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How to Cure and Remove HEMORRHOIDS

rexmadrigal · 68 · 96971


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on: Feb 26, 2010, 08:57 AM
Do you know that 90% of hemorrhoids can be treated as an office procedure?

Hemorrhoids are treated depending on the grading system.
Grade I hemorrhoids are those that are bleeding but with no protruding mass
Grade II hemorrhoids are those that comes out on straining but spontaneously reduce
Grade III hemorrhoids are those that needs to be manually reduced
Grade IV hemorrhoids are those that can't be reduced

Majority  of cases are Grades I-III. These cases can in most circumstances can be treated with an office procedure called rubber band ligation.

Don't be afraid this is not a painful procedure. It uses a rubber band ligator to apply the rubber band and consequently leading to the elimination of hemorrhoids.

I personally operate only on Grades III and IV.

This is your colorectal surgeon speaking.
Posted on: Feb 12, 2010, 08:11 PM

This is one of the worst cases of hemorrhoids which is a Grade IV. Normally, surgery is the only option but due to advance age and medical co morbid factors, rubber band ligation was applied.

The first rubber band was applied using a rubber band applicator on the selected hemorrhoidal pile.

Several bands applied on other piles.After 1 week, the results are dramatic.
I'll see if I can post the results.


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Reply #1 on: Feb 26, 2010, 12:15 PM
Wow sir, nakakatakot naman to tingnan.... tanong lang,
ano ba yung kadalasan cause ng hemorrhoids at paano to maiwasan?
Thanks 4 the info!


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Reply #2 on: Feb 26, 2010, 09:03 PM

Thanks for the interest.

I posted those pictures not to scare anyone but rather to educate our members regarding hemorrhoids which if not properly cared of, might lead to serious cases like the one I posted.

Hemorrhoids are actually normal cushions for individual's adoptation to passage of stools.

Anything that can make you constipated will lead to symptomatic hemorrhoids.

Lack of fiber intake leading to constipation would be the main culprit.

Presence of anything that can delay passage of stools leading to constipation.

Tumors in the distal rectum.

Pregnancy especially during the later stages.




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Reply #3 on: Feb 26, 2010, 09:30 PM
yes, doc how can we prevent this to happen? more thing doc, can a senior citizen still undergo this kind of surgery?  :thankyou:
« Last Edit: Oct 20, 2010, 01:47 AM by FutureGizmo »


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Reply #4 on: Feb 27, 2010, 06:51 AM

First, how do we prevent this.

The key here is a high fiber diet. Remember, anything that comes out from down there has something to do with what came in.

To prevent hemorrhoids is to prevent constipation as what I posted on the topic on colorectal cancer.

When we say high fiber diet, it means a daily dose of green and leafy vegetables. The nice ones are malunggay, pechay, talbos na kamote, kangkong, etc. Together with your usual daily meal, add these.

You can have fruits also instead of vegetables. Fruit that are rich in fiber like the ponkan, oranges, etc. Siempre the usual papaya that we all know.

ADD TO THESE is the water intake. It's not just 8 glasses of water. It depends on the humidity, temperature, and the activity that you have. I always tell my patients to buy a 2 liter bottle of mineral water so they can monitor their intake. Make sure you finish it from 7am in the morning to before 7am the following day.

Activity has something to do with constipation also. Regular exercise will definitely improve bowel movement.

If you follow these three important rules, then you have a great chance of not being constipated.

A nice stool is like a jumbo hotdog, soft, formed stools that comes out after a little push that will not last 5 minutes. I mean when you feel it, it goes out right away in one batch.

A NICE DAILY ROUTINE LIKE THESE will most likely prevent hemorrhoids which is caused by anything that makes you constipated.

FOR ELDERLY, yes it can be done and the picture posted was that of an elderly patient. Operating on elderly patients require added preparations before the procedure and definitely, yes, it is being done.

There are by the way a lot of fiber substitutes in the market  if you can't eat vegetables and fruits on a daily basis. Senna concentrates and psyliium fibers are the best. Most so called cleansers are actually just liquid solutions of Senna concentrates and psyllium. Don't waste your money on buying these. Just take two senokot tablets before bedtime or stuff like fibermate, etc.
« Last Edit: Oct 20, 2010, 01:47 AM by FutureGizmo »


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Reply #5 on: Feb 28, 2010, 07:16 AM

Marami, maraming salamat!   God knows, you have helped many people w/ this info.
« Last Edit: Oct 20, 2010, 01:47 AM by FutureGizmo »


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Reply #6 on: Feb 28, 2010, 08:00 AM
Doc rex,
thanks for educating other people about this. im very sure many are unaware of many points u've raised/mentioned. sana sundin nila yung mga sinabi mo:
high fiber (fruits & veggies)
exercise.  :rakenrol:
for most people, mahirap kasi sundin kahit isa jan  :watchuthink:
ako takot ako magkasakit, so super health conscious ako.  :hihi:

A nice stool is like a jumbo hotdog, soft, formed stools that comes out after a little push that will not last 5 minutes...

thanks for mentioning this.
from what i know, 'healthy stool' nga yung stool na 'isang buo parang hotdog' pag lumabas. yung stool na parang 'stool' ng kambing, totoo po ba talaga na 'unhealthy' yun?
also, is there such thing as a 'healthy stool color'? brown stool, perhaps? kasi may naririnig ako dati na iba ibang kulay na stool, like green, blue, red, yellowish, etc
do u know what each color indicates?

anong libro po ba ang nagdidiscuss nito? any books that u can recommend? (note:  i have no problem with medical jargons)
Thanks Doc!


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Reply #7 on: Feb 28, 2010, 02:01 PM

You are right, it seems that the three guidelines are quite hard but looking at it, a little exercise, 2 liters of water, and a high fiber diet( this can be substituted with fiber supplements like senokot  daily), is not hard as it look.

There no such thing as a healthy colored stool which can either be yellowish, greenish or brownish.

Ash colored is no no which means blockage of bile which connotes biliary obstruction.

Reddish, bright red that is(hematochezia), means bleeding somewhere down the rectum which most often are hemorrhoidal in origin or worst, distal rectal cancers.

Black the so called alkitran(the one for asphalt) is what we call melena. This means the blood was mixed with bile resulting to degradation of red cells. This can either be upper GI bleeding or a tumor or lesion arising at the right side of the colon

Posted on: Feb 28, 2010, 12:54 PM

As I promised, this is the result of rubber band ligation for 4th degree hemorrhoids on an elderly patients with heart problems.

This is one week post ligation and as you can see, much of the edema had sibsided and it do look better that before treatment.

Posted on: Feb 28, 2010, 01:42 PM

A circumferentially prolapsed 4th degree hemorhoids that can only be treated with a so called "Whitehead operation"

Hemorroidal pile being dissected from the dentate line with removal of all hemorrhoidal plexuses.

Flap sutured back at dentate line after removal of all piles.

This is a technique used for advanced cases of hemorrhoids specifically 4th degree circumferentially prolapsed. It is a little bit harder than the usual hemorrhoidectomy but if done properly, it offers an immediate relief of symptoms.

Rarely is there a need for such operation. In fact I only do it once or twice a year but with good results.
« Last Edit: Oct 20, 2010, 01:49 AM by FutureGizmo »


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Reply #8 on: Mar 02, 2010, 10:35 AM

You are right, it seems that the three guidelines are quite hard....

Thanks sa infos doc

1 of my Q's was about stool 'shape'.
from what i know, 'healthy stool' nga yung stool na 'isang buo parang hotdog' pag lumabas. yung stool na parang 'stool' ng kambing, totoo po ba talaga na 'unhealthy' yun?

also, naituro ba sa inyo kung totoo yung idea na ang lumulutang na stool ay 'healthy' while yung lumulubog na stool ay 'unhealthy'?



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Reply #9 on: Mar 02, 2010, 12:03 PM

First the shape of the stools. What we need to achieve is a well formed soft stools. For that we need a base for the stools to form, to become bulky and that's what we call bulk formers. We get these from vegetables and fruits. Why do we need bulky stools that are well formed but soft? So you can have that nice jumbo hotdog. When you fell the urge, if you have a "jumbo hotdog" then it can come out fast and with just a little straining.

Goat like stools are danger signs. It is mostly associated with colorectal cancer. It forms that way because once you have an intraluminal mass causing obstruction especially circumferential, then the stools take that shape and since it's causing obstruction, then it stays longer on the vault before you can push it out.

Champorado like stools can also be a bad sign especially if you see those blood admix with the stools.

For later stages of tumor obstruction you can have watery stools. Only this type can come out from the obstructing tumor.

Now for the floating stuff. To be honest, stools that float mean there's a lot of fat content. That's what we call steathoreic stools. When you eat fishes like gindara, or had a fatty meal like litson, you'll notice there would be a floating casino there in the bowl.

Again, thanks for your interesting question and hope to hear more from you.


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Reply #10 on: Mar 22, 2010, 03:40 PM
hi doc, i just noticed in my company's healthcare benefits that they include these two:

Scalpel Hemorrhoidectomy
Conventional Hemorroidectomy

what's the difference of the two?

And also, totoo po ba na kapag mahilig daw sa maanghang nakakacause ng hemorrhoid??


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Reply #11 on: Mar 23, 2010, 06:07 AM
I am not really sure what it is. But when you say scalpel that means surgical knife which is the conventional way of doing hemorrhoidectomy. Meaning you cut out the tissues using a knife.

There are several ways of doing it. Some Uses cautery, some uses a stapler which is what we call stapler hemorrhoidectomy. The bottom line is how to remove these piles.


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Reply #12 on: Mar 23, 2010, 07:46 AM
doc yung red juice maganda sa bowel movement. mahal nga lang  :D


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Reply #13 on: Mar 23, 2010, 09:03 AM
Ang naging remedy ko lang when  I was on my last term of pregnancy was pineapple juice (lots of it) and Senokot, recommended by my OB.  :D


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Reply #14 on: Mar 23, 2010, 12:20 PM
Yup you're right red juice, senokot. Any fiber supplement will do. Prune juice, etc.

As long as you have that jumbo hotdog, gone will be the hemorrhoids.


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