USA: Hemorrhoids an Age Old Problem With A New Solution

MADISON, WISCONSIN (Ashland Daily Press), December 31st, 2004: Hemorrhoids have caused human suffering probably from the onset of mankind. Surgical treatment has been recorded as far back as Hippocrates, the Father of Modern Medicine - 460 B.C. Hemorrhoids are dilated, swollen veins in and around the anus and lower rectum. They are similar to varicose veins of the legs. Symptoms include rectal bleeding, pain (severe on occasion) and itching (pruitis ani). Hemorrhoids are common, affecting up to half of the population by age 50. Increased risk factors include family history, constipation, diarrhea and pregnancy. Many cases of mild to moderate disease can be treated medically. Increasing fluid and fiber will decrease constipation and diarrhea. Warm tub baths will decrease symptoms, along with good hygiene and topical application of Vaseline or hand cream. Physician prescribed suppositories may be of benefit. When medical prescriptions fail, surgical correction is required. Translated from Hippocrates, treatment was as follows, "Having laid him on his back, force out the anus as much as possible with the fingers, make the irons red hot, and burn the pile until it be dried up. When the cautery is applied, the patient's head and hands should be held so that he may not stir, but he himself should cry out, for this will make the rectum project the more." Modern anesthesia has eliminated this scenario, but post-operative pain has continued to be a major factor preventing many patients from seeking a surgical option. That all changed with the introduction of a new procedure - PPH (Procedure for Prolapse and Hemorrhoids) introduced in the U.S. in October 2001. This procedure, instead of removing the prolapsed hemorrhoids, in a very pain sensitive area, "lifts up" or repositions the anal tissue. This reduces blood flow to the hemorrhoids which, consequently, causes shrinkage and ultimately their disappearance. Various studies report a patient satisfaction status of 90 percent or greater. Post-operative pain with PPH is much diminished. As with any surgical procedure, complications may occur but are relatively rare (10-20 percent) and most are not serious. The two most common are post-op bleeding (rarely requiring blood transfusion) and temporary urinary retention. Much more rarely, a more serious complication has developed. This procedure is done in the hospital using local anaesthesia with conscious sedation or spinal anaesthesia. Average operative time is 30-60 minutes. The average hospital stay is three to four days. The Fall Report is provided by Fall General Surgery, Ashland and Hayward, a practice that includes Dr. George Fall, general surgeon, James Fogarty, general surgeon, and James Nibler, general physician.