hemorrhoids.

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The concept is with PPH that the hemorrhoidal tissue is pushed back to its normal position and then the excess tissue is removed. This allows for a little bit of hemorrhoidal tissue to remain and this adds to the comfort patients have when they have bowel moments because the hemorrhoidal tissues acts as a cushion.  THD simply cuts off the arterial blood supply to the hemorrhoid, effectively allowing it to wither away. At the same time, THD returns the remaining hemorrhoid tissue back up to its normal position.  And, all of this is done without cutting.

Both the PPH and the THD are performed in an area above what we call the dentate line.  Above the dentate line there are no classical pain fibers so the procedure is much less uncomfortable.  After the operation, This allows patients to return to their activities of daily living much quicker.  A traditional hemorrhoidectomy is much more painful post operatively because the operation is performed both above and below the dentate line and affects the nerve endings that control pain.  PPH and THD are definitely vast improvements over a traditional hemorrhoidectomy.

The board certified surgeons of Los Angeles Colon and Rectal Surgical Associates can educate you about hemorrhoids and their various treatments.  You can schedule a confidential consultation by calling (310)273-2310.

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