MUDr. Tomáš Mašek: In the prevention of hemorrhoids, more use of venopharmaceuticals is needed
While in the past the diagnosis of hemorrhoids was inextricably linked to traditional surgical solutions, today - thanks to the expansion of the indication for venopharmaceuticals for this condition - the number of patients who have to undergo these procedures is a minority. We asked coloproctologist MUDr. Tomáš Mašek how the potential of venopharmaceuticals can be utilized in the prevention and treatment of hemorrhoid disease.
You have been treating hemorrhoid disease from the perspective of a proctologist-surgeon for several decades. How has the approach to venopharmaceuticals changed over that time?
Thirty years ago, at the beginning of my career, hemorrhoids were almost exclusively treated surgically. These were classical operations under general anesthesia, and the healing time after the procedure was 4-6 weeks. Nowadays, new methods of surgical treatment are available, and venopharmaceuticals have also entered the market, helping to improve the condition of veins not only in the lower limbs but also in the rectum. Thanks to this, recently only a small percentage of patients need to undergo classic hemorrhoid surgery.
Venopharmaceuticals are a suitable supportive treatment both before and after surgery
What effects of venopharmaceuticals have you been able to observe in your practice?
I have good experience with venopharmaceuticals in toning the venous wall, practically in the treatment of thrombotic hemorrhoids and in preventing the recurrence of hemorrhoid disease.
What is the goal of using venopharmaceuticals before surgery?
Venopharmaceuticals before hemorrhoid surgery serve to prepare the venous system of the rectum for surgical intervention.
And what use do they have after surgery?
After hemorrhoid surgery, venopharmaceuticals are suitable for toning the venous system and preventing perianal thrombosis.
Dosage and duration of use – recommended topics for discussion with a doctor
Can venopharmaceuticals be indicated for patients with recurrent venous surgeries?
Yes, they can, as part of the prevention of recurrences.
If patients decide to take over-the-counter venopharmaceuticals on their own, what should they discuss with their doctor?
It is advisable for them to discuss the dosage and duration of use of venopharmaceuticals with their treating physician.
What impact does the availability of micronized diosminas a venopharmaceutical have on treatment?
The benefit of the micronized form is better penetration of the active ingredient into tissues.
Family history as a reason for the preventive use of venopharmaceuticals
At what age do your patients start taking venopharmaceuticals? Do you think it is timely, or should they start this treatment earlier?
Nowadays, venopharmaceuticals are used at the first sign of problems. However, it is also possible to use them preventively, especially for people with a family history of varicose veins and hemorrhoids.
What is the gender distribution of patients with hemorrhoid disease in your practice? And how does the age indicator factor into these statistics?
In our practice, about 70% of patients with hemorrhoidal issues are women and 30% men. After the age of 40, the number of people with these problems increases, but patients as young as 25 are not uncommon.
Is the potential of venopharmaceuticals currently fully utilized in practice, or do you still see some room for improvement?
There is definitely potential to use venopharmaceuticals more in prevention rather than relying on them only after the first complications arise.
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