Treatment for Hemorrhoids

  • Best Treatment for Hemorrhoids that you need to See
    Most people may experience anal discomfort at some point in their Lives, but they don’t talk about it because it’s quite an embarrassing topic to discuss. The most common complain involve pain and itching and in some cases may even involve bleeding. “Anal diseases are any abnormalities in anus and the most common anal disease are hemorrhoids, anal fissure which is a wound in the anus and then fistulas or yung pigsa na pumutok na hindi gumagaling.” The risk increases especially if you have a poor diet and hygiene. Too much moisture in your bottom can also lead to itching.…
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  • Treatments for hemorrhoids | Colon and Rectal Specialist
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    Treatments for hemorrhoids | Colon and Rectal SpecialistMANILA, Philippines - Hemorrhoids are actually present in all individuals whether healthy or not. They are the vascular cushions which surround the general area of the rectum and anus. The term 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 affect quality of life and daily living.  There are many traditional remedies and non-surgical treatments…
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  • About Hemorrhoids
    MANILA, Philippines - Hemorrhoids are actually present in all individuals whether healthy or not. They are the vascular cushions which surround the general area of the rectum and anus.The term 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 affect quality of life and daily living. There are many traditional remedies and non-surgical treatments for hemorrhoids. However, if none of these…
    in Treatment for Hemorrhoids Read 8269 times
  • What are the symptoms of hemorrhoids?
     * What are the symptoms of hemorrhoids?  Bleeding from hemorrhoids is usually bright red, often dripping into the toilet bowl, or noticed when wiping. The stools themselves are normal looking, indicating that the bleeding is originating only from the anorectal area.  Sludge of dark blood and stool mixed thoroughly together is usually from a source within the small and large intestines and not hemorrhoids. Hemorrhoidal bleeding is painless, and this differentiates it from anal fissures, which is also a very common anal condition that presents with similar bright red bleeding during defecation, but with anal pain. Hemorrhoids only become painful…
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  • What are the forms of treatment – surgical and non-surgical?
     * What are the forms of treatment – surgical and non-surgical? Hemorrhoids only require treatment when there are symptoms.  And the type of treatment depends on the severity of symptoms.  Mild symptoms may be managed just by eating a lot of fiber and taking in bulk laxatives such as psyllium to improve the consistency of stools and ease bowel movement.  Some over-the-counter creams may provide symptomatic relief. Non-surgical and almost painless treatments for hemorrhoids include injection sclerotherapy, infrared photocoagulation (often mislabeled as “laser treatment”), and rubber band ligation, any of which can be done safely in the clinic as an…
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 * What are the symptoms of hemorrhoids? 

Bleeding from hemorrhoids is usually bright red, often dripping into the toilet bowl, or noticed when wiping. The stools themselves are normal looking, indicating that the bleeding is originating only from the anorectal area.  Sludge of dark blood and stool mixed thoroughly together is usually from a source within the small and large intestines and not hemorrhoids. Hemorrhoidal bleeding is painless, and this differentiates it from anal fissures, which is also a very common anal condition that presents with similar bright red bleeding during defecation, but with anal pain.

Hemorrhoids only become painful when they thrombosed or incarcerated.  Thrombosed hemorrhoids occur when blood clots within the hemorrhoids, causing very obvious swelling and pain.  While surgery for this may be effective during the first 4 days of the attack, if left alone the swelling and pain gradually subside and disappear after 2 weeks.  Usually this occurs just once or twice in a person’s lifetime, and it is uncommon to have repeated episodes of thrombosis. 

Doctors often classify patients as to having either external or internal hemorrhoids.  External hemorrhoids are located just outside the anus, and hence are always visible on routine inspection.  Many people have them without suffering from any symptoms, and therefore these may be safely left alone.  Sometimes external hemorrhoids may make cleaning difficult, allowing sweat and anal discharge to hide between folds, resulting in anal itching.

Internal hemorrhoids arise from inside the anus and are therefore only visible when, because of excessive laxity, they protrude outside.  This condition is called prolapsed, and usually occurs during defecation.  When internal hemorrhoids prolapsed they may either slip back inside on their own, or require manipulation by the person for it goes back in.  When the prolapsed hemorrhoids cannot be returned, they become trapped outside, resulting in pain and swelling.  This scenario is called incarcerated hemorrhoids.

 * What are the forms of treatment – surgical and non-surgical?

Hemorrhoids only require treatment when there are symptoms.  And the type of treatment depends on the severity of symptoms.  Mild symptoms may be managed just by eating a lot of fiber and taking in bulk laxatives such as psyllium to improve the consistency of stools and ease bowel movement.  Some over-the-counter creams may provide symptomatic relief.

Non-surgical and almost painless treatments for hemorrhoids include injection sclerotherapy, infrared photocoagulation (often mislabeled as “laser treatment”), and rubber band ligation, any of which can be done safely in the clinic as an out-patient procedure.  In scientific studies comparing these methods, rubber band ligation was found to be the most effective and cheap, which is why it is the most common non-surgical procedure for hemorrhoids in the world today.

Non-surgical treatment is often ineffective for large, incarcerated or thrombosed hemorrhoids.  Surgery is usually recommended in these situations, and also when non-surgical treatment has failed to relieve symptoms.  Traditional surgery requires cutting out the hemorrhoid using a variety of instruments such as scissors, knives, cautery, and ultrasonic dissectors. Unfortunately, any wound created in the outer skin of the anus results in often Sever post-operative pain, which is responsible for the reputation of hemorrhoid surgery being one of the most painful of operations.

* What are the advances in hemorrhoids treatment?

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 (which was modified from the staplers used to reconnect intestines during major abdominal surgery), the hemorrhoids are excised and the anus repaired from the inside, something which is difficult to do with traditional surgery.  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, although with a small recurrence rate.

                                                     

     Stapled Hemorrhoidectomy                           Transanal Hemorrhoidal Dearterialization (THD)

Another advanced surgical technique is Transanal 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.  However, because it is a new technique, not very many studies evaluating its long-term effectiveness have come out.

 All surgical procedures for hemorrhoids, whether traditional or innovative, may sometimes develop complications such as bleeding, infection and stricture. It is important therefore when seeking treatment, to see an expert in anal diseases.

 * What are some common misconceptions about hemorrhoid treatments?

One 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. 

Another misconception about hemorrhoid treatment is the use of lasers.  A true LASER is defined as Light Amplification by Stimulated Emission of Radiation, and in medical applications is used as a very fine, and precise cutting instrument (such as when in ophthalmology).  The technology is very expensive, and therefore using a true laser for hemorrhoid surgery makes the procedure quite prohibitive

There are other misconceptions in the public about hemorrhoid treatment. Unfortunately this is propagated by many false claims and unscrupulous practices.  Hemorrhoids are a very common condition that is often bothersome, sometimes very painful, but never life-threatening.  All symptoms must be evaluated by a doctor to make sure one truly has hemorrhoids. There are a variety of surgical and non-surgical options, and these should always be discussed first with an expert prior to making a decision on treatment.

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



MANILA, Philippines - Hemorrhoids are actually present in all individuals whether healthy or not. They are the vascular cushions which surround the general area of the rectum and anus.

The term 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 affect quality of life and daily living. 

There are many traditional remedies and non-surgical treatments for hemorrhoids. However, if none of these work, surgical procedures may be required as a last resort. 

Below are some misconceptions about hemorrhoids treatment and the truth behind each:

*Ano ang kulugo sa puwit?                         

Ang kulugo sa puwit o tinatawag ding “condyloma acuminate” ay parang mga butlig na nakapalibot sa puwit at maari ring hanggang sa may genital area. Ang sakit na ito ay maaring ituring na sexually transmitted disease (STD) o nakukuha sa pakikipagtalik. Ito ay maaring magsimula nang napakaliliit, parang ulo lang ng aspili o karayom at maaring lumaki nang lumaki at mapuno ang buong paligid ng puwitan. Karaniwang walang mararandamang pagkirot ang mga mayroon nito at maaring hindi mamalayan ang pagkakaroon nito. Kalaunan ay maaring makaranas ng mga sintomas tulad ng pangangati, pagkirot, at pagkakaroon ng mga maliliit na umbok o butlig sa puwitan.

Ano ang sanhi?                                               

Ang kulugo sa puwit ay sanhi ng papilomang birus na pantao (human papilloma virus o HPV). Ito ay naisasalin sa pamamagitang ng direktang kontak mula tao sa tao. Maari rin itong maisalin sa pakikipagtalik. Hindi kailangan ang anal sex upang magkaroon nito.

Dapat bang tanggalin ang mga kulugo?

Oo. Kapag ito ay hindi naalis, ito ay maaring lumaki at kumalat. Pag pinabayaan, tumataas ang panganib na ito ay maging kanser sa lugar na kinaroroonan.

Ano ang mga pwedeng ipanglunas?

Kung ito ay nasa maliit na lugar lamang, maari itong gamitan ng mga pamahid na gamot. Maari ring gumamit ng liquid nitrogen na magpapayelo (freeze) ng mga kulugo. Pwede rin itong tanggalin sa pamagitan ng operasyon (surgery) kung ito ay malalaki na o kaya ay nasa loob ng tumbong (rectum) o puwit. Ang operasyon ay karaniwang paghiwa o pagsunog sa mga kulugo. Ginagamitan din ito ng pampamanhid (anesthesia).

Kailangan bang maospital para sa opersyon?

Hindi. Ito ay karaniwang ginagawa lamang sa klinika bilang out-patient procedure.

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

2nd Floor, Podium Building, The Medical City,

Ortigas Avenue, Pasig City, Metro Manila

Tel No. (632) 9881000 or (632) 6356789 ext. 7789

www.colonandrectalspecialists.com , www.crsi.com.ph

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Clinic Hours: Mondays to Saturdays – 8:00 AM to 5:00 PM except Wednesdays

Ang Mga Espesiyalista

Manuel Francisco T. Roxas, M.D.

Robert L. Chang, M.D.

Catherine S. Co, M.D.

Carlo C. Cajucom, M.D.

Marc Paul J. Lopez, M.D.

Dione P. Sacdalan, M.D.

The colorectal cancer doctors are in: Dr. Marc Lopez and Dr. Dione Sacdalan are only the 20th and 21st graduates of the 29-year-old PGH program for colorectal cancer specialists. They’re available for consult at the country’s first outpatient colorectal specialty clinic in the country, located at the MEDICard Lifestyle Center in Makati.

In the Philippines, we can take heart in the fact that we have a lot of competent cardiologists around. And for those with sagging spirits who need a lift somewhere, they can revel in the fact that we do have a lot of very good plastic surgeons/dermatologists. But did you know that there are less than 40 colorectal surgeons in the Philippines, and that MEDICard Lifestyle Center has launched the first outpatient colorectal specialty clinic in the country?

  The clinic, which opened only last October, is designed to make cost-effective care for colorectal problems accessible to the public, what with colorectal diseases now the fourth leading cause of cancer deaths globally.

  “We can see patients for consult. We can also do out-patient procedures under local anesthesia. We can do endoscopies, minor operations like excisions of hemorrhoids, management of fissures in the operating room of this building,” says Dr. Dione Parreño-Sacdalan, one of only two practicing female colorectal surgeons in the country today, the other being Dr. Catherine Sim Co. Both are affiliated with PGH and The Medical City.

 Dr. Sacdalan had her post-residency training in colorectal surgery at the Philippine General Hospital (PGH). She also had further training focusing on anorectal diseases and minimally invasive surgery at the Chulalongkorn Memorial Hospital in Thailand and had colorectal observership stints in the University of Minnesota Medical Center in Minnesota and Memorial Sloan-Kettering Cancer Center in New York, USA.

 “We’re the first organized group of colorectal surgeons offering outpatient clinic services in the country,” Dr. Marc Paul Jose Lopez introduces himself. “There are a lot of concerns among a good part of the population about colorectal diseases, anorectal diseases such as hemorrhoids, abscesses (pigsa) and fissures (punit sa puwit). The spectrum goes further down to colorectal cancer, which is at present on the rise.”

 Dr. Marc Paul Jose Lopez is one of the two male colorectal surgeons in the clinic, the other one being Dr. Carlo Cajucom. Dr Lopez had his post-residency training in colorectal surgery at PGH and his post-fellowship training in advanced laparoscopic colorectal surgery in Vietnam. He also had further training in colorectal surgery specializing in anorectal diseases and laparoscopic colorectal surgery in Thailand. He is currently a consultant at PGH, Asian Hospital and Medical Center, and Manila Doctors Hospital.

While there’s no clear shred of evidence on what causes colorectal cancer, the problem is mostly associated with low fiber and high animal fat intake.  

 Dr. Sacdalan gives us the lowdown: “There are different regions in the gastrointestinal tract. From the mouth, the food goes to the esophagus and then to the stomach. And then it goes to the small intestines, then the large intestines or the colon, and then down into the rectum and out into the anus. In cases of colorectal cancer, we have to differentiate where the mass is because the management differs. That’s one of the things we’re able to provide to our patients: an in-depth discussion not only of the disease but how it will affect them and their families.”

 What are the symptoms?

 “Still most common when it comes to the colon is abdominal pain; for rectum, it’s blood in the feces,” Dr. Lopez asserts. “Symptoms of abdominal pain, difficulty in defecation, blood in your stools may already indicate that in all likelihood your tumor may be in an advanced stage or it may already be huge. That’s why we advocate screening for the general population when they’re not feeling anything yet. The recommendation is that at 50 years of age, particularly for those with no family history of colorectal cancer, without any symptoms, they come in and we can perform a screening procedure on them. It can start earlier if the patient’s father or mother has colorectal cancer.”

 “We catch these patients already in an advanced stage because we don’t have a screening program similar to what they have in the States or Australia, where patients have access to medical care,” Dr. Sacdalan explains. “And if we recommend colonoscopy, for instance, for an average-risk patient, it would cost a lot. The cost in itself is prohibitive (a colonoscopy generally costs P15,000 to P25,000, depending on who will do it, where it will be done, etc.).”

 She points out, “Screening will demonstrate possibly polyps and hinder growth later on. Or if there’s a cancerous mass already, we can recommend treatment while it is still at an early stage.”

 Dr. Lopez laments, “The sad part is that screening is not part of our national health program, even in hospitals, there’s no hospital-based screening program. Unfortunately, this being the state of health of the country, we get most of our patients in Stage III already. When in fact we can get them in the earlier stage, of course it follows that the prognosis or outcomes are expected to be better.”

 Dr. Sacdalan notes with concern, “What’s sad is people don’t know that screening is needed at age 50, or as early as 40, if there’s a history of colorectal cancer in the family.”

 Sadder still is the fact that today, there are more young people, as young as 20, getting colorectal cancer in an advanced stage.

“There have been studies by one of our colleagues, that for Filipinos, the average age at time of diagnosis is earlier than that of Westerners and that it’s more aggressive,” says Dr. Sacdalan.

 “MEDICard accommodates cardholders who come for screening,” Dr. Lopez assures patients.  

What took the colorectal clinic so long to open?

Dr. Lopez hastens to reply, “It took long to have this because there’s only a limited number of colorectal surgeons in the country. In the society, there are only around 40 colorectal surgeons. Right now, there are only three training programs in the country — one at PGH, Jose Reyes Memorial Medical Center, and a new one in Davao.”       

 Marc and Dione are only the 20th and 21st graduates of the 29-year-old PGH program. The focus should be on prevention, early consult, and early detection.

 There comes a ray of hope: “If we catch them in the late stages, there’s still very much a chance for cure,” Dr. Lopez stresses. “When it comes to survival for colorectal cancer, it’s very good now as opposed to, say, when I was just a trainee because there have been a lot of improvements not only in the surgical techniques but also in terms of the other therapies, like chemotherapy and radiation. Even patients in Stage IV whom we would write off already before, now have a chance of even a cure, if not a better life. For Stage I patients, more than 90 percent are doing well in five years. It’s really better to catch it early for a better prognosis and there will be better outcomes.”

 The MEDICard Lifestyle Center Colorectal Clinic is now in the forefront of colorectal care in the Philippines. They utilize the multi-disciplinary team approach of management. “It’s not just the surgeon who decides or recommends whatever’s needed for the patient,” Dr. Sacdalan points out. “We also involve the medical oncologist, radiation oncologist, and other specialties like palliative care if it’s Stage IV or a pain specialist. The permutation of options is endless. It’s important that all the specialties are around so they can come up with the best approach for this particular patient. We try to tailor the treatment, depending on the patient’s preferences, their goals for treatment, their financial capability.”

 Colorectal Specialists offers diagnostic examinations such as examination for common anorectal conditions, sexually transmitted diseases, endorectal and endoanal ultrasonography. It offers treatments for hemorrhoids and fissures, acute and chronic anal pain, fecal incontinence and constipation, anal abscess/anal fistula, anal warts, inflammatory bowel disease, colorectal tuberculosis. And of course, it specializes in comprehensive management of colon and rectal cancer.

 Its staff offers state-of-the-art treatment options for hemorrhoids like rubber band ligation, stapled hemorrhoidopexy and trans-anal hemorrhoidal dearterialization (or THD).

For colorectal cancer which will entail hospital admission, the colorectal specialists offer minimally invasive surgery or laparoscopic surgery, robotic colorectal surgery, and anal sphincter preservation, which can be done at their affiliate hospitals. Some benign anorectal diseases can be managed in the clinic setting under local anesthesia while others can be performed in the operating room but still as a day or out-patient procedure. Not all colorectal and anal problems are managed surgically. Non-operative treatment options may be recommended when deemed necessary.

 For any problems, embarrassing as they may seem, down there on your bottom, help is always available since there are colorectal specialists in the house!

It has claimed the lives of famous and powerful people – from local and Hollywood stars, to politicians, models, etc. The fact that they succumbed to this deadly disease is proof that colon cancer does not discriminate between rich and poor, young and old or male and female.

And despite the media exposure it has been getting lately, the number of colon cancer patients continue to rise. In 2008, it has caused 608,000 and experts say this number will continue to grow in the coming years. To date, colon cancer is now the fourth leading cause of cancer deaths globally.

However daunting the scenario may be, there are ways to prevent colon cancer.  Awareness, prevention, early detection and screening are the main weapons against this menacing disease.  Fortunately, cost-effective care for colorectal problems is easily accessible at Colorectal Specialists, Inc., (CSI) located at the MediCard Lifestyle Center.

CSI is the only specialty clinic in the country where colorectal surgeons are grouped together to offer outpatient clinic services.  It is at the forefront of colorectal care in the Philippines, utilizing a multi-disciplinary team approach of management.  This means that it’s not only the surgeon who decides or recommends what a patient needs.  The medical oncologist, radiation oncologist and other specialties like palliative care are involved.  CSI at the MediCard Lifestyle Center offers state-of-the-art treatment options for haemorrhoids like rubber band ligation, stapled hemorrhoidopexy and tran-anal hemorrhoidal dearterialization or THD.

“We deal with all kinds of colorectal pathology, from benign to malignant cysts, even anorectal, which means from the anus to the anal canals including haemorrhoids, fistula, fissures, incontinence, constipation and of course colon diseases like infections, inflammations and cancers,” says Dr. Carlo Angelo Cajucom, one of four colorectal surgeons in CSI.

Dr. Cajucom earned his medical degree from the University of Santo Tomas and did his general surgery residency at Quirino Memorial Medical Center.  He then had his fellowship training in colorectal surgery at the Jose Reyes Memorial Medical Center, as well as post fellowship training in Sydney’s Royal Prince Alfred Hospital.

Dr. Cajucom underscores the importance of early detection of signs and symptoms so patients can easily be diagnosed and treated before the disease becomes advanced.  This is especially important in a country like the Philippines, where the majority of patients are diagnosed in the very late stages and where there is no screening.  Unlike countries like the US or Australia, the Philippines does not have a screening program. 

Dr. Cajucom adds that people who belong to the general risk population, meaning those who are not predisposed to having colorectal cancer, must have themselves screened at age 50, every three to five years.  Those at high risk must undergo screening at least upon reaching 40 or 10 years before.

“Supposing you have a relative who was diagnosed with colorectal cancer at 38 years old, then you must have yourself screened at 28 years old,” explains Dr. Cajucom.  He adds that those who are extremely high risk must be screened as early as 10 – 12 years old.    

Dr. Cajucom notes that people should watch out for the following risk factors for colorectal cancer: strong family history or genetics, aging, low fiber intake and those who like to eat grilled or red meat.  He adds that the symptoms to watch out for include abdominal pain, fecal blood, and difficulty in defecation.

More than being mindful of the risks, Dr. Cajucom encourages people not to feel embarrassed to seek medical attention in case they experience symptoms of colorectal disease.  After all, the stigma won’t help anyone recover from cancer.

To know more about colorectal diseases and how you can prevent or cure them, visit Colorectal Specialists, Inc. at the MediCard Lifestyle Center, 51 Paseo de Roxas corner Buendia Avenue, Makati City from Mondays through Fridays, 1-7 pm and Saturdays from 9 am – 3 pm. You may also call them 555-0832.  Equally competent doctors in the said facility include Dr. Catherine Co, Dr. Dione Sacdalan and Dr. Ancoy Lopez.

MEDICARD recently opened its Colorectal Specialist Clinic - a first in the HMO industry.

Located at the MEDICard Lifestyle Center at the corner of Paseo and Buendia St., Makati, the clinic offers the latest technology and expertise in colorectal healthcare.

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