What are haemorrhoids?
Haemorrhoids are pathologically dilated blood vessels directly beneath the skin of the anal canal. Normally, these vessels help the sphincter muscle to seal.
Symptoms
Bleeding and blood on the stool are common. However, the source of bleeding can also lie elsewhere in the bowel – which is why a colonoscopy should always be performed in addition. Other symptoms include itching, a feeling of pressure, pain, skin irritation at the anus and problems with hygiene.
Treatment
I assess your symptoms in a detailed consultation at the practice and with a gentle palpation examination. Ointments and suppositories as well as a change in diet often help. I recommend surgery if these measures are not sufficient and your quality of life is impaired.
My surgical methods
- HAL (haemorrhoidal artery ligation): gentle ligation of the supplying vessels – the haemorrhoids regress.
- HAL-RAR: in addition, the mucosa is lifted and excess tissue is gathered inwards.
- Haemorrhoidectomy (Milligan-Morgan): complete removal of the haemorrhoid, especially in advanced disease. The small wound usually heals without problems in the following weeks.
- Sclerosing: the haemorrhoid is sclerosed from the inside with a fine electric scalpel.
We decide together which method is suitable – a combination often makes sense too. I operate exclusively under general anaesthesia in a private hospital. Nevertheless, most patients can leave hospital a few hours after the operation.
Skin tags
Skin tags (marisques) are small folds of skin at the outer anus. They develop over the course of life and are usually harmless. If they are a hygienic or cosmetic nuisance, itch or swell during sport, I remove them with a minor procedure under general anaesthesia. You can go home a few hours afterwards.
Anal fissure
In an anal fissure, the skin of the anal canal tears. Typical symptoms are pain during bowel movements, which often lasts up to two hours, and blood on the stool. Fresh fissures often heal by themselves. If the fissure persists, a spasm of the sphincter muscle usually prevents healing.
I first treat with special ointments that relax the sphincter muscle, and with dietary measures – this heals the fissure in most cases. If this does not help, I remove the scar tissue under general anaesthesia and, if necessary, treat the sphincter spasm with a muscle-relaxing injection. I do not perform a permanent division of the sphincter muscle.
Frequently asked questions
Do I have to stay in hospital after haemorrhoid surgery?
Usually not. I operate under general anaesthesia in a private hospital; most patients can leave hospital a few hours after the operation.
Do I need a colonoscopy before treatment?
Blood in the stool does not necessarily come from haemorrhoids. A colonoscopy should therefore always be performed in addition.
Is the sphincter muscle cut in the case of an anal fissure?
No. I first treat with ointments and, if necessary, surgically by removing the scar tissue and with a muscle-relaxing injection.