HEMORROIDES
Dra Ma. Cecilia Fontanilla Dra. Susan
¿Qué son las hemorroides? ¿Qué síntomas producen? ¿Cómo se diagnostican? ¿Cómo se trata la enfermedad hemorroidal? ¿Cuándo debo realizar otro tratamiento? ¿Cómo prevengo la enfermedad hemorroidal?
¿Qué son las hemorroides?
Son paquetes venosos dentro del ano que se estrechan con el pasaje de las heces. Se piensa que su función es relajar los esfínteres luego de la defecación.
Todos tenemos hemorroides pero cuando estas sangran y prolapsan por el ano hablamos de “enfermedad hemorroidal”. Esta se puede presentar sobre todo si existen factores como constipación, obesidad, heces muy duras, embarazo, problemas hepáticos.
¿Qué síntomas producen?
Lo más común es el sangrado con la defecación, cubriendo las heces, en el papel higiénico o inodoro como goteo.
Una hemorroide puede protruir a través del ano e irritarse con dolor y picazón.
Algunas hemorroides pueden trombosarse. Esto resulta cuando se tapan con un coágulo y es un proceso muy doloroso que puede necesitar resolución quirúrgica.
Siempre tener en cuenta que todo sangrado en mayores de 50 años debe estudiarse con una colonoscopía, aún más si hay antecedentes familiares o personales de cáncer colorectal.
Otros síntomas pueden ser: picazón local y la secreción que mancha la ropa interior.
¿Cómo se diagnostican?
El Dr. deberá realizar un exámen físico local inspeccionando la región anal, realizando un tacto rectal y muchas veces se precisa un exámen endoscópico para descartar otras patologías asociadas (pólipos, etc) que pueden causar sangrado.
¿Cómo se trata la enfermedad hemorroidal?
Es fundamental el tratamiento médico higiénico dietético, cambios de la dieta con ingesta de fibras (vegetales, frutas y cereales), dos litros de agua por día, baños de asiento, analgésicos y pomadas locales.
¿Cuándo debo realizar otro tratamiento?
Cuando las hemorroides prolapsan por el ano o sangran demasiado se debe recurrir al tratamiento invasivo.
Uno de los tratamientos más efectivos y seguros es la ligadura con bandas: con esta técnica el médico coloca con un dispositivo o endoscopio una banda de goma en la base de la hemorroide. Esta corta la circulación y el tejido muerto cae en unos días. Este tratamiento provoca escasas molestias y debe consultarse ante dolor intenso, fiebre , dificultad para orinar o sangrado importante luego del procedimiento.
Otros son la escleroterapia (se inyecta un químico en la hemorroide para sacarla), cirugía convencional (“hemorroidectomía”: muy efectiva y recomendada en casos de prolpasos importantes o cuando las hemorroides se asocian a otra patología).
¿Cómo prevengo la enfermedad hemorroidal?
1- Ir al baño urgente cada vez que sea necesario
2- Evitar el estreñimiento
3- Actividad física (caminar)
4- Consumir fibras y líquidos
Dra. Ma. Cecilia Fontanilla (Cirugia General)
Dra. Susana M. Russo (Gastroenterología)
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