CAMAGÜEY.- Not a little addressed is less present a disease that affects many people, and is the appearance of problems with their hemorrhoids. To know about this disease, one of the most assisted illnesses in proctology services, we asked Dr. Ramón Estopiñán Rebollar, a seasoned specialist in Coloproctology and head of this service of the university hospital Manuel Ascunce Domenech, of this city, who is, in addition , Assistant Professor and head of the Chapter of the Cuban Society of Coloproctology in the province of Camagüey.

What is hemorrhoids?

- It respond to varicose alterations at the level of the anus.

-What are the causes of the illness?

-It may be hereditary, also product of constipation, pregnancy and childbirth, to stand up for long periods of time.

-"Does it prefer people by their sex?"

- They appear in anyone, but it is more frequent in the feminine sex.

-The symptoms?

-Discomfort at the level of the anus, pruritus or stinging, bleeding, pain, although the latter appears before some complication.

-"Is there only a type?"

- No, they are classified in grades I, II, III and IV. In the I, they are small hemorrhoidal packages that produce bleeding; II, apart from bleeding occasionally occur through prolapse through the anus and are reduced spontaneously; are classified in III, those that show a protrusion at the time of defecation and the person has to introduce them with the hands; and the IV, responds to large packs of hemorrhoidal mucus that provoke the prolapse of these and are kept constantly outside.

"They are also classified as internal and external."

-How is the internal type detected?

- Through complementary examinations, such as anoscopy and others. Through these procedures, we visualize the hemorrhoidal plexuses (set of veins within the sub mucosa of the rectum and the anus).

-"Do they always have surgical treatment?"

"No, it depends on the degree to which they are. Usually operable ones are those of degrees III and IV, with maintained discomfort, which include bleeding and the presence of external hemorrhoidal packets. In addition, when they are in grades I and II and are associated with perianal fistulas, anal fissure and condyloma acuminata and other diseases.

-Without not being treated surgically, what is oriented?

-Measures that eradicate or alleviate the aforementioned causes, and are related to food, toxic habits and others.

- Can they be caused by toxic habits?

"Yes, they do. Especially they affect those who ingest alcoholic beverages and if you already have it and add the habit or addiction, it gets worse, in this person the bleeding is greater.

- It is very heard that the patients suffer from these again, that is, they reappear ...

-It is not like this. The doctor decides to remove a specific hemorrhoidal package that is dilated and leaves others undeveloped and over the years, they arise but are not the same.

"It means then that surgical interventions of this kind are successful ..."

"Yes, without a doubt."

"After the surgery, the person stayed for several days, is it the same in the days that run?

"No, not at all. We operate under local anesthesia and on an outpatient basis and only leave in the hospital those people with concomitant ailments such as: diabetics, cardiac patients, hypertensive patients, or those with central nervous system disorders and thus we are attentive to various complications and act immediately, if they did appear, of course.

- We do not talk about drugs in these consultations to avoid self-medication; however, on this occasion it is of great interest that one is Cuban, conceived in the Center for Genetic Engineering and Biotechnology (CIGB) of the capital, specifically a suppository, what can you tell me about it?

"Yes, it's Proctokinasa's suppositories, which came to light after a very rigorous five-phase clinical trial, and is now being applied to pregnant women. They do not have adverse reactions.

- Do they fit for all people with hemorrhoids problems?

- No, it is only indicated for complications of hemorrhoids, such as thrombus and hemorrhoidal flow (prolapsed, with thrombosis, edema and infectious process), that is, the doctor, after checking the patient is who determines its use or do not.

"I want to emphasize that it is not designed to cure hemorrhoids but to treat them in the face of complications."

"And in those who have been prescribed, have they succeeded?"


- What effect do they provide?

- They reduce pain and inflammation, and sometimes the inflammatory process disappears.

"Another thing to keep in mind is that many patients come to the clinic after four or six days of the crisis, and it does not have the same effect. Treatment should be started as soon as the problem arises, the moment you feel the inflammation, then if you self-medicate and come to us when you do not see improvement, when you apply it, you can not find the expected progress. "

-How can the drug be reached?

-It's at the hospital level. The proctologist issues the prescription and it is provided at the hospital, according to the specialist's guidelines.

"Something to keep in mind is how to place the suppositories, this or any other. It is a mistake to introduce them through the thin part, it is the other way around, because otherwise and leaving the fat part out the anus does not close. "

-There are practices related to natural and traditional medicine, and even unorthodox procedures, what do you tell me about it?

-There are opinions and have no scientific basis, if someone has improvement with some of these initiatives does not mean that is valid for the rest. Everything, even natural and traditional medicine should be indicated by the doctor.

Translated by Linet Acuña Quilez