Common Misconceptions about Treatments for Hemorrhoids

Hemorrhoids are actually present in all individuals whether healthy of not. They are the vascular cushions which surround the general area of the rectum and anus. The term we call hemorrhoids is associated with the symptoms when this part of the body becomes enlarged, inflamed, thrombosed or prolapsed. Many people have them without suffering from any symptoms, and therefore these may be safely left alone. Treatment is usually required for those whose hemorrhoidal symptoms such as excruciating throbbing pain impact on quality of life and daily living. There are many traditional remedies and non-surgical treatments for hemorrhoids. However, if none of these works, surgical procedures maybe required as a last resort. There are common misconceptions about hemorrhoids treatments that hinder sufferers to seek medical attention.

Misconception No.1- All surgical procedures for hemorrhoids are very painful. Due to this reputation of being a painful operation, advances in hemorrhoid surgery have focused on making it less painful.  One such operation is stapled hemorrhoidectomy. Using a specially-designed, single-use stapler instrument the hemorrhoids are excised and the anus repaired from the inside. The end result is that the surgical wound is inside, and no wound is visible outside the anus. Scientific studies have proven that this is less painful than traditional surgery.

Another advanced surgical technique is Transarterial Hemorrhoidal Dearterialization (THD).  Using a doppler ultrasound, the blood vessel supplying the hemorrhoid is identified and ligated with stitches.  Deprived of its blood supply, the hemorrhoid then shrinks and shrivels.  Again there is no wound outside and is therefore almost painless. 

Misconception No. 2 – Another more common misconception about surgery for hemorrhoids is that it can cause fecal incontinence, or the inability to control farting or defecation.  Again this is not true. Properly done hemorrhoid surgery, using any of the techniques discussed previously, does not entail cutting or injuring the anal muscles.  Therefore no complication such as incontinence should develop. 

All surgical procedures for hemorrhoids, however, whether traditional or innovative, may sometimes develop complications such as bleeding, infection and stricture. It is important therefore when seeking treatment, to see practitioners with real expertise in performing such procedures.

Colorectal Specialists provides comprehensive, advance and efficient care to wide range of colorectal conditions. Its expertise is in the surgical management of colorectal cancer, diverticulitis, inflammatory bowel diseases, and other benign disorders like hemorrhoids, fissures, fistulae, polyps, fecal incontinence, sexually transmitted diseases (STDs), and other colorectal problems. It always strives to provide comfort, privacy and total quality service to its clienteles.

Rectal Cancer 

1. What is Rectal Cancer?

Rectal Cancer is cancer is a tumor arising from the lowest 15 centimeters of the large intestines, lying within the pelvis and connecting the colon to anus. Rectal cancer, unlike colon cancer, has a tendency to recur locally within the pelvis in the other organs near the colon and has a worse outcome. Local recurrence of rectal cancer is common (15-45%) after standard surgery and is often catastrophic. It is difficult to cure, and the associated symptoms are debilitating. Accordingly, preventing local recurrence is one of the main treatment goals with rectal cancer. Roughly one third of all colorectal cases involve the rectum.

2. How does one know if one has rectal cancer?

Rectal cancer can cause many symptoms that require a person to seek medical care. However, rectal cancer may also be present without any symptoms, hence it is important to have routine health screening check up. Symptoms, to be aware of include the following:

* Bleeding

- Seeing blood mixed with stool is an urgent sign. Although many people bleed due to hemorrhoids, a doctor should be notified in the event of any rectal bleeding. It is a sad fact that many patients with rectal cancer attribute their symptoms to hemorrhoid, causing them to delay consultation.

-  Prolonged rectal bleeding (perhaps in small quantities not seen in the stool) may lead to anemia, causing fatigue, shortness of breath, light-headedness, or a fast heartbeat.

* Obstruction

-  A rectal mass may grow so large that it prevents the normal

passage of stool. This blockage may lead to the feeling of severe constipation or pain when having a bowel movement. In addition, abdominal pain  and cramping may occur due to the blockage.

- The stool should pass around the rectal mass. Therefore,

pencil-thin stool maybe another sign of an obstruction from rectal cancer.

-  A person with rectal cancer may have a sensation that the stool cannot be completely evacuated after a bowel movement, requiring frequent trips to the bathroom.

* Weight loss, usually unexplained

3. Who are at risks/what are the risk factors?

The actual cause of rectal cancer is unclear. However, the following are risks factors for developing rectal cancer:

* Increasing age

* Smoking

* High-fat diet and/or diet mostly from animal sources

* Personal or family history of colorectal cancer or polyps in the colon

 * Lack of screening for colorectal cancer

 4. What happens if you have rectal cancer?

Rectal cancer usually develops over several years, first growing as a benign precancerous growth called a polyp. Some of these polyps will eventually turn into cancer and begin to grow and penetrate the wall of the rectum, after which they spread into the lymph nodes and reach other organs like the liver and the lungs.

 5. How is rectal cancer diagnosed?

Screening for rectal cancer is the only way to prevent this disease. Screening test  for rectal cancer include the following:

* Fecal Occult Blood Test  (FOBT)

* Endoscopy, wherein a doctor inserts a scope through the anus. The scope  maybe rigid, as in proctosigmoidoscope or flexible and connected to a video camera, as in colonoscopy (which views the entire colon) or flexible sigmoidoscopy (which views the lower part of the colon). If a rectal tumor is found on endoscopy, a biopsy is performed. If biopsy confirms that it is rectal cancer, the next important phase in management is accurate staging of the disease, which will determine the appropriate treatment. Stage I patients can be treated by surgery alone, while stage II and III patients will require radiochemotherapy  prior to surgery. The treatment for stage IV patients is best individualized. The test to stage rectal cancer include:

* Endorectal Ultrasound is a test where a special ultrasound probe is inserted into the anus, with a unique ability to determine how deep the tumor has grown into the rectal wall; whether there is a spread to the lymph nodes around the area; and whether there is invasion into the anal muscles.

* CT scan and MRI to evaluate the tumor in relation to the pelvis, as well as check for spread to the liver.

* Chest x-ray or CT scan of the lungs

* CEA blood test

6. What are the available treatment options?

 The standard surgical procedure is called wide or total mesorectal excision. Preoperative chemoradiotherapy  has been found to reduce the risk of local recurrence and to cause fewer long-term toxic effects than if the chemoradiotherapy  is given postoperatively. At five years, the overall survival among patients with locally advanced rectal

cancer, irrespective of whether they have had preoperative or postoperative chemoradiotherapy is about 75%.

A common concern among patients with rectal cancer is possibility of permanent colostomy, where the anus is removed and feces is made to come out of an opening in the abdominal wall. Thankfully, with the appropriate use of preoperative chemoradiotherapy and the surgical

Technique of total mesorectal excision, surgeons are now more able to preserve the anus during rectal cancer surgery. However,  this highly complex operations usually will necessitate the creation of a temporary colostomy in order to prevent the passage of feces  into the freshly reconstructed anus. This temporary colostomy is then closed in a separate operation later, when the anus is completely healed.

 At present, a permanent removal of the anus with the creation of  a colostomy , is only performed if there is evidence on endorectal  ultrasound that the anal muscles are involved. This situation is uncommon, and occurs in less than 20% of the cases.

 7. What are the outcomes of rectal cancer?

 The outlook for recovery from rectal cancer is unique for each individual. Many factors are involved when considering the chance of survival after rectal cancer treatment.Treatment of rectal cancer depends on the stage or extent of disease.

 According to stage, the following approximations of the likelihood of survival 5 years after treatment are as follows:

Stage I - The cancer is in the inner layers of the rectum, and the probability of being alive in 5 years is approximately 70-80%.

 Stage II -  The cancer has spread through the muscle wall of the rectum, sometimes invading adjacent organs like urinary bladder, vagina or prostate. The probability of being alive in 5 years is approximately 50-60%.

 Stage III - the cancer has spread to the lymph nodes. The probability of being alive in 5 years is approximately 30-40%.

Stage IV - the cancer has spread to other organs far from the rectum, like the liver and lungs. The probability of being alive in 5 years is less than 10%.

Services Available:


1) Fecal Occult Blood Test  (FOBT) yearly with flexible sigmoidoscopy every 3 years

2) Colonoscopy every 5 to 10 years

3) Virtual CT colonography every 3 to 5 years.


1) Colonoscopic Polypectomy

Comprehensive Rectal Cancer Treatment Program

* State-of-the-art Staging Modalities

1) Endorectal Ultrasound

2) Triphasic CT scan

3) MRI

* Multidisciplinary Treatment planning

* Neo-adjuvant (Preoperative) Chemoradiotherapy

* State-of-the-art Surgery

1) Total Mesorectal Excision

2) Sphincter-preservation, avoiding permanent colostomies

3) Pelvic Nerve Preservation

4) Minimally-invasive surgery

* Note: This information is not intended as a substitute for professional medical advice. For any inquiries please visit or call your specialists.

Mga Kaalaman tungkol sa Almoranas


 * Ano ang Almoranas?

Ang almoranas ay binubuo ng mga ugat, balat at malambot na kalamnan na nakapalibot sa ating tumbong at puwet.  Ito ay may babahagyang ginagampanan sa ating pagdumi. Lahat tayo ay mayroon nito, ngunit sa pagdaan ng mga araw ng pagdumi at pag-iri, ito ay nagbabago, nagiging maluwag at  mahina habang tayo ay tumatanda.

Ang sakit na ating tinatawag na almoranas  ay nararanasan kapag ang paghina at pagluwag na ito ay nagkakaroon ng  mga sintomas o palatandaan tulad ng pagdurugo, pananakit at paglabas ng ilang bahagi nito sa butas  o labasan ng ating dumi.

Halos lahat tayo ay maaring makaranas ng mga sintomas ng almoranas sa iba‘t-ibang panahon ng ating buhay ngunit ito ay maari lamang hayaan at hindi nagdudulot ng panganib. Ang pagsangguni sa doktor ay kinakailangan kung ang mga sintomas ay nakakasagabal  sa pangaraw-araw na pamumuhay. 

    * Ano ang mga sintomas o palatandaan ng almoranas?

Ang pagdurugo mula sa almoranas ay mapapansin bilang mapula at sariwang bahid ng dugo  sa dumi. Ito ay nagangahulugan na ang pagdurugo ay nanggagaling lamang sa ibabang bahagi  ng tumbong o puwet.  Ang maitim na dugo na nakahalo sa dumi ay nangangahulugan na ang pagdurugo ay nanggagaling sa maliit o malaking bituka (colon) at hindi sa almoranas. Ang pagdurugo ng almoranas ay walang kasamang kirot kumapara sa anal fissure na may katulad na mapula at sariwang  bahid ng dugo subalit may kasamang pagkirot at pananakit.

Makakaramdam lamang ng matinding pagkirot o  pananakit  kung ang almoranas ay mamaga  lumabas sa tumbong at maipit. Ang pamamaga ay karaniwang  dulot ng pamumuo ng dugo (thrombosis) sa mga ugat ng almoranas. Ang operasyon o ang pagtanggal nito ay epektibo lamang sa loob ng apat na araw. Kung ang almoranas ay hahayaan, ang kirot at pamamaga  ay dahan-dahang mawawala sa loob ng 2 Linggo. Ang ganitong pamumuo ng dugo ay mararanasan lamang nang 1 o 2 beses ng isang tao sa kanyang buong buhay. Bihira itong maulit muli

 May dalawang uri ng almoranas ayon sa mga eksperto.  Ang una ay makikita sa labas ng butas ng puwet (external) Ito ay pangkaraniwan at hindi nagdudulot ng anumang sintomas. Mas makabubuti na ito ay hayaan lamang . Paminsan-minsan ang ganitong uri ng almoranas ay nagdudulot ng pangangati (anal itching) ng maaring dulot ng pawis, o mga duming naiiwan  sa mga gitla ng puwet.

 Ang pangalawang uri ng almoranas ay iyong matatagpuan sa loob ng  tumbong (internal). Ito ay makikita lamang kapag ito ay lumabas sa butas ng puwet (prolapse) pangkaraniwan habang dumudumi at umiire. Ang lumabas na almoranas ay maaring bumalik sa loob nang mag-isa  o mangangailangang ibalik  sa pamamagitan ng  pagtulak ng daliri. Kung ito ay hindi maibalik sa loob, ito ay mananatili sa labas, maiipit o masasakal, mamamaga at  magdudulot ng matinding pagkirot (incarcerated hemorrhoids).

    * Ano ang nararapat na  lunas  sa almoranas- operasyon o hindi?

 Ang almoranas ay nangangailangan lamang ng lunas kung ito ay kakikitaan ng sintomas.  Ang mga bahagyang sintomas ay maaring mabigyang lunas sa pamamagitan  lamang ng pagkain ng mga gulay, prutas at mga pagkaing mayaman sa hibla o fiber. Maaari ding uminom ng psyllium (bulk fiber)  upang mapadali ang pagdumi.  Ang ilang mga pamahid na gamot na mabibilil ay maaari ding magbigay ng pangunahing lunas sa mga sintomas.

May mga paraan ng paggamot na hindi masakit at hindi nangangailangan ng operasyon. Kabilang dito ang injection sclerotherapy, infrared photocoagulation (na madalas naipagkamali na “laser treatment”), at rubber band ligation.  Alin man sa mga ito ay ligtas at maaring gawin sa klinika ng isang espesiyalista.  Sa isang pag-aaral na isinagawa ng mga eksperto na naghahambing sa mga pamamaraang ito, sinasabing ang rubber band ligation ang pinakamura at pinakamabisa. Ito ang dahilan kung bakit ito ang nanguna sa mga  ganitong uri ng panglunas

 Sa isang banda, may mga kaso ng almoranas na maaring  matugunan lamang ng isang operasyon.  Kabilang na dito ang malalaki at  mga naipit (incarcerated) . Ang karaniwang operasyon ay ginagamitan ng iba’t ibang instrumento  tulad ng  gunting, lanseta,  cautery, at  ultrasonic dissectors. Karaniwang  ang hiwa at sugat bunga ng operasyon  ay nagdudulot ng matinding pagkirot. Ito ang isang  dahilan kung bakit ang operasyon ng almoranas ay naituring na isa sa mga pinakamasakit na operasyon.

  * Ano ang mga makabagong pamamaraan  sa  paggamot ng almoranas?

Ang isa pang makabagong pamamamaraan ay tinatawag na Transarterial Hemorrhoidal Dearterialization (THD). Ito ay ginagamitan ng doppler ultrasound. Ang ugat na dinadaluyan ng dugo sa almoranas ay hinahanap at tinitalian sa pamamagitan ng pagtahi. Ang pagkaputol ng pagdaloy ng dugo ang siyang nagpapaimpis at nagpapaliit ng almoranas. Ito ay halos wala ring sakit at walang sugat sa labas na makikita.

 Ang isa pang makabagong pamamamaraan ay tinatawag na Transarterial Hemorrhoidal

 Dearterialization (THD).  Ito ay ginagamitan ng doppler Ultrasound. Ang ugat na dumadaloy sa almoranas ay hinahanap at tinitalian sa pamamagitan ng pagtahi. Ang pagkaputol ng pagdaloy ang siyang nagpapaimpis at nagpapaliit ng almoranas. Ito ay halos wala ring asakit at walang sugat sa labas na makikita.


    * Ano ang mga karaniwang  maling akala tungkol sa almoranas?


Ang isa sa mga maling akala tungkol sa almoranas ay ito lang ang natatanging sakit sa puwet. Halos lahat ng mga sintomas ay hinihinalang almoranas kahit na ito ay maaring fissures, impeksiyon o maging kanser . Kaya’t kinakailangan ng opinyon ng eksperto upang malaman ang tunay na problema.

Ang isa pang maling akala tungkol sa almoranas ay maari ito maging kanser. Ito ay hindi totoo.  Ang almoranas ay hindi kumakalat at hindi mapanganib sa buhay.  Maaaring may mga pangyayari na ang kanser ay naipagkamaling almoranas nang unang tingnan ng doktor at nang lumaon ay napatunayang ito ay kanser pala.

Ang isa pang pagkakamali ay ang pag-aakalang  ang pag-opera ng almoranas ay makakapagdulot ng pagkawala ng pamigil sa pagdumi (incontinence). Ito ay hindi totoo. Ang operasyon na isinagawa ng totoong eksperto ay walang kumplikasyon at hindi makapagdudulot  ng ganitong  problema.

Ang isa pang maling kaalaman tungkol sa paggamot ng almoranas ay ito ay ginagamitan ng laser.  Ang totoong LASER (Light Amplification by Stimulated Emission of Radiation) ay may kamahalan at hindi karaniwang ginagamit  sa operasyon ng almoranas.


Marami pang ibang maling akala ang madla tungkol sa almoranas at ito ay patuloy na naipapalaganap  ng mga walang tunay na kaalaman sa sakit na ito.  Ang almoranas ay pangkaraniwang nararanasan. Ito ay maaring magdulot ng labis na pananakit at abala sa pangaraw-araw na pamumuhay ngunit ito ay hindi nagdudulot na panganib sa buhay.  Ang lahat ng sintomas na mararanasan ay nararapat na isangguni sa doktor upang  malaman kung ito ay totoong almoranas. Maraming mga pamamaraan ang mapagpipilian - maaring gamitan  ng operasyon o hindi. Kinakailangan ng opinyon ng eksperto bago  magpasiya.


*  Ang impormasyong ito ay hindi pamalit sa mga payong  medikal. Magtanong  at sumangguni sa mga espesiyalista.

Page 14 of 14