Conservative Treatment of Haemorrhoids at the Onset of the Third Millenium from the Aspect of the Gastroenterologist

Overview

The author recapitulates first the development of haemorrhoid treatment during the last 30 years, as he followed it up in his practice. He attempts to evaluate and list indications for conservative treatment and compared them with surgical treatment. He indicates perspectives for the future and emphasizes the risk of development of colorectal carcinoma in the Czech Republic and the increase of diseases of civilization which include haemorrhoids.He analyzes the results recorded in 510 patients with haemorrhoids treated at the gastroenterological department of the hospital in Šternberk during the last six years by ligation, sclerotization, cryodestruction, thermocoagulation and argon laser.Based on these results he outlines the indications and contraindications of conservative treatment of haemorrhoids according to different stages of the disease. He prefers ligation to thermocoagulation in stages I-II. As an alternative to the surgical solution he mentions cryodestruction or the argon laser technque. He demands before onset of treatment in patients above 40 years total coloscopy. In cases with familial incidence of colorectal carcinoma or tumours in general he recommends coloscopy in all instances. An essential supplement of treatment of haemorrhoids is also modification of dietary habits, lifestyle, local hygieny, constipation.

Key words:
haemorrhoids - constipation - conservative treatment - coloscopy - colorectal carcinoma.