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Best Treatment for Hemorrhoids that you need to see


Posted on Tue, 10 Jan 0:38 EDT
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Most people may experience anal discomfort at some point in their Lives, but they 
donít talk about it because itís quite an embarrassing topic to discuss. The most 
common complain involve pain and itching and in some cases may even involve bleeding.

ďAnal diseases are any abnormalities in anus and the most common anal disease are 
hemorrhoids, anal fissure which is a wound in the anus and then fistulas or yung 
pigsa na pumutok na hindi gumagaling.Ē

The risk increases especially if you have a poor diet and hygiene. Too much moisture 
in your bottom can also lead to itching. But why this anal ailments may temporarily 
cause discomfort and soreness. There are many ways to alleviate the situation.

ďOne of the main message is even if this are common condition, this are not life 
threatening condition, best to have check up just to make sure. Especially if youíre 
at age 40 or 50 or if you have changes the way you move your bowels. ď

What type of food should you eat to avoid anal discomfort ?

What treatment options are available for this kind of medical condition ? All these 
and more tonight on medtalk.

Joining us tonight, Dr. Armando Crisostomo a colorectal surgeon at the QualiMed 
Health Network. He is also a former president of Philippine College of Surgeons. Also 
joining us tonight, Dr. Manuel Francisco Roxas Consultant Director of The Medical 
City Colorectal Clinic and the chairman of the Department of Surgery of the Medical 
City.

Host : So as colorectal surgeons, you tackled the medical concerns of the rectum and 
the anus. So tonight is about anal diseases. What are Anal disease?

Dr. Manuel: Well, there are many diseases can actually affect the anus so we call 
them anal diseases because they affect lost and there several very common once for 
instance hemorrhoids, fissures and the abscesses and fistulas as well as anal warts. 
But other than that there are other condition that should be brought by the attention 
of the Doctor also so there are many conditions. So we love them all because we 
discussing in a topic like this, in a forum like this.

Host: So before we go to the diseases of the anus and the rectum, let first 
understand the function of the rectum and the anus.

Dr. Arman: Well the rectum or the anus considered the terminal portion of the gastro 
intestinal track. It is part of the expiratory system. So any excess food or waste 
materials that our body ingest and no longer needs are expelled to the very important 
part of the anatomy called the anus or rectum. And here usually, as we become adults 
the stools which form part of the waste materials become somewhat solid in character. 
And in children or babies we have not developed that ability to voluntarily expel the 
contents of the rectum but as we get older we developed that capability to be able to 
detect whether weíre going to passed out gas, or whether going to passed out 
something very soft, or we have some diarrhea or whether what is going to come out in 
solid. So an appropriate time our anus or rectum is very sensitive organ in itself. 
Because itís able to distinguish whether youíre going to pass gas, liquid or solid 
tools at appropriate time. So it gives you this signals which are processed by your 
brain so at an appropriate time youíll go to the comfort room to expel yourself. Just 
imagine if you put a mixture of air, water and the solid in your hand. Can your hand 
be able to expel air only, liquid only your hand cannot do that but they say anus and 
rectum can do that. So that how important that portion of the anatomy.

Host : So people realize how important it is

Dr Manuel: They will realize it when they get older, when they aged. One of the most 
important structures of the anus is the muscle. It allows you to either you hold it 
when you donít want it to go or to release it. And if thereís weakening in the 
muscles people will notice that they canít hold it as well anymore so it called 
incontinence. The function of the rectum is to store these things. If you donít want 
to release it, it allows you to store it. And then its releases it in one nice go. 
Without that function people will just go constantly and it doesnít have that 
satisfying expulsion that the muscle of rectum provides. So very complex and 
fascinating organ also at least.

Host: And because itís very complex, very fascinating would like learn more about it. 
And these diseases or the pain and irritation come because of certain medical 
conditions that are brought about by maybe controlling it or maybe releasing it too 
much. Letís go now to the diseases that cause anal pain and probably irritation and 
discomfort. What among the common diseases that should we tackle first?

Dr Arman: Maybe the most common we have worldwide the hemorrhoids.

Host: Letís start with hemorrhoids, what exactly are hemorrhoids. How do they form 
and which part of the anus is affected?

Dr. Arman: Well, every one of us even as newborn we weíre born with certain tissues 
in our anal rectal area which try to cushion the expulsion of the fatal material. Now 
because of the certain pee disposing condition like poor bowel habits in which you 
have to little fiber in your diet or you tend to be constipated or you strain too 
much as you move your bowels, these cushion slide down it become somewhat in flame. 
And inside this cushion are certain blood vessels also. So that when this blood 
vessel slides down some of them get traumatized and they result in some symptoms like 
bleeding. Now in general we have 3 types of hemorrhoids; we have the external 
hemorrhoids which is found outside and this is only sensitive and therefore the main 
symptom of these hemorrhoids is pain. The second type of hemorrhoids are more of the 
internal hemorrhoid and these are the blood vessel are located so when you have 
internal hemorrhoid, these are the one that presents bleeding. If you have both its 
called the mixed hemorrhoids, so these patient will have mixed hemorrhoid it will 
feel something bulging out when they have particularly difficult bowel movement and 
then sometimes they also have bleeding as well. So depending whether you have 
hemorrhoid that is located externally, internally or mixed one that will determine 
the kind symptom that you will present.

Host: You mention that it is common.

Dr Arman: Itís quite common.

Dr Manuel: You have to understand all of us are born with hemorrhoidal tissues. 
Thatís part of normal anatomy. Itís just that when people have symptoms due to the 
factor mention thatís when we label them as hemorrhoidal disease.

Host: All of us born with hemorrhoidal tissues and they triggered they become..

Dr Arman: When they slide down they become what we called pathologic or symptomatic 
hemorrhoid.

Dr. Manuel: You know our anus are uses every day. Just sitting down on them produces 
pressure. Eventually these structures become lacks, become loss as we aged as we use 
them constantly so thatís when some people developed hemorrhoidal symptoms.

Host: Do you only get hemorrhoids if youíre constipated or even when you have 
diarrhea?

Dr. Manuel: There are some actually, some are running families and some are young and 
they developed these symptoms also so itís a chicken and egg situation. Some because 
of constant training will develop hemorrhoid. But there are others whoís anatomy 
impredisposes them to more hemorrhoidal symptoms and the more they strain the more 
theyíre diet not too good then it worsen the symptoms.

Host: Weíll talk about diet, weíll talk about taking in more fiber so that it doesnít 
trigger those hemorrhoids, weíll talk about that and more when medtalk return.

Host: Does it vary to person to person?

Dr. Manuel: Yes from type of hemorrhoid. So for instance internal hemorrhoid come out 
they come out when you move and sometimes patient have to push it back in. That one 
of the symptoms called the Prolapsed. Pain maybe one of the symptoms but usually 
because it flame so the pain generally, because what we called thrombosed hemorrhoid 
and the pain usually last a few days before it disappears. And that one of the ways 
we try to distinguish hemorrhoids from what we called fissures. Which weíll talk 
about later. The pain you feel every day, every time you go is usually due to a 
fissure rather than a hemorrhoid.

Host: So weíll distinguish it later. So Hemorrhoids..

Dr. Manuel: If theyíre painful they really very swollen or very prolapsed and you can 
see that obviously from the outside.

Host: But upon check up with your doctor or will the individual know or like thereís 
a warning sign?

Dr. Arman: Weíll the most alarming for many patients is actually when they passes 
tool and thereís blood griped into the toilet bowl. That can very alarming from many 
patients. And itís often the trigger that makes them seek consultation with physician 
or surgeons like us and well it can differly from one patient to another to extent 
and severity of the bleeding. But usually the bleeding stops after a few minutes.

Dr. Manuel: Itís just very scary because bright red and when it gripsed into the 
toilet bowl and it spread

Dr. Arman: Or when they wiped themselves after having bowl. Thereís blood in the 
tissue.
Host: Ok so it that caused from alarm or..

Dr. Manuel: Well itís the sign that you should get check up.

Host: Does it mean you have wound a pop blood vessel or a tare?

Dr. Manuel: It could be either one. But you know hemorrhoids are not a life 
threatening condition. Even if there bleeding usually they will stop but do we need 
to check that thereís nothing more serious thatís happening and if itís just a 
hemorrhoid we really assure patient that itís just hemorrhoid.

Host: Do you know if you have hemorrhoids? Will you know it until you pus?

Dr. Arman: Youíll feel it. Especially when it prolapses. After you wipe yourself 
often some patient feel there is something bulging in their anal area.

Dr. Manuel: What we do recommend is donít presume its hemorrhoid. Let us, Let us 
Doctors be the one to tell you because we need to check up you thoroughly. 
Particularly at certain aged group, 40, 50 above. We need to make sure that thereís 
nothing more than just a hemorrhoid.

Dr. Arman: There are more serious disease conditions like rectal cancer or colon 
cancer that present also with bleeding and therefore sometimes the patient will 
dismissed it and think it just a hemorrhoid or sometimes because of embarrassment 
because youíre dealing with a very sensitive part of anatomy. They delay consultation 
and sometimes there are more serious problem occurring pala.

Host: Doctors we have question from twitter.. ĒI am planning to work abroad, should I 
have my Hemorrhoids removed?Ē

Dr. Manuel: If youíre not feeling anything you shouldnít. Because everyone has 
hemorrhoidal tissue and we only treat symptoms. And thatís one of our advocacies in 
our Philippine Society in Colorectal Surgeons. Sometimes were asked to remove 
hemorrhoids just because of these physical examination findings on work application 
for abroad. I think the agencies are afraid that these people will have hemorrhoid 
problem while theyíre overseas and they will end up having to have it treated over 
there. But you know we only treat hemorrhoid when thereís symptomatic. So if patient 
are not feeling anything we donít need to treat them.

Dr. Arman: We should take advantage of this opportunity to educate the public that 
not all hemorrhoids have to be removed. When you mention that it should be removed or 
advised that it should be removed seems to implicate that it has to be surgically 
excised. Right now we usually grade hemorrhoids from grade one the most, the 
smallest, and least symptomatic to grade four. And usually we advised surgery only if 
it is very severe grade four. You have bleeding, recur bleeding and the hemorrhoid 
has prolapsed to the point that even the patient cannot pushed it back any longer. So 
that is the only the type of hemorrhoid that should be surgically excised. The lower 
grades are form of hemorrhoids can be treated either based on their symptoms, dietary 
modification, better education on how to handle your bowel habits and even the really 
small symptomatic ones as mention by Dr. Ramy here, should actually not be given 
anything. Theyíre just observed.

Dr. Manuel: There are also non-surgical ways of treating them. For instance rubber 
bond ligation, or injecting what we called sclerotherapy agents. Which are easy for 
people to go through out-patient procedure so speak to us specialist first if youíre 
considering treatment of hemorrhoid whether itís necessary or not.

Host: And necessary treatment will help you in preventing the hemorrhoids. Let say 
thereís treatment given, will the hemorrhoid come back after the treatment given. 
What are the preventive measures for it not to come back or recur?

Dr. Manuel: The treatment is a balanced what the patient feels and what he want. 
Surgery for instance can remove hemorrhoids more permanently but this can be very 
painful. So some patients donít want the pain of surgery. So we offer them something 
less painful, less traumatic, but at the expense of the possibility of coming back 
but like I said hemorrhoids are not life threatening. Some people can have hemorrhoid 
and not want to anything done to them and thatís fine with us too. As long as we 
checked them up and make sure thereís nothing more serious than their hemorrhoids.

Dr. Arman: Most of our patient even after hemorrhoid rectum. We try to educate them 
and treat them so that they least the currence of any symptoms will be prevented. And 
itís really all of modifying lifestyle, having more fiber on their diet and if youíre 
not able to take enough fiber even take in some either natural or artificial fiber 
supplements. That may help you have an easier bowel movement.

Host: So weíve discussed and you enlighten us on hemorrhoids, now letís go to 
fissures. Maybe we can use your model here doctor. Please help us understand what are 
fissures.

Dr. Manuel: This is the model of rectum and anus. The most important structure of 
anus are the muscles, these are the muscles over here, this is your rectum, these 
purple things here are your hemorrhoid, external going outside and internal. A 
fissure is just a wound in the anus thatís why it is painful if you notice this 
little red line over here. This organ over here thatís a wound. Thatís the wound of a 
fissure. And this is the rectum, this is the example of a folip and this is the 
example of a tumor. So all of these may have similar symptoms but the most important 
symptom of fissure is pain because itís wound. And then bleeding because the wound is 
fresh.

Host: Again, thereís bleeding. Why does this happen, why a fissure developed?

Dr. Manuel: Well trauma. Either you have a very hard stool that you forced out. Or 
you can have repeated bowl of diarrhea which will traumatized also your anus.

Host: Are there types for the fissure? Will the fissure recur?

Dr. Manuel: There are two types. The first type is the acute fissure which just 
happens recently and usually heals on its own like any wound within a month. And 
then, thereís a chronic fissure that keep coming back. And thatís the problem that 
most of our fissure patients deal with. They keeps coming back sometimes they think 
its hemorrhoid but itís really the pain during bowel movement that let them visits 
us.

Dr. Arman: One characteristic symptom that alerts me to the possibility of a fissure, 
is that the patient will often complain when you see or examined them the pain is out 
of proportion to what you see on the rectal physical examination. And secondly, some 
of these patients develop a certain phobia already to having a bowel movement. They 
fear going to the comfort room anymore because each bowel movement seems to elicits 
that painful episode because of the bowel movement will traumatized the fissure again 
and again causing the development.

Host: Understandable. Of course you donít want to see blood on your stool and you 
donít want it such a so 
much pain from your description.

Dr. Arman: These causes a vicious cycle because of their fear of having a bowel 
movement this tend to withhold. And therefore it becomes even more constipated.

Host: Will that lead to hemorrhoids if they hold it and the stool become harder than 
it usually?
Dr. Manuel: They can have both hemorrhoid and fissure. In fact the interesting thing 
is most of our patient with fissure actually the first thing would tell us in the 
clinic is ďDoc, I have hemorrhoidsĒ. And then when we interview them, when we check 
them we tell them you know itís not hemorrhoids causing your pain itís the fissure 
and the fissure needs to be treated. If you only treat the hemorrhoids, then the 
symptoms of the fissure will persist thatís why itís very important that the Doctor 
or the surgeon really distinguish what the patient is feeling. Itís hemorrhoidal 
symptoms or its fissures symptoms because the treatment may vary.

Host: So you canít just self medicate it at home and assume that it might be a 
fissure or its just hemorrhoids.

Dr. Manuel: Well fissures like hemorrhoids are also not life threatening. So many 
people as long as they know itís a fissure or hemorrhoid will live with it. And we 
only treat those who really want to have themselves treated. However again, like 
hemorrhoids you need to get checked up to make sure that itís really just a fissure 
or hemorrhoid.

Host: Thereís another disease doctorís called anal abscesses which is closely linked 
to fistula. Weíll talk about that. It is a life threatening are these other two 
diseases life threatening weíll talk about that.

Host: This time doctors letís talk about anal abscesses and fistula.

Dr. Manuel: You know a pimple, a pimple in the face theyíre usually a clogged pore 
and then the sebum accumulates and then it gets infected then it worst. That similar 
to abscesses or pigsa, there are glance also in the anus that secrete mucus and then 
they got clogged. And that mucus gets infected and becomes what we called a pigsa or 
an abscesses and it drains. Medyo malas lang because the bacteria in the anus is 
different than what you have on your skin. The bacteria are more inner length. So 
while the abscesses like this one, this is an abscesses here collecting pus its burst 
out in the skin the wound doesnít heal after it burst out, the wound doesnít heal 
because there is a connection between the wound to the inside of the anus so it 
continuously gets infected and that what we called a fistula.

Host: No wonder theyíre closely linked.

Dr. Arman: The infection usually comes from the stool, the bacteria of the stool. 
Some of them enter that opening and continue reduce pus.

Host: You have to drain the pus.

Dr. Manuel: Well the pus has to be drain.

Host: it doesnít drain on its own?

Dr. Manuel: Sometimes it does.

Dr. Arman: Many times it does actually draining on its own. Then it becomes a 
fistula.

Dr. Manuel: if it doesnít drain out you drain it out. But then even that become a 
fistula.

Host: So it is automatic that if you have anal abscesses it will become a fistula 
whether or not to drain it?

Dr. Manuel: Well not automatic but very high, 50-75% at a time.

Host: Can you avoid that happening?

Dr. Arman: But in terms of the anus or the rectum, thereís really no way to prevent 
it. Because remember all of us are born with those kind of anal glance that our 
secrete mucus to help sort of lubricate the stool as they come out. So parang suwerte 
or malas na lang that some bacteria able to enter that opening and produce the 
infection.

Host: Is there a way para maiwasan ang magkapigsa in that area in which is common. 
Youíll hear once in a while, I have a pigsa in that area.
Dr. Manuel: Itís not easy to prevent. You can be the most hygienic and clean person 
and it still can hit you. So you just be aware in your condition I supposed and if it 
becomes a fistula.

Host: Is it connected to any other health problem? Is it a health concern?

Dr. Manuel: Of course itís a health concern because it stills a long standing 
infection. There is a small risk that if you leave it for ten years it can developed 
into cancer. But thereís small risk. The biggest risk really is in those whose immune 
systems may not be as healthy. Diabetics, those on chemotherapy, and then the 
infections can be really bad.

Dr. Arman: Because their resistance to the infection is down.

Host: Is there medication to increase your immune resistance? Aside from the common 
medication we have?

Dr. Manuel: If youíre a chemotherapy agent, maybe. But you know that infection, that 
the fistula will remain. It really requires a form of surgery to heal it so thereís 
no medication that actually cure the fistula. What the medication will do perhaps 
lessen the chance of the infection becoming life threatening.

Dr. Arman: Unlike hemorrhoids, where in some most hemorrhoids cannot, should not be 
treated surgically. Once you have abscesses or a fistula it should be treated usually 
through surgery.

Host: Is this a part of or can you get it from sexually transmitted infection?

Dr. Arman: Occasionally yes. At least in my practice, I think ramyís also, weíll 
observe this to be slightly more frequent among homosexual men. And maybe because of 
that practice of having anal receptive intercourse, trauma, continuous trauma and of 
course poor hygiene in that area can contribute with it to the formation of anal 
abscesses and fistula.

Dr. Manuel: Let me add on, not majority are not homosexual. Majority are just run 
come out of mill. There more straight forward to treat but there are fistula that 
more difficult to treat and when we dig in to the history thatís when we find out 
that there are other conditions that maybe making it more difficult to treat. Whether 
itís sexually transmitted or immune compromise condition or even tuberculosis. So 
many other but for most of the patient maybe 90% straight forward abscesses becoming 
fistula because of clogged infected gland.

Host: Can you be the cleanest and can still have the abscesses?

Both Doctors: Yes.

Host: Because you mention hygiene so Iím thinking lang kung sobra kang linis you can 
still have it.

Both Doctors: Yes.

Host: Walang pinipili.

Dr. Arman: walang pinipili. We would advised to the public not to self medicate. 
Especially a tendency again to a public itís because of the embarrassment in seeking 
consultation is that they self medicate themselves too long with antibiotic. Thinking 
that it will disappear. Sometimes the symptoms get reduce. The inflammation subsides 
in antibiotics but very rarely do they get cured permanently just with antibiotic 
treatment.

Dr. Manuel: And you might drinking the wrong type of antibiotic by self medication. 
So you really need to see a doctor.

Host: Letís talk about anal warts. Is this common? How do they developed?

Dr. Arman: Anal warts are still as not as common as the first 3 diseases that we have 
discussed. But again in my practice Iím seeing this more frequently now compared to 5 
to 10 years ago. Anal warts will definitely majority of these if not all, is really a 
sexually transmitted. The main cause is actually is the HPV virus. HPV virus is the 
one who produces the symptoms.

Dr. Manuel: Itís similar to your cervical warts.

Host: So itís the form of genital warts.

Dr. Arman: Genital warts or anal warts just have really one cause. the HPV virus.

Host: Human Phapiloma Virus.

Dr. Arman: It is the one that also leads to cervical cancer as well.

Host: Why did they form in that area? What are they like?

Dr. Manuel: Almost like that but they can call less. They can form into a group 
together that will look like cally flowers or even make it huge.

Dr. Arman: Sometimes they are small.

Host: Can they be look like as a hemorrhoids, no?

Dr. Manuel: Well to an expert I donít really look like a hemorrhoid. And many of this 
people know they have a history.

Dr. Arman: Well, yeah some of these are just very small lesions but some of them can 
be really very large almost looking like the vegetable cauliflower.

Host: itís not like the warts that we normally see like a dot.

Dr. Manuel: No, they group together and they grow faster. In fact one of our 
difficulties with these problem is they can recur even if we treat them they have a 
tendency to recur. Or they have the tendency to get reinfected with our partners 
again. So itís a little more complexing in treating.

Dr. Arman: We have to treat this patient rather holistically but at least now 
compared before many of our patients choose to be embarrassed in admitting their 
sexually preferences but now theyíre more open. And weíre able to advice them 
properly because of that. So aside of treating them either symptomatically or 
sometimes we apply some chemicals to sort of cauterized or actually surgically 
cauterized large lesions or we have to excised the relievery a large lesions we 
really advised them to really abstain from anal receptive intercourse and of course 
practice more hygienic sexual practices as well.

Dr. Manuel: The other issue with warts is because its sexually transmitted disease 
there maybe also other sexually transmitted diseases like gonoreha, syphilis and then 
also HIV which is also growing in this country. So that the big issue that we have 
to, that we will grafted more and more in the future.

Host: The statistic that you mentioned earlier that you noticed the last five years 
has increased.

Dr. Arman: Iíve really seen many more patients.

Dr. Manuel: When we were training in PGH, many years ago. Maybe we would see one a 
month. Now weíre seeing 3 a week. A charity services. That how fast theyíve become.

Dr. Arman: Our lifestyle in our country really has changed. Thatís why I always tell 
my patient even if Iím able to remove or cauterized your warts Iím not able to 
eradicate the virus. The virus actually really stays there.

Host: You just cauterized the warts. What you see. You take it out via surgery or 
cautery.

Dr. Arman: But the virus sensually remains in that area so when your resistance goes 
down you can have recurrence with these warts again.

Dr. Manuel: The other thing is just like cervical warts that can cause cervical 
cancer, long standing anal warts can cause to anal cancer.
Host: So aside from taking it out you need to monitor that. And you should not feed 
that virus.

Dr. Arman: You really need to be monitored. You need to change you life style. And 
really improve on your immune system. Through good nutrition. Being physically fit, 
exercising.

Dr. Manuel: And safe sex.

Host: How often should one see a colorectal surgeon?

Dr. Manuel: For warts? It depends we see them weekly for the first weeks of treatment 
and then maybe monthly for the first 6 months and then every 3months. We have other 
things. Sometimes we give this immunization against this HPV also.

Host: To learn more about being more careful about and general well being and the 
rectum and the anus for this particular episode, I understand March is devoted to..

Dr. Manuel: Colorectal Cancer Awareness Month. Itís the international month for the 
colorectal cancer awareness.

Host: March is colorectal cancer awareness month. Please tell us about the activities 
for this month. And your advocacies.

Dr. Manuel: Well colorectal cancer is one of the most common cancers worldwide. Its 
number either number 2 or number 3, in some countries its number one. And this also 
one of the most preventable and curable cancer when caught early. So our advocacy 
campaign is really greater awareness so that we could pick it up early when its 
either preventable as folip or curable as an early stage cancer.

Host:
how do we catch it as a patient how do we identify or how do we know when to 
see our doctor?

Dr. Manuel: As long as reached 45 or 50, even if youíre feeling healthy and youíre 
not feeling anything else you should get screened. Either colonoschrophy
which can 
be good for 10 years if its normal. Or what we call a microscopic blood every year. 
Itís a stool exam that checked for microscopic blood every year and only if itís 
positive it with be colonoscopy.

Dr. Arman: But that for average population. However if you have what we call a first 
degree relative meaning a brother, a sister, or your parents whom had a history of 
colon or rectal cancer the risk is higher and you should be screened earlier. Than 
the usual. 45 or 50 you should be screened maybe even 40 or young.

Dr. Manuel: of course there are warning sign. Screening is for people who are not 
feeling anything if you have warning sign this is not a screening anymore. You should 
get diagnosed. The warning sign are the blood on your stools. A change in your bowel 
habit, abdominal pain, unexplained weight lost, anemia if youíre pale and you donít 
know why youíre pale.

Host: Are they open to get into colorectal exam? Are they open getting their stool?

Dr. Arman: More and more patient are getting more open. Again one of the reasons why 
we get a lot of advance stage in colorectal cancer in our country aside of course of 
the economic reason for the poorer section of the population there is again delay in 
consultation. They get embarrassed because they have colorectal bleeding. Theyíre 
fearful that somebody like one of us the colorectal surgeon will focus finger in very 
private part of your anatomy. That not a comfortable feeling or idea to have. So this 
causes delay.

Dr. Manuel: But we need to stress in general population that part of being healthy. 
Having a healthy lifestyle is getting yourself a screened, getting yourself check up. 
One of the sad things we often see in our practice you have very healthy, should be 
healthy 80y.o, they have no hypertension, and they have no heart disease have no 
diabetes. And yet they come to ask they have a cancer and we feel bad about it they 
had a colonoscopy maybe ten years previously this would have been avoided.

Dr. Arman: Or sometimes they will seek consultation with a physician who may not even 
bother to do rectal exam. Even if theyíre already presenting with these warning 
signs. They will be often be prescribed the anti-hemorrhoidal preparations or even 
medication against what we call amoebasis. Very frequent because they dismisses the 
diarrhea and the rectal bleeding as due to amoeba. And without doing a rectal exam 
will just prescribed and not even, yun pala meron ng starting or beginning rectal 
cancer.

Host: So nadismiss yung potential diagnosis? Life style changes, doctors are there 
certain types of food that you should take more of or should you avoid spicy food if 
you already have the hemorrhoids.

Dr. Manuel: Well whatís in the literature about of risk factors for colorectal cancer 
in terms of food is high in fat content, low in fiber, red meat, processed meat, 
barbequed meat, all of these are factors.

Host: Everything in moderation but would you advice to your patient to completely 
avoid?

Dr. Manuel: What we would advice is even if youíre vegetarian or eating healthy get 
yourselves screened. Because thatís not guaranteed that youíre not going to get 
colorectal cancer. So screening is the most important aspect of healthy living. 
Exercise also has been shown to decrease the incidences. Obesity increases the risk. 
Diabetes also but still even if youíre not diabetic you get screened, cause you donít 
know.

Host: Lalo na kung risk factor or if itís hereditary. Doctors your final message to 
all of our viewers regarding in taking good care of our health most especially in 
this part of our body.

Dr. Manuel: Well for hemorrhoids and fissures is not life threatening condition. But 
itís very common we do recommend if you have symptoms in the anus do not dismiss it. 
Get to see an expert who will then tell you if its fissure or hemorrhoids, you donít 
have it to be treated if you donít want to. But get checked because our advocacy is 
early diagnosis of potentially more serious problems like colorectal folips and 
cancers.

Dr. Arman: Well the good news is that majority of anal diseases including colorectal 
cancer can be prevented and can be detected or can be treated. So prevention 
necessity requires eating a lot of fiber, diet, exercising a lot, avoiding smoking, 
is just necessity healthy lifestyle and good bowel habits. In the same way in 
colorectal cancer. Most of these can be either prevented if you have healthy 
lifestyle or see a specialist in the earliest possible time and have yourself 
screened at a proper time. 


Know More :
http://colonandrectalspecialists.com/en/talk-to-our-doctors/best-treatment-for-
 hemorrhoids-that-you-need-to-see

https://www.youtube.com/watch?v=Tgij3xNsDbQ
 
Contact Us: 988-1000 local 7789
2nd Floor Podium Building, the Medical City
Contact person : Dr. Manuel Roxas

Dr. Manuel Roxas

Tags : hemorrhoids and the treatment, treatment for hemorrhoids, hemorrhoids, stapled 
hemorrhoidectomy 


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