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.
See Dr. Wilson also at:
What a Difference
60 Minutes Can Make
It’s just an hour. At 2 a.m. on March 14, time changes as we “spring forward” one hour overnight. It wouldn’t seem to be that big of a deal, but it is according to researchers at the University of Michigan’s Center for Sleep Science. They have found that in the days immediately following the spring time change each year more people have serious car accidents, most likely due to the sleep loss and adjustments that our biological clocks must make to the new schedule.
To prepare for the time change, start going to bed and waking up 15 minutes earlier each day between now and the start of Daylight Savings Time. This helps reset your biological clock.
The spring time change isn’t the only time we should be concerned about our levels of sleep. According to the sleep researchers, adults ought to get 8 to 8.5 hours of sleep every night, but few of us do. This does more than leave us groggy in the mornings. Findings have shown that a lack of sleep may increase risks of obesity, diabetes, stroke and heart attacks.
The National Sleep Foundation offers this advice for healthy sleep:
