New, less invasive techniques are transforming haemorrhoid surgery and improving patients' quality of life

Haemorrhoids are one of the most common proctological conditions. It is estimated that up to half of the adult population will suffer from them at some point in their lives. Although people are often embarrassed to seek medical advice, it is a medical problem with multiple treatment options, ranging from conservative measures to advanced surgical techniques.

At the Ruber Internacional Hospital in Madrid, the General and Digestive Surgery Department, headed by Dr. César Canales, benefits from the experience of Dr. Javier Die Trill, a general surgeon and specialist in coloproctology. Thanks to years of dedication in this area, Dr. Die Trill has achieved very satisfactory results in the comprehensive management of this condition.

‘There are many therapeutic possibilities, and they must be adapted to the size, degree and symptoms produced by the haemorrhoids. Today, surgical treatment does not have to be painful in most cases,’ explains the doctor.

What are haemorrhoids and how do they manifest themselves?

Haemorrhoids are normal vascular cushions in the anal canal, whose function is to contribute to sealing and continence. The problem arises when they become inflamed or prolapsed.

Dr Die TrillThere are internal haemorrhoids, which are not visible in the early stages and mainly manifest themselves through bleeding, and external haemorrhoids, which are covered with skin and more likely to cause acute pain when they become thrombosed.

The most common symptoms include:

Bright red bleeding during bowel movements.
Anal pain or itching.
Feeling of a lump or prolapse.
Mucous discharge or difficulty with hygiene.
‘Persistent bleeding, anal pain that does not improve, or a prolapse that does not reduce spontaneously are clear signs that you need to see a surgeon,’ emphasises Dr Die Trill.

Treatment options: from conservative treatment to advanced surgery

The approach does not always involve surgery, acknowledges the specialist at Ruber Internacional. In many cases, conservative treatment is sufficient to relieve symptoms and improve quality of life. This includes:

A diet rich in fibre and plenty of water to prevent constipation.
Hygiene habits that reduce straining during bowel movements.
Use of local ointments and venotonic medications that strengthen the vein walls.
When these measures are not effective, there are different surgical techniques, as explained by Dr Die Trill:

Elastic band ligation or ethoxysclerol sclerosis: these are performed on an outpatient basis, are quick and cause minimal discomfort. They are indicated for grade I-II internal haemorrhoids.
Classic haemorrhoidectomy (Milligan-Morgan or Ferguson, also with laser): indicated for grade III-IV haemorrhoids, it offers lasting results, although with a longer recovery time.
Stapled haemorrhoidectomy (PPH): currently less commonly used, with less post-operative pain and faster recovery in some selected cases.
‘The aim is to offer the patient the most effective treatment with the least possible aggression, always adapting to their clinical symptoms and concerns,’ explains Dr Die Trill.

Recovery and quality of life after surgery

Postoperative care requires maintaining a high-fibre diet, good hydration and avoiding straining during bowel movements. Mild pain or bleeding is normal in the first few days, but a specialist should be consulted if fever, persistent pain or heavy bleeding occurs.

‘Thanks to our accumulated experience and teamwork, we have managed to ensure that haemorrhoid surgery is no longer associated with a painful and traumatic process. Today, we can talk about extraordinary results that improve our patients' quality of life. Early diagnosis allows for simpler, less aggressive treatment with better results,’ says Dr Die Trill.