Excisional
Paolo Hospital Phaholyothin
12-Jan-2021
Hemorrhoids is the disease that can be found in people of all genders and ages, which is caused by severe and chronic force to pass feces, especially in those with severe constipation while excreting. Therefore, it makes the blood congested in the veins at the anus, causing the blood vessels and tissues around the end of the intestine to grow and become hemorrhoids. The factors of the disease not only come from severe force to pass feces, but also comes from chronic constipation; frequent excretion; long excretion, such as reading and excreting at the same time; pregnant women; cirrhosis; and old age.
There are 2 types of hemorrhoids, which are internal hemorrhoids and external hemorrhoids.
Internal hemorrhoids are hemorrhoids that are located above the dentate line. It can be divided into 4 stages, which are: Stage 1: No lump that sticks out of the anus; Stage 2: There is a lump that sticks out while forcing to pass feces and pulls back by itself; Stage 3: There is a lump that sticks out while forcing to pass feces, but cannot pull back by itself. The hand is needed to push it back in; and Stage 4: There is a lump that sticks out and it cannot be pushed back in by hand, in which excisional hemorrhoidectomy is needed.

External hemorrhoids are hemorrhoids that are located under the dentate line and outside the anus. A lump may be present. The skin that covers the lump may cause irritation and pain. The patient often comes to see the doctor with the symptoms as follows:
• Feces with blood in it. The blood will be fresh and not mixed with mucus.
• There is a lump that sticks out while excreting or sticks out all the time.
• Pain around the anus. Excisional hemorrhoidectomy is needed only in Stage 4.
How to deal with hemorrhoids
The doctor will consider the symptoms and severity level of the disease. Stage 1 emphasizes the use of medication and practices. Stage 2 and Stage 3 (in the beginning) emphasize the use of medication, practices, and some types of specific medicine to fasten the hemorrhoid. Lastly, in Stage 3 (relatively large size) and Stage 4, excisional hemorrhoidectomy is needed.
Self-protection
• Food Eat food that helps to increase fiber, like vegetables and fruits. Drink water no less than 2 liters per day. Avoid spicy and oily food. Consume less meat.
• Excretion Avoid using force to pass feces when excreting for a long time. Have regular bowel movements on schedule. Soak your bottom in warm water, especially in the morning.

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