Hemorrhoids: Symptoms, Treatment, and Surgery Concerns - Surgery

Dr. Ke Fangxu reply Surgery

---

Hello,
1.
There is no medical evidence to support that staying up late causes hemorrhoids; however, many patients with hemorrhoid flare-ups in the clinic do not have other contributing factors besides lack of sleep.
Prolonged sitting, standing, or squatting can lead to poor blood circulation, which may cause hemorrhoids to swell and bleed, indeed worsening the symptoms.
2.
Young, slender women often experience habitual constipation, which is sometimes not due to poor lifestyle habits but rather a unique condition in these patients.
This usually improves with age, and some patients have reported that their symptoms resolved after pregnancy.
Generally, for these patients, increasing water intake or using laxatives is not very effective.
I do not recommend frequent use of enemas at such a young age; however, these patients often experience remarkable improvement with fiber supplements.
I usually suggest taking fiber supplements for a period and gradually increasing the intake of fruits and vegetables in their daily diet.
3.
Hemorrhoidal tissue can become engorged and swollen during bowel movements due to straining and the squatting position, which is the cause of burning pain.
Additionally, the swelling of hemorrhoidal tissue can create a sensation of incomplete evacuation.
Therefore, we recommend shortening the time spent on the toilet, aiming for efficiency.
Even if there is still a feeling of urgency, it is advisable to leave the bathroom and move around; the urge will typically subside once the hemorrhoidal tissue reduces in size.
If the urge persists, returning to the toilet later is acceptable.
4.
After hemorrhoid surgery, aside from experiencing pain and abnormal sensations for one to two weeks, there are generally no significant long-term complications.
Most patients will fully recover within a month.
The original appearance of the hemorrhoids will depend on the size of the external hemorrhoids; if they are large, small skin tags may remain after surgery, but this will not affect anal function.
5.
It is true that there is a possibility of recurrence if a patient becomes pregnant after surgery, which is why I do not often recommend surgery for very young patients.
However, if the hemorrhoids have reached a significant size, undergoing surgery beforehand can be a proactive measure to avoid complications during pregnancy.
6.
Habitual constipation is not linked to cancer; this is often sensationalized by over-the-counter medication or "laxative tea" sellers.
Surgery is generally recommended in several situations: first, if there is frequent and significant bleeding that is unresponsive to medication, leading to anemia, as surgery may be life-saving; second, if acute flare-ups cause extensive swelling, prolapse, and severe pain, as surgery may prevent further damage to the anal sphincter; third, if severe prolapse affects daily activities, requiring excessive time to manage after bowel movements, causing inconvenience in work or school; fourth, patients may request surgery even if the physician believes the condition is not severe, as the patient's suffering is paramount.
Typically, hemorrhoid surgery is performed without blood transfusions unless there is pre-existing severe anemia.
Generally, young women should have hemoglobin levels between 12 and 14; if below 8, a transfusion may be necessary before surgery.
Whether the patient has anemia needs to be confirmed through blood tests.
Hemorrhoid surgery performed under spinal anesthesia indeed requires the patient to lie flat for eight hours post-operation to prevent cerebrospinal fluid leakage, which can cause severe headaches.
However, if general anesthesia (intravenous sedation) is used, the patient can resume activities and eat without needing to fully awaken.
Severe hemorrhoids usually develop over many years, and abnormal lifestyle and bowel habits are significant contributors to their worsening.
Regardless of whether surgery is performed or if hemorrhoids are present, maintaining good dietary habits and a healthy lifestyle is essential.
Ultimately, these are common recommendations; one should not take their youth for granted and engage in reckless behavior, as neglecting health can lead to difficulties later on.
Wishing you a speedy recovery!

---

Reply Date: 2010/01/08