By Dr. W. Gifford Jones
Would Napoleon Bonaparte have been victorious at Waterloo if he hadn't been suffering from hemorrhoids? If cryosurgery had been available, would it have changed the outcome? No one knows the answer. But even when you're not on horseback directing a battle, it's hard to concentrate while suffering hemorrhoidal pain. Fortunately, most hemorrhoids can now be treated effectively with little discomfort by cryosurgery.
Hemorrhoidal sufferers should first beware of over-the-counter medication. The Johns Hopkins Medical Letter points out that some ingredients in such therapies are potentially harmful. Boric acid is safe when applied to the skin as an antiseptic. But it can be toxic when it's absorbed through the thin mucous membranes lining the rectum.
Don't be fooled by labels stating that a product contains turpentine oil, Peruvian balsam, camphor, lanolin or alcohol. This conveys the impression that these ingredients are important for healing. However, The U.S. Federal Drug Administration claims the healing and pain-reducing properties of these agents have never been proven.
Laugh at T.V. ads that claim a medication relieves internal rectal pain. This is an impossible assertion since there are no nerve endings inside the rectum. Patients' symptoms are caused by external irritation around the rectal area.
It's been aptly said that, "He who treats himself has a fool for a patient". Being your own doctor can be particularly dangerous if you suffer from diabetes, hypertension, heart or thyroid disease, or have difficulty urinating due to an enlarged prostate gland. Medications that state they shrink hemorrhoidal tissues may have an adverse effect on these conditions.
For years patients have endured swollen, bleeding hemorrhoids because they fear the cure is worse than the disease. Now a technique called, "cryosurgery" makes this fear a thing of the past.
The technique is simple, sensible and can be done as an office procedure. A tiny rubber band is placed over the neck of the hemorrhoid which makes the pile swell like a balloon. Then the hemorrhoid is quickly frozen to -89 degrees by using nitrous oxide. About a minute is required to transform the pile into a hard, white mass. The rubber band is then removed and patients return to work.
How does this technique cure hemorrhoids? Intense freezing kills the tissue and in about five days the pile drops off. Some patients may notice slight bleeding or a bit of irritation until the raw surface heals. But since there are no pain fibers "inside" the rectum there is practically no discomfort to this procedure.
Cryosurgery has several advantages. It does not require anesthesia. Today, about one in 10,000 general anesthetics results in death. Not even local anesthetic is needed. Equally important there is no chance of making the rectal opening too small or that muscles will lose their tone. For instance, one study showed that 9 per cent of patients following routine surgery for hemorrhoids were unable to control rectal gas. And 6 per cent were also incontinent of feces.
Disadvantages are few. Since only one hemorrhoid can be done at each visit during cryosurgery, the process normally requires three visits at two week intervals. Also there's about a five per cent chance another pile will develop at some later time. But recurrence of symptoms can also happen when surgery is used to treat hemorrhoids.
The most common complication is a small blood clot that occurs at the anal area. This happens in about three per cent of cases and normally subsides with time and warm compresses. If the clot is large and painful, a small incision is made to remove it. Significant post-operative bleeding occurs rarely, once in several thousand cases. This may occur after the surgical procedure for piles as well.
Some surgeons tend to consider cryosurgery as a gimmick or passing fad. Initially this attitude may have had some merit. Now, after thousands of successful cases, it's hardly valid. After witnessing this operation many times I recommend it enthusiastically to my own patients.
Preventing hemorrhoids is a better tactic than cryosurgery after the fact. A diet rich in fiber holds water making stools soft, bulky, and requiring less strain with bowel movements. Common sense dictates it's easier on the rectum to pass stools as soft as toothpaste than those as hard as rocks.
Be sure to see your doctor if rectal bleeding occurs. Never assume it's due to hemorrhoids. This can be a fatal error if early malignancy is present.
W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com
My book, �90 + How I Got There� can be obtained by sending $19.95 to:
Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1
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