Why are hemorrhoidal discomforts more frequent during pregnancy?
Hemorrhoids are already a frequent pathology in the general population, what happens in pregnant women is that there are a series of physiological and metabolic changes that favor things like the worsening of constipation, the evacuation difficulty and a difficulty of venous return at the level of the pelvic area and the lower extremities that can progressively cause either hemorrhoids to develop or worse hemorrhoidal symptoms that the pregnant patient previously suffered.
What should be done during pregnancy and after pregnancy?
During, the same pregnancy conditions us a bit the therapeutic options to offer, which basically is conservative medical treatment that includes dietary supplements with fiber and liquids, the use of topical ointments with local anesthetics and anti-inflammatory and vasotonic substances that favor venous return.
After delivery is when you really make an approach to how the patient is. In some cases, all the symptoms are solved and the patient remains asymptomatic, so nothing more should be done.. But in some, and with certain frequency, the symptomatology persists. Basically there is bleeding, inflammation, itching and lumps that swell and deflate with periodicity. In these cases is when we consider going to a specialist, to carry out a proper exploration and diagnosis of the degree of hemorrhoids, in this way, can also indicate the best treatment individually for each case.
When is surgery indicated?
The surgical indication is given by our patients. When we have a patient whose symptoms do not manage to control with conservative medical treatments is when we recommend to go through the operating room. And as for surgery options, for years now, we rely on laser energy. Initially we used the CO2 laser that cut very well but had a lower coagulation potential and that, when it comes to operating areas as vascularized as the hemorrhoidal area, it is still an inconvenience. In recent years we have developed laser diode surgery that has a much higher coagulation potential and in surgery we do not see a drop of blood. As for the different techniques, in the case of internal hemorrhoids, we use photo-coagulation, which eliminates hemorrhoidal tissue without wounds.. There is just a small ulcer, a burn, and the post-operative is practically painless. In those cases of more developed, external hemorrhoids and that have a tissue hypertrophy that must be removed, we use the laser diode in contact version, a kind of electric scalpel but using laser energy, which does not burn the tissues so much, which results in less inflammation and less pain in the post-operative period.