Hemorrhoids, which is estimated to be seen in 4.4 percent of the world’s population and in one out of every 2 people between the ages of 45-65 in Turkey, is becoming more common due to a sedentary lifestyle and irregular diet. Stating that due to the pandemic, there has been an increase in hemorrhoids cases due to the loss of healthy eating habits and inactivity. Dr. İsmail Hakkı Ocak said, “Hemorrhoids is a disease that is common in our society, often reluctant to go to the doctor because of the region where it occurs, and causes anemia due to prolonged bleeding. It occurs due to sedentary life, irregular diet, prolonged diarrhea, constipation or genetic predisposition and pregnancy. We estimate that curfews and the relocation of offices to homes during the pandemic period increase the incidence of the disease. However, we cannot give an exact figure for the number of patients. Most of the patients are ashamed and hesitant to be treated. However, what is sometimes thought to be hemorrhoids can actually be rectal cancer.”


Pointing out that there may be various complaints according to the type and stage of the disease in hemorrhoid patients, Inday Clinic specialists Op. Dr. İsmail Hakkı Ocak gave the following information about the symptoms and types of the disease:

“Hemorrhoids, which initially only manifests itself with bleeding, cause swelling, pain and itching in the rectum in the later stages of the disease. There may be different reasons for bleeding from the breech area. Like hemorrhoids, rectal cancer can also bleed. Therefore, bleeding must be taken into account. Hemorrhoids are divided into internal and external hemorrhoids. Internal hemorrhoids manifest as bleeding, swelling, pain, wetness and itching, while external hemorrhoids manifest as sudden swelling, pain and sometimes bleeding. Internal hemorrhoids, which initially occur in the anus and in the last part of the intestine, become more pronounced as the disease progresses. It mostly presents with sudden swelling, stiffness and pain. In the first stage, it manifests itself with bleeding. In the second stage, it comes out during the toilet, it swells and bleeds. It enters the anus by itself after the toilet. In the third stage, when pushed in manually after the toilet, it enters the breech. It causes swelling, bleeding, pain, wetness and itching in the anus. In the fourth stage, where the disease is most severe, it goes out during the toilet but does not go back in. Apart from bleeding, there may be sudden pain, swelling and areas of necrosis (tissue death).


Pointing out that hemorrhoids are not a sign of cancer, but serious life-threatening diseases such as breech fissure, anal fistula, rectal abscess, rectum and bowel cancer also develop in the hemorrhoidal region. Dr. Ocak said, “Unfortunately, very few patients with hemorrhoidal complaints go to the doctor. However, patients with such complaints should be examined by a general surgeon. In the treatment, the first examination is guiding. We examine our patients who come to our clinic with an illuminated instrument called anoscope, which allows us to evaluate the 5-6 cm distance in the breech. If necessary, we can also request a colonoscopy from the patient.


Kiss. Dr. İsmail Hakkı Ocak explained the treatment methods they applied within the Inday Clinic as follows:

“Especially in the first stage, when the disease has just started and the complaints are not very severe, drug treatment should be started. We can achieve very satisfactory results with non-surgical treatment methods for patients who do not respond to drug treatment for a long time, who develop suddenly, or who have severe bleeding and pain complaints. We apply 3 types of non-surgical treatment methods to patients: Rubber Band Ligation, Infrared Photocoagulation and Laser Hemorrhoid Treatment, which do not require anesthesia. We achieve successful results with Infrared Photocoagulation, in which damage and fixation is made in the tissues we call the hemorrhoid nozzle with the help of a device that produces infrared rays in very advanced stages, and with Rubber Band Ligation, which allows the hemorrhoids to be tied from the roots with the help of rubber and to stop feeding within 7-10 days, which allows them to dry and fall off on their own. Laser Hemorrhoids, in which the vessels in the hemorrhoids are burned and extinguished, is a very popular and effective treatment method in recent years. It is often preferred because of its applicability in all phases.”

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