Who is suitable for ligation?
The method is used for internal hemorrhoids of the second and third stages. Through an anoscope, a latex ring is placed on the leg of the node, the blood flow stops, and after 7–14 days the node is rejected with the formation of a scar. The procedure is performed on an outpatient basis, without anesthesia or incisions, and takes a few minutes. One node is treated in one session; in case of multiple nodes, procedures are carried out at intervals of 2–4 weeks. Limitation: for external nodes and the fourth stage, the method is ineffective; hemorrhoidectomy is needed here.
When should hemorrhoids be operated on?
Conservative treatment - suppositories, ointments, phlebotonics - is effective in the first and second stages, when the nodes do not fall out or correct themselves. It relieves aggravation, but does not remove already formed nodes.
In the third and fourth stages, when the nodes fall out and do not reset on their own, with repeated bleeding with anemia and thrombosis, surgery remains a radical solution.
What are they often doing at the same time?
In a significant proportion of patients, hemorrhoids are combined with an anal fissure or anal polyp. It is irrational to eliminate them with separate operations: this is a second anesthesia and a second recovery period. Therefore, interventions are often combined—in one operation, nodes are removed and a fissure or polyp is excised at the same time.
Recovery
The most sensitive period is the first 7–10 days, especially the first bowel movements. The key condition for a smooth recovery is soft stools: a laxative diet, sufficient fluids and, if necessary, laxatives are prescribed. It is strictly forbidden to push during this period.