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علاج البواسير بالليزر
Haemorrhoids are normal blood vessels at the end of the rectum; they become a disease when they enlarge, prolapse or bleed because of raised pressure from chronic constipation, prolonged straining, long sitting and pregnancy. Laser haemorrhoid treatment directs a laser beam through a fine fibre into the haemorrhoidal tissue, shrinking and sealing its vascular tissue from within rather than excising tissue with a scalpel. Its main clinical advantage is that it does not create a wide open wound in an area of dense nerve supply, so pain afterwards is usually less than with conventional excision and return to work is faster. That does not make it best for every case: large prolapsing haemorrhoids, those with substantial skin tags, or complete prolapse may respond more durably to conventional excision, and the decision rests on the grade and configuration. Before any treatment, the non-negotiable step is correct diagnosis: rectal bleeding must never be assumed to be haemorrhoids. Examination and proctoscopy — and colonoscopy where there are risk factors, older age, a change in bowel habit, weight loss or anaemia — are essential to exclude other causes, some of them serious. And the real long-term treatment is **correcting the cause of the pressure**: fibre, fluids, no straining and no prolonged sitting on the toilet; otherwise the problem returns after any procedure.
Clinical examination and proctoscopy to grade the haemorrhoids, with colonoscopy where risk factors, atypical bleeding or a change in bowel habit exist — because bleeding may have another cause.
Fibre, fluids and stool softeners to regulate bowel movements, topical ointments and suppositories, and toilet-behaviour modification. Many early grades settle with this alone.
The procedure is done under local anaesthesia with sedation, or regional or general anaesthesia as appropriate, with rectal preparation per the team’s instructions.
A fine laser fibre is introduced into the haemorrhoidal tissue and delivers calculated energy that shrinks and seals the vessels, so the tissue fibroses and shrinks gradually without wide excision.
A review confirms healing, alongside a permanent plan of fibre, fluids and avoiding straining, since a persisting cause of pressure brings the problem back after any procedure.
Tell your surgeon about your medications, especially blood thinners and aspirin, and about liver disease, clotting disorders or inflammatory bowel disease. Report heavy or black bleeding, or bleeding with weight loss or a change in bowel habit — these require investigation before any procedure aimed at the symptom. Follow bowel preparation and fasting as the team specifies, and arrange an escort if anaesthesia is deeper than local. Start increasing fibre and fluids now, since good bowel regulation greatly eases recovery. Ask what grade your haemorrhoids are, why laser suits you compared with banding or excision, and whether a second session may be needed.
Keep stools soft with fibre, fluids and a softener if prescribed — this is the single most important step, since constipation after the procedure causes pain and bleeding and delays healing. Sitting in warm water (sitz baths) several times daily soothes the area; clean with water and pat dry without rubbing. Use the prescribed analgesia, avoid straining, and do not sit long on the toilet or read there. Expect mild to moderate pain, slight bleeding with bowel movements in the first days, and a sensation of fullness. Avoid heavy lifting and strenuous exercise for a week or more as advised. Seek care promptly for heavy or persistent bleeding, fever, inability to pass urine, severe increasing pain, or pus or foul odour.
Usually 20–40 minutes, with same-day discharge
الدكتور داوود محمود داوود — استشاري جراحة السمنة والمناظير والجراحة العامة في الأردن، وحاصل على البورد الأردني في الجراحة العامة، وعضو في جمعية الجرّاحين الأردن…
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