Dr. Khaldoun Ghareb |
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Dr. Khaldoun Ghareb is a colorectal and proctology specialist in the General Surgery Department of Medcare. He performs a full range of colorectal and rectal surgeries using advanced laparoscopic methods that do not depend on conventional procedures. He is an expert in surgical oncology and lower gastrointestinal surgery including diagnostic laparoscopy. |
Understanding haemorrhoids
Haemorrhoids (piles) are enlarged blood vessels that develop inside the rectum, or under the skin around the anus. They’re usually small, round, discoloured lumps. You can feel them on your anus or hanging down from your anal canal.
It’s normal to have blood vessels in your anus – they have an important role to play in continence. But when these veins get enlarged, they may cause pain or display the following symptoms:
So, let us understand, what causes haemorrhoids?
Typically, an increase in the pressure in the lower rectum can lead to haemorrhoids. This may be due to:
Self-management of haemorrhoids as the first line of treatment
You can reduce your chances of getting haemorrhoids and also manage your symptoms if you make a few changes to your diet and lifestyle such as:
Doctors use diagnostic tests to determine the correct line of treatment for your haemorrhoids, such as:
Medical intervention for treatment of haemorrhoids
Specific interventions depending on the size of the haemorrhoids and the severity of the symptoms are:
Minimally invasive modern interventions
Trans-anal Haemorrhoidal Dearterialization (THD) is a Doppler Guided Treatment that is less painful, affords faster recovery and does not create an anal wound as it’s performed without a traditional surgery.
Mucopexy is a surgical procedure, usually performed with TDH. Your surgeon will make a stitch around and through the length of the haemorrhoid. Both the ends (top and bottom) of the stitch are tied together, pulling up and strangulating the haemorrhoid. It’s a relatively pain free procedure and the patient can leave the hospital on the same day.
Trans-anal minimally invasive surgery (TAMIS): A specialized device is placed inside the anal canal to provide the surgeon access to the rectum. A high-definition camera and laparoscopic instruments are placed through the TAMIS device, allowing the surgeon to operate with the utmost precision.
What is bowel (faecal) incontinence?
Inability to control bowel movement, causing stools to leak suddenly from the rectum.
What are the possible causes of bowel (faecal) incontinence?
Possible causes of bowel incontinence include continuous diarrhoea, chronic constipation, haemorrhoids, muscle damage, nerve damage or pelvic floor dysfunction.
Who is at risk of developing bowel (faecal) incontinence?
Bowel incontinence is common in adults over sixty-five years of age, especially among women who have given birth or in patients who have undergone an anal operation.
How can bowel (faecal) incontinence be diagnosed?
Bowel incontinence may be diagnosed through a simple physical examination of the rectum by a doctor. Other tests like anorectal manometry in which a pressure monitor measures the strength of the sphincter muscles, an electromyography to assess the health of muscles and the nerves or an anorectal ultrasound which uses high-frequency sound waves to create images of tissue layers beneath the surface of the anal canal.
What are the treatment options for bowel (faecal) incontinence?
Conservative treatments include lifestyle and diet change, pelvic floor muscle exercises and biofeedback which is a type of bowel training exercise.
Another procedure without traditional surgery, in which a self-expanding material, equipped with shape memory, is used. After 24-48 hours from implantation, the prostheses expand by absorbing the physiological fluids and increase their volume up to 550% of their original size. Thanks to the "shape memory" effect, the implants are able to return to their initial shape following the movement of the anal sphincter.
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