Hemorrhoids

The rectum and anus are the final stages of the digestive tract through which stool is
expelled from the body. The rectum is a continuation of the sigmoid colon; it begins in front of the
midsacrum and ends in an expanded section called the rectal ampulla. It is about 3 inches away
from the anus. The anal sphincter, at the end of the rectum, controls the release of stool. There is
an internal sphincter, as well as an external sphincter. One is controlled by the autonomic system
while the other that helps control the muscle and keep stool in the rectum, respectively.

In the lowest part of the rectum and anus, Hemorrhoids are swollen veins that, sometimes,
the walls of these blood vessels stretch so thin that the veins bulge and get irritated (especially
during defecation). The veins the in the lower rectum swell due to a buildup of pressure which can
affect blood flow. It may occur because of extra weight, pushing during bowel movements, or
strain from lifting heavy objects.

Swollen hemorrhoids are also called piles. It is one of the most common causes of rectal
bleeding. All people are born with hemorrhoids, however, it could cause rectal bleeding if they
become enlarged. Hemorrhoids are rarely dangerous and usually clear up within a few weeks but
it should be checked doctor to make sure it’s not a more serious condition. There are two types:
internal and external hemorrhoids. Internal Hemorrhoids are inside the rectum and far enough that
it cannot be seen or felt. There are few pain-sensing nerves there, so they usually do not hurt and
bleeding may be the only sign. External Hemorrhoids, on the other hand, happen under the skin
around the anus; they bleed and cause intense pain. In addition, external hemorrhoids can collect
excess blood and develop a clot. Sometimes hemorrhoids prolapse, or enlarge and bulge outside
the anal sphincter. They may be seen as moist bumps that are pinker than the surrounding areas.
These usually go back inside without treatment or they often can by gently pushing them back into
place; surgery shall be considered only when hemorrhoids do not respond to home remedies and
non-surgical options.

A new treatment for this is the Hemorrhoid Energy Therapy using the HET Bipolar System.
According to the Gastroenterology Associates of Florida (2018), it is a simple and effective
treatment that is non-surgical for symptomatic low grade hemorrhoids. In a single procedure, the
disposable device, called the HET bipolar device, uses low thermal energy combined with gentle
hemorrhoid tissue compression to treat hemorrhoids by significantly shrink internal hemorrhoids,
in the area of the human body that does not feel much pain. This is different from other treatments
because it’s fast; it typically takes seconds to complete and doesn’t require multiple procedures.
Kantsevoy and Bitner (2013) evaluated the safety and effectiveness of the device and they
concluded that it is safe and easy to use; moreover, it’s highly effective. It is able to terminate
bleeding in grades I and II of internal hemorrhoids and prolapse of grade II internal hemorrhoids.
“It may be an effective alternative to rubber band ligation in patients with larger internal
hemorrhoids and those with hemorrhoids close to the dentate line in which banding may produce
debilitating pain” according to Crawshaw, Russ, Ermlich, Delaney and Champagne (2016). They
stated that the HET system is safe as well as it easy to use. However, in comparison to currently
used techniques for symptomatic grade hemorrhoids, effectiveness is only short-term.
References:
Crawshaw, B. P., Russ, A., Ermlich, B. O., Delaney, C. P., & Champagne, B. J. (2016).
Prospective Case Series of a Novel Minimally Invasive Bipolar Coagulation System in the
Treatment of Grade i and II Internal Hemorrhoids. Surgical Innovation, 23(6), 581-585.
https://doi.org/10.1177/1553350616660628
Gastroenterology Associates of Florida. (2018). Hemorrhoid Energy Therapy. Wellington
Florida: Author
Hemorrhoids: Causes and Symptoms of Internal vs. External Hemorrhoids (2018). Retrieved
from: https://www.webmd.com/digestive-disorders/understanding-hemorrhoids-basics#1
Kantsevoy, S. V., Bitner, M. (2013). Nonsurgical treatment of actively bleeding internal
hemorrhoids with a novel endoscopic device (with video). Gastrointestinal Endoscopy, 78(4),
649–653. https://doi.org/10.1016/j.gie.2013.05.014
Tresca, A. J. Overview of the Anal Sphincter (2018). Retrieved from:
https://www.verywellhealth.com/anal-sphincter-1942667