STORY BYExcuse the expression, but hemorrhoids can be a real pain in the rear. Just ask Amy Von Blon, who will tell you quite frankly that it's a painful, itchy nuisance that no one needs to live with.
As a result of multiple pregnancies, Von Blon had a chronic problem with hemorrhoids, a condition in which veins around the anus or lower rectum become swollen and inflamed. Traditional therapies, such as hemorrhoidal creams and suppositories, provided no relief from the pain, itching and bleeding. So Von Blon opted for a new surgical procedure to alleviate the symptoms.
Unlike the traditional hemorrhoidectomy, which can result in extreme pain and a lengthy healing process, a minimally invasive procedure for prolapse and hemorrhoids puts patients on the short, fast road to recovery. Dr. Erik Wilson, assistant professor of surgery, at The University of Texas Medical School at Houston , offers this alternative approach.
To understand the procedure, you must first understand what causes hemorrhoids. Everyone has hemorrhoidal veins. If they stay in place, they shouldn't cause any problems, but chronic constipation or diarrhea, excessive weight, aging and pregnancy can cause veins to weaken.
Gravity takes over, and those veins, along with the mucosa, which is the lining of the anus, can slide down and become kinked and engorged with blood.
Hemorrhoids, which are not life-threatening, are one of the most common ailments among the adult population. The American Society of Colon and Rectal Surgeons estimates that as many as 50 percent of Americans will have hemorrhoids during their lifetime.
But just because hemorrhoids are common and benign doesn't mean patients should self-diagnose, Wilson cautions. A doctor needs to evaluate suspected hemorrhoids, especially if there is bleeding. This could be a sign of a more serious health problem, such as colorectal cancer.
If it is indeed a hemorrhoid, symptoms may only last a few days. For some people, however, it is a constant problem that may warrant surgery.
The older surgical method involves substantial cutting to remove the stretched veins. This includes cutting nerve-filled skin on the outside of the anus, which is why patients may experience so much pain, Wilson explains.
Until the wounds from surgery heal, every time the patient has a bowel movement, there may be extreme pain. Bleeding may occur, and there also is a high-risk of infection. Because of swelling and irritation, it may be 4-6 weeks before the pain stops.
With the minimally invasive technique, Wilson doesn't cut the skin because he isn't removing the whole hemorrhoid. Rather, he is stapling the veins and mucosa back into place. It's the same idea as a facelift. He's just tucking what droops back into its normal, youthful position.
The little bit of cutting and stapling that is required is done above the "pain line," Wilson says, so patients may only experience pain or pressure for two or three days.
"With this new surgical approach, some patients don't feel any pain at all," says Wilson, a partner in Minimally Invasive Surgeons of Texas. "It's a lot less traumatic. With the traditional surgery, every time patients had a bowel movement, they had to pray. It was that painful. Surgery was often far worse than the symptoms for at least six weeks."
Von Blon said she didn't experience any pain after the minimally invasive outpatient surgery, which is done under general anesthesia. She had the procedure on a Friday, and was cooking for her family the very next day. Since then, she hasn't had any problems with hemorrhoids.
Wilson says the rate of hemorrhoid recurrence after surgery is low. With the traditional hemorrhoidectomy, the rate of recurrence over a patient's lifetime is between 10-20 percent. With the newer, minimally invasive technique, the rate also is believed to be low. As with any surgery, Wilson warned, there is a risk of bleeding, infection, scarring and recurrence, but if done by an experienced surgeon, those risks are minimal.
Also, surgery may not be the best solution for everyone. "Hemorrhoids don't turn into cancer. They aren't life-threatening. They can just be a nuisance," Wilson said. "It may not require surgery, but if it bothers you so much that it is affecting your lifestyle, it's worth pursuing treatment. We can fix it, and now we can fix it with a treatment that offers far less pain and discomfort."
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Dr. Erik Wilson is chief of the Division of Minimally Invasive and General Elective Surgery at the UT Medical School.
He also is medical director of bariatric surgery at Memorial Hermann - Texas Medical Center.
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Eating healthy
reverses metabolic syndrome
Dr. Tasnime Akbaraly of University College London and her colleagues were interested if healthy eating could actually turn-the-tide and reverse metabolic syndrome, which is having 3 or more of the following risk factors: excess abdominal fat; high triglycerides, hypertension, low levels of HDL the “good” cholesterol, or type 2 diabetes. Having metabolic syndrome doubles a persons’ risk of heart disease and greatly increases the odds of developing type 2 diabetes.
The researchers studied 339 British civil servants with metabolic syndrome, and how closely the adhered to the Alternative Healthy Eating Index (AHEI) to see if it could help reverse metabolic syndrome. The AHEI is a set of published nutritional guidelines by the Harvard School of Public Health in 2002 that emphasizes whole grains, fruits, vegetables and decreased red meat consumption.
Five years into the study, nearly 50% no longer had metabolic syndrome. People who followed the AHEI guidelines the closest were nearly twice as likely to have reversed their metabolic syndrome. The results of the study were published in Diabetes Care, online July 29, 2010.
Dr. Alice Lichtenstein, an expert on diet and heart health from Tufts University in Boston who was not involved in the study said, "It's not about focusing on individual components of the diet, it's really the whole package, and that becomes important because it means that if one of the components of a healthy diet is to eat more fruits and vegetables, just buying a pill saying that there's a concentrated extract of fruits and vegetables is probably not what's going to help you."
Call and make an appointment with Wellness Coach Sam Hester, CWC, CPT, LWMC, at 713-500-3327. It's confidential and free. For more information on the wellness services provided, visit UT Counseling and WorkLife Services.
