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Hemoroider: Valg av behandlingsmetode

Innhold i artikkelen

Færre enn 10 prosent av henviste pasienter trenger kirurg.

  • Grad 1
    • Behandles med avføringsmiddel og uparfymert salve. Milde steroidsalver (eks. Scheriproct®) kan benyttes i kortere perioder. Ved smerter brukes lokalbedøvende salver (eks. Xylocain®). I noen tilfeller kan det være aktuelt å bruke gummistrikkmetoden.
  • Grad 2
    • Denne typen hemoroider anbefales behandlet med gummistrikkmetoden.
  • Grad 2-3
    • Disse kan behandles med gummistrikkmetoden, men åpen operasjon med kirurgisk fjerning av hemoroidene eller hemoroidopeksi anbefales.
  • Grad 4
    • Er aktuelt ved store hemoroider eller ved komplikasjoner som blodpropp (trombose), sprekkdannelser (fissurer) og fistler - 
  • Hemoroider som det har dannet seg blodpropp i
    • Gir sterke smerter og behandles enten med kirurgisk fjerning i lokalbedøvelse eller med åpen operasjon i narkose
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Vil du vite mer

Dette dokumentet er basert på det profesjonelle dokumentet Hemoroider . Referanselisten for dette dokumentet vises nedenfor

  1. Mounsey AL, Halladay J. Hemorrhoids. Am Fam Physician 2011; 84: 204-10. American Family Physician
  2. Nisar PJ, Scholefield JH. Managing haemorrhoids. BMJ 2003; 327: 847-51. PubMed
  3. Riss S, Weiser FA, Schwameis K, et al. The prevalence of hemorrhoids in adults. Int J Colorectal Dis. 2012 Feb;27(2):215-20 . pmid:21932016 PubMed
  4. Jacobs D. Hemorrhoids. N Engl J Med 2014; 371: 944-51. doi:10.1056/NEJMcp1204188 DOI
  5. Hjorthaug JB. Oppdatert om hemoroidekirurgi. Gastroenterologen, 11.05.2012. gastroenterologen.no
  6. Qvist N. Kirurgisk behandling af symptomgivende hæmorider. Ugeskr Læger 2006; 168: 2903-6. PubMed
  7. Christiansen J. Kirurgisk hæmoridebehandling. Ugeskr Læger 2004; 166: 3581-4. PubMed
  8. Cataldo P, Ellis CN, Gregorcyk S, et al.; Standards Practice Task Force, The American Society of Colon and Rectal Surgeons, USA. Practice parameters for the management of hemorrhoids (revised). Dis Colon Rectum 2005; 48: 189-94. PubMed
  9. Perrotti P, Antropoli C, Molino D, De Stefano G, Antropoli M. Conservative treatment of acute thrombosed external hemorrhoids with topical nifedipine. Dis Colon Rectum 2001; 44: 405-9. PubMed
  10. Alonso-Coello P, Guyatt GH, Heels-Ansdell D, Johanson JF, Lopez-Yarto M, Mills E, Zhuo Q. Laxatives for the treatment of hemorrhoids.. Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD004649. DOI: 10.1002/14651858.CD004649.pub2. DOI
  11. Altomare DF, Rinaldi M, La Torre F, et al. Red hot chili pepper and hemorrhoids: The explosion of a myth: Results of a prospective, randomized, placebo-controlled trial. Dis Colon Rectum 2006; 49: 1018-23. PubMed
  12. Davis B, Lee-Kong SA, Migaly J, et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Hemorrhoids. Dis Colon Rectum 2018; 61: 284-92. pmid:29420423 PubMed
  13. MacRae HM, Temple LK, McLeod RS. A meta-analysis of hemorrhoidal treatments. Semin Colon Rectal Surg. 2002;13:77-83. PubMed
  14. Shanmugam V, Hakeem A, Campbell KL, Rabindranath KS, Steele RJC, Thaha MA, Loudon MA. Rubber band ligation versus excisional haemorrhoidectomy for haemorrhoids. Cochrane Database of Systematic Reviews 2005, Issue 1. Art. No.: CD005034. DOI: 10.1002/14651858.CD005034.pub2. DOI
  15. Iyer VS, Shrier I, Gordon PH. Long-term outcome of rubber band ligation for symptomatic primary and recurrent internal hemorrhoids. Dis Colon Rectum 2004; 47: 1364-70. PubMed
  16. Greenspon J, Williams SB, Young HA, Orkin BA. Thrombosed external hemorrhoids: outcome after conservative or surgical management. Dis Colon Rectum 2004; 47: 1493-8. PubMed
  17. Zuber TJ. Hemorrhoidectomy for thrombosed external hemorrhoids. Am Fam Physician 2002; 65: 1629-32. American Family Physician
  18. Sneider EB, Maykel JA.Diagnosis and management of symptomatic hemorrhoids. Surg Clin North Am. 2010; 90(1): 17-32.
  19. Nienhuijs SW, de Hingh IHJT. Conventional versus LigaSure hemorrhoidectomy for patients with symptomatic Hemorrhoids. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD006761. DOI: 10.1002/14651858.CD006761.pub2. DOI
  20. Khafagy W, El Nakeeb A, Fouda E, Omar W, Elhak NG, Farid M, Elshobaky M.Conventional haemorrhoidectomy, stapled haemorrhoidectomy, Doppler guided haemorrhoidectomy artery ligation; post operative pain and anorectal manometric assessment. Hepatogastroenterology. 2009; 56(93): 1010-5.
  21. Giordano P, Gravante G, Sorge R, Ovens L, Nastro P. Longterm outcomes of stapled hemorrhoidopexy vs conventional hemorrhoidectomy: a meta-analysis of randomized controlled trials. Arch Surg 2009; 144: 266-72. PubMed
  22. Ganio E, Altomare DF, Milito G, Gabrielli F, Canuti S. Long-term outcome of a multicentre randomized clinical trial of stapled haemorrhoidopexy versus Milligan-Morgan haemorrhoidectomy. Br J Surg 2007; 94: 1033-7. PubMed
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