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Ambulatory Proctologic Clinic


Hemorrhoids, anal fistula, fissure and pilonidal sinus diseases affects 60% of the local population. Pain and bleeding are the most common symptoms experienced by many patients.  With the risks that goes with the traditional operation, we started a new era in the management of these diseases by using the latest and most advance equipments such as the IRC, Ellman RF, CO2 Laser.
Our 20 years experience coupled with our expertise, we are able to achieve a quick and safe surgery. Most of the procedures will only take 10 to 30 minutes with minimal discomfort.
Hemorrhoids (HEM-uh-roids), also called piles, are swollen and inflamed veins in your anus and lower rectum. Hemorrhoids may result from straining during bowel movements or from the increased pressure on these veins during pregnancy, among other causes. Hemorrhoids may be located inside the rectum (internal hemorrhoids), or they may develop under the skin around the anus (external hemorrhoids). 
Hemorrhoids are common ailments. By age 50, about half of adults have had to deal with the itching, discomfort and bleeding that can signal the presence of hemorrhoids.
Fortunately, many effective options are available to treat hemorrhoids. Most people can get relief from symptoms using home treatments and lifestyle changes. 
The veins around your anus tend to stretch under pressure and may bulge or swell. Swollen veins -hemorrhoids - can develop from an increase in pressure in the lower rectum. Factors that might cause increased pressure include:
-Straining during bowel movements
-Sitting for long periods of time on the toilet
-Chronic diarrhea or constipation
-Anal intercourse
It is  also possible to inherit a tendency to develop hemorrhoids. Hemorrhoids are more likely as you get older because the tissues that support the veins in your rectum and anus can weaken and stretch with aging.
 Signs and symptoms of hemorrhoids may include: 
-Painless bleeding during bowel movements — you might notice small amounts of bright red blood on your toilet     tissue or in the toilet bowl
-Itching or irritation in your anal region
-Pain or discomfort
-Swelling around your anus
-A lump near your anus, which may be sensitive or painful
-Leakage of feces
Hemorrhoid symptoms usually depend on the location. Internal hemorrhoids lie inside the rectum. You usually can not see or feel these hemorrhoids, and they usually do not cause discomfort. But straining or irritation when passing stool can damage a hemorrhoid delicate surface and cause it to bleed. Occasionally, straining can push an internal hemorrhoid through the anal opening. This is known as a protruding or prolapsed hemorrhoid and can cause pain and irritation. 
External hemorrhoids are under the skin around your anus. When irritated, external hemorrhoids can itch or bleed. Sometimes blood may pool in an external hemorrhoid and form a clot (thrombus), resulting in severe pain, swelling and inflammation. 

 When to see a doctor
Bleeding during bowel movements is the most common sign of hemorrhoids. But rectal bleeding can occur with other diseases, including colorectal cancer and anal cancer. Do not assume that bleeding is coming from hemorrhoids without consulting a doctor. Your doctor can do a physical examination and perform other tests to diagnose hemorrhoids and rule out more serious conditions or diseases. Also consider seeking medical advice if your hemorrhoids cause pain, bleed frequently or excessively, or do not  improve with home remedies. 
If your hemorrhoid symptoms began along with a marked change in bowel habits or if you are  passing black, tarry or maroon stools, blood clots or blood mixed in with the stool, consult your doctor immediately. These types of stools can signal more extensive bleeding elsewhere in your digestive tract. 
Seek emergency care if you experience large amounts of rectal bleeding, lightheadedness, dizziness or faintness. 
The best way to prevent hemorrhoids is to keep your stools soft, so they pass easily. To prevent hemorrhoids and reduce symptoms of hemorrhoids, follow these tips: 
Eat high-fiber foods. Eat more fruits, vegetables and whole grains. Doing so softens the stool and increases its bulk, which will help you avoid the straining that can cause hemorrhoids or worsen symptoms from existing hemorrhoids. Add fiber to your diet slowly to avoid problems with gas.
-Drink plenty of fluids. Drink six to eight glasses of water and other liquids (not alcohol) each day to help keep stools soft. 
-Consider fiber supplements. Most people do not  get enough of the recommended amount of fiber — 20 to 35 grams a day — in their diet.  Studies have shown that over-the-counter fiber supplements, such as Metamucil and Citrucel, improve overall symptoms and bleeding from hemorrhoids. These products help keep stools soft and regular. If you use fiber supplements, be sure to drink at least eight glasses of water or other fluids every day. Otherwise, the supplements can cause constipation or make constipation worse.
-Do not  strain. Straining and holding your breath when trying to pass a stool creates greater pressure in the veins in the lower rectum.
-Go as soon as you feel the urge. If you wait to pass a bowel movement and the urge goes away, your stool could become dry and be harder to pass.
-Exercise. Stay active to help prevent constipation and to reduce pressure on veins, which can occur with long periods of standing or sitting. Exercise can also help you lose excess weight that may be contributing to your hemorrhoids.
-Avoid long periods of standing or sitting. Sitting too long, particularly on the toilet, can increase the pressure on the veins in the anus.
Hemorrhoids surgery 
The rectum is the final portion of the large intestine. It empties stool from the body through the anus. Hemorrhoids are "cushions" of tissue filled with blood vessels at the junction of the rectum and the anus. These cushions normally act to prevent the leakage of stool from the anus. These vascular cushions can become swollen and inflamed, usually due to increased intra-abdominal pressure, such as straining when constipated or during pregnancy. Such swelling causes pain, bleeding, and itching.
Hemorrhoid removal is recommended when non-surgical treatment (fiber rich diet, laxatives, stool softener, suppositories, medications, or warm baths) does not provided adequate relief from:
persistent itching
anal bleeding
blood clots (thrombosis of the hemorrhoids)


Under The Supervision of : Dr. Muhannad Ahmad Diab