{"id":8798,"date":"2026-04-17T11:13:12","date_gmt":"2026-04-17T02:13:12","guid":{"rendered":"https:\/\/www.heartfull.or.jp\/kano\/?page_id=8798"},"modified":"2026-07-08T10:17:53","modified_gmt":"2026-07-08T01:17:53","slug":"proctological-surgery","status":"publish","type":"page","link":"https:\/\/www.heartfull.or.jp\/kano\/proctological-surgery","title":{"rendered":"Proctological Surgery"},"content":{"rendered":"<div class=\"KoteiPage_Wrap\">\n<h2 class=\"KoteiPage_Title\">Proctological Surgery<\/h2>\n<h3 class=\"KoteiPage_SubTitle\">Piles and Proctological Surgery<\/h3>\n<p class=\"KoteiPage_Text\">Piles, also known as hemorrhoids, are one of the anal conditions treated by the Department of Gastroenterological Surgery. This page explains symptoms, related conditions, prevention tips, and when surgical treatment may be needed.<\/p>\n<p class=\"KoteiPage_Text\">The Department of Gastroenterological Surgery diagnoses and treats conditions commonly known as &#8220;hemorrhoids.&#8221; These include hemorrhoids, anal fissures, and anal fistulas. These conditions may cause pain, bleeding, swelling, or discomfort.<\/p>\n<p class=\"KoteiPage_Text\">In many cases, daily habits are important for managing piles and related anal conditions. Regular meals, proper bowel habits, and daily bathing may help reduce symptoms. However, surgery may be needed if symptoms do not improve with medications such as ointments or suppositories.<\/p>\n<h4 class=\"KoteiPage_SubTitle KoteiPage_SubTitle--sub\">Hemorrhoids (Piles)<\/h4>\n<p class=\"KoteiPage_Text\">Hemorrhoids formed inside the dentate line are called <b>internal hemorrhoids<\/b>. Those formed outside are called <b>external hemorrhoids<\/b>. Sometimes, hemorrhoids may protrude outside the anus. This is called prolapse.<\/p>\n<p class=\"KoteiPage_Text\">Piles can occur when blood circulation around the anus becomes poor. Common causes include straining during bowel movements or staying in the same posture for a long time. Surgical treatment involves ligation and excision of the hemorrhoids under spinal anesthesia. A hospital stay of approximately 4 to 5 days is required.<\/p>\n<div class=\"PilesProcto_InlineTableWrap\" style=\"width:100% !important; margin:24px 0 32px 0 !important; padding:0 !important; overflow-x:auto !important; overflow-y:visible !important; -webkit-overflow-scrolling:touch !important; border-radius:6px !important; box-shadow:0 2px 16px rgba(0,0,0,0.07) !important; box-sizing:border-box !important;\">\n<table class=\"PilesProcto_InlineTable\" style=\"display:table !important; width:100% !important; min-width:900px !important; table-layout:fixed !important; border-collapse:collapse !important; border-spacing:0 !important; background:#ffffff !important; border:1px solid #d6ccb0 !important; font-size:14px !important; line-height:1.7 !important; box-sizing:border-box !important;\">\n<colgroup>\n<col style=\"width:13% !important;\" \/>\n<col style=\"width:18% !important;\" \/>\n<col style=\"width:18% !important;\" \/>\n<col style=\"width:51% !important;\" \/>\n      <\/colgroup>\n<thead>\n<tr>\n<th scope=\"col\" style=\"padding:13px 14px !important; background:linear-gradient(135deg,#0d4427,#2d8a52) !important; color:#ffffff !important; border:1px solid #d6ccb0 !important; border-left:4px solid #c9a84c !important; font-size:13px !important; font-weight:700 !important; text-align:center !important; vertical-align:middle !important; line-height:1.5 !important; box-sizing:border-box !important;\">&nbsp;<\/th>\n<th colspan=\"2\" scope=\"col\" style=\"padding:13px 14px !important; background:linear-gradient(135deg,#0d4427,#2d8a52) !important; color:#ffffff !important; border:1px solid #d6ccb0 !important; font-size:13px !important; font-weight:700 !important; text-align:center !important; vertical-align:middle !important; line-height:1.5 !important; box-sizing:border-box !important;\">Classification<\/th>\n<th scope=\"col\" style=\"padding:13px 14px !important; background:linear-gradient(135deg,#0d4427,#2d8a52) !important; color:#ffffff !important; border:1px solid #d6ccb0 !important; font-size:13px !important; font-weight:700 !important; text-align:center !important; vertical-align:middle !important; line-height:1.5 !important; box-sizing:border-box !important;\">Symptoms<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<th rowspan=\"4\" scope=\"rowgroup\" style=\"padding:14px 12px !important; background:linear-gradient(135deg,#0d4427,#2d8a52) !important; color:#ffffff !important; border:1px solid #d6ccb0 !important; border-left:4px solid #c9a84c !important; font-size:13px !important; font-weight:700 !important; text-align:center !important; vertical-align:middle !important; line-height:1.5 !important; box-sizing:border-box !important;\">Internal<br \/>Hemorrhoids<\/th>\n<th scope=\"row\" style=\"padding:14px 12px !important; background:#f0f8f3 !important; color:#1a6b3c !important; border:1px solid #d6ccb0 !important; border-left:4px solid #c9a84c !important; font-size:13px !important; font-weight:700 !important; text-align:center !important; vertical-align:middle !important; line-height:1.5 !important; box-sizing:border-box !important;\">Grade I<\/th>\n<td style=\"padding:12px !important; background:#ffffff !important; color:#1c1c1c !important; border:1px solid #d6ccb0 !important; text-align:center !important; vertical-align:middle !important; box-sizing:border-box !important;\">\n            <img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.heartfull.or.jp\/kano\/wp-content\/uploads\/2015\/09\/50dca5a9ab7b849aa6b473dcd01b710c.jpg\" alt=\"Piles Grade I internal hemorrhoids\" width=\"175\" height=\"108\" style=\"display:block !important; width:auto !important; max-width:175px !important; height:auto !important; margin:0 auto !important; padding:0 !important; border:none !important;\" \/>\n          <\/td>\n<td style=\"padding:14px 18px !important; background:#ffffff !important; color:#1c1c1c !important; border:1px solid #d6ccb0 !important; font-size:14px !important; font-weight:500 !important; text-align:left !important; vertical-align:middle !important; line-height:1.7 !important; word-break:normal !important; overflow-wrap:break-word !important; box-sizing:border-box !important;\">No prolapse. Bleeding often occurs during bowel movements, but pain is usually not present.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\" style=\"padding:14px 12px !important; background:#e6f2eb !important; color:#1a6b3c !important; border:1px solid #d6ccb0 !important; border-left:4px solid #c9a84c !important; font-size:13px !important; font-weight:700 !important; text-align:center !important; vertical-align:middle !important; line-height:1.5 !important; box-sizing:border-box !important;\">Grade II<\/th>\n<td style=\"padding:12px !important; background:#ece5d6 !important; color:#1c1c1c !important; border:1px solid #d6ccb0 !important; text-align:center !important; vertical-align:middle !important; box-sizing:border-box !important;\">\n            <img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.heartfull.or.jp\/kano\/wp-content\/uploads\/2015\/09\/96183f87ccbf513be73c8ee4b767caa9.jpg\" alt=\"Piles Grade II internal hemorrhoids\" width=\"174\" height=\"108\" style=\"display:block !important; width:auto !important; max-width:175px !important; height:auto !important; margin:0 auto !important; padding:0 !important; border:none !important;\" \/>\n          <\/td>\n<td style=\"padding:14px 18px !important; background:#ece5d6 !important; color:#1c1c1c !important; border:1px solid #d6ccb0 !important; font-size:14px !important; font-weight:500 !important; text-align:left !important; vertical-align:middle !important; line-height:1.7 !important; word-break:normal !important; overflow-wrap:break-word !important; box-sizing:border-box !important;\">Prolapse occurs during bowel movements. However, it returns spontaneously. Bleeding and pain may begin to develop.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\" style=\"padding:14px 12px !important; background:#f0f8f3 !important; color:#1a6b3c !important; border:1px solid #d6ccb0 !important; border-left:4px solid #c9a84c !important; font-size:13px !important; font-weight:700 !important; text-align:center !important; vertical-align:middle !important; line-height:1.5 !important; box-sizing:border-box !important;\">Grade III<\/th>\n<td style=\"padding:12px !important; background:#ffffff !important; color:#1c1c1c !important; border:1px solid #d6ccb0 !important; text-align:center !important; vertical-align:middle !important; box-sizing:border-box !important;\">\n            <img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.heartfull.or.jp\/kano\/wp-content\/uploads\/2015\/09\/95423fc0d603a62d04880ac4c562d61a.jpg\" alt=\"Piles Grade III internal hemorrhoids\" width=\"173\" height=\"108\" style=\"display:block !important; width:auto !important; max-width:175px !important; height:auto !important; margin:0 auto !important; padding:0 !important; border:none !important;\" \/>\n          <\/td>\n<td style=\"padding:14px 18px !important; background:#ffffff !important; color:#1c1c1c !important; border:1px solid #d6ccb0 !important; font-size:14px !important; font-weight:500 !important; text-align:left !important; vertical-align:middle !important; line-height:1.7 !important; word-break:normal !important; overflow-wrap:break-word !important; box-sizing:border-box !important;\">Prolapse occurs and does not return unless pushed back in manually.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\" style=\"padding:14px 12px !important; background:#e6f2eb !important; color:#1a6b3c !important; border:1px solid #d6ccb0 !important; border-left:4px solid #c9a84c !important; font-size:13px !important; font-weight:700 !important; text-align:center !important; vertical-align:middle !important; line-height:1.5 !important; box-sizing:border-box !important;\">Grade IV<\/th>\n<td style=\"padding:12px !important; background:#ece5d6 !important; color:#1c1c1c !important; border:1px solid #d6ccb0 !important; text-align:center !important; vertical-align:middle !important; box-sizing:border-box !important;\">\n            <img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.heartfull.or.jp\/kano\/wp-content\/uploads\/2015\/09\/a7013b53f2edf1220e3968c61da6b43f.jpg\" alt=\"Piles Grade IV internal hemorrhoids\" width=\"174\" height=\"108\" style=\"display:block !important; width:auto !important; max-width:175px !important; height:auto !important; margin:0 auto !important; padding:0 !important; border:none !important;\" \/>\n          <\/td>\n<td style=\"padding:14px 18px !important; background:#ece5d6 !important; color:#1c1c1c !important; border:1px solid #d6ccb0 !important; font-size:14px !important; font-weight:500 !important; text-align:left !important; vertical-align:middle !important; line-height:1.7 !important; word-break:normal !important; overflow-wrap:break-word !important; box-sizing:border-box !important;\">Prolapse cannot be pushed back in. The hemorrhoids become hard. Pain and bleeding may subside, but mucus leakage may soil underwear.<\/td>\n<\/tr>\n<tr>\n<th rowspan=\"2\" scope=\"rowgroup\" style=\"padding:14px 12px !important; background:linear-gradient(135deg,#0d4427,#2d8a52) !important; color:#ffffff !important; border:1px solid #d6ccb0 !important; border-left:4px solid #c9a84c !important; font-size:13px !important; font-weight:700 !important; text-align:center !important; vertical-align:middle !important; line-height:1.5 !important; box-sizing:border-box !important;\">Acute Phase<\/th>\n<th scope=\"row\" style=\"padding:14px 12px !important; background:#f0f8f3 !important; color:#1a6b3c !important; border:1px solid #d6ccb0 !important; border-left:4px solid #c9a84c !important; font-size:13px !important; font-weight:700 !important; text-align:center !important; vertical-align:middle !important; line-height:1.5 !important; box-sizing:border-box !important;\">Thrombosed External Hemorrhoids<\/th>\n<td style=\"padding:12px !important; background:#ffffff !important; color:#1c1c1c !important; border:1px solid #d6ccb0 !important; text-align:center !important; vertical-align:middle !important; box-sizing:border-box !important;\">\n            <img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.heartfull.or.jp\/kano\/wp-content\/uploads\/2015\/09\/a18383a1f5a5380023fcf95c6d185307.jpg\" alt=\"Piles thrombosed external hemorrhoids\" width=\"175\" height=\"108\" style=\"display:block !important; width:auto !important; max-width:175px !important; height:auto !important; margin:0 auto !important; padding:0 !important; border:none !important;\" \/>\n          <\/td>\n<td style=\"padding:14px 18px !important; background:#ffffff !important; color:#1c1c1c !important; border:1px solid #d6ccb0 !important; font-size:14px !important; font-weight:500 !important; text-align:left !important; vertical-align:middle !important; line-height:1.7 !important; word-break:normal !important; overflow-wrap:break-word !important; box-sizing:border-box !important;\">A thrombus, or blood clot, forms around the anus. The skin may rupture and bleed. Severe pain may also occur.<\/td>\n<\/tr>\n<tr>\n<th scope=\"row\" style=\"padding:14px 12px !important; background:#e6f2eb !important; color:#1a6b3c !important; border:1px solid #d6ccb0 !important; border-left:4px solid #c9a84c !important; font-size:13px !important; font-weight:700 !important; text-align:center !important; vertical-align:middle !important; line-height:1.5 !important; box-sizing:border-box !important;\">Strangulated Hemorrhoids<\/th>\n<td style=\"padding:12px !important; background:#ece5d6 !important; color:#1c1c1c !important; border:1px solid #d6ccb0 !important; text-align:center !important; vertical-align:middle !important; box-sizing:border-box !important;\">\n            <img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.heartfull.or.jp\/kano\/wp-content\/uploads\/2015\/09\/edbad7166c5739f48eea570a2f3d09d8.jpg\" alt=\"Piles strangulated hemorrhoids\" width=\"175\" height=\"108\" style=\"display:block !important; width:auto !important; max-width:175px !important; height:auto !important; margin:0 auto !important; padding:0 !important; border:none !important;\" \/>\n          <\/td>\n<td style=\"padding:14px 18px !important; background:#ece5d6 !important; color:#1c1c1c !important; border:1px solid #d6ccb0 !important; font-size:14px !important; font-weight:500 !important; text-align:left !important; vertical-align:middle !important; line-height:1.7 !important; word-break:normal !important; overflow-wrap:break-word !important; box-sizing:border-box !important;\">Multiple thrombi form within the hemorrhoid. As a result, the hemorrhoid becomes prolapsed, swollen, and difficult to reduce. Severe pain may occur.<\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n<h4 class=\"KoteiPage_SubTitle KoteiPage_SubTitle--sub\">Perianal Abscess<\/h4>\n<p class=\"KoteiPage_Text\">A perianal abscess occurs when E. coli from stool spreads to the anal area and pus accumulates. It may cause pain, redness, swelling, and sometimes a high fever. Incision and drainage are necessary.<\/p>\n<p class=\"KoteiPage_Text\">After drainage, an anal fistula may remain. This is a tunnel for pus. In that case, hospitalization and surgery for excision may be required.<\/p>\n<div style=\"width:100% !important; max-width:260px !important; margin:18px 0 18px 0 !important; padding:0 !important; background:transparent !important; box-shadow:none !important; border:none !important;\">\n    <a href=\"http:\/\/www.heartfull.or.jp\/kano\/wp-content\/uploads\/2015\/09\/3d0dae8fe6089a2640a42236dbb7d940.jpg\" style=\"display:block !important; width:fit-content !important; max-width:100% !important; margin:0 !important; padding:0 !important; line-height:0 !important;\"><br \/>\n      <img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.heartfull.or.jp\/kano\/wp-content\/uploads\/2015\/09\/3d0dae8fe6089a2640a42236dbb7d940.jpg\" alt=\"Perianal abscess and anal fistula\" width=\"175\" height=\"143\" style=\"display:block !important; width:auto !important; max-width:100% !important; height:auto !important; margin:0 !important; padding:0 !important; border-radius:6px !important;\" \/><br \/>\n    <\/a>\n  <\/div>\n<div class=\"Pg_TextBlock\">\n<ul class=\"Pg_InfoList\">\n<li class=\"Pg_InfoList_Item\">Pus discharges through an opening formed in the skin around the anus.<\/li>\n<li class=\"Pg_InfoList_Item\">If there is no opening, or if the opening becomes blocked, pain and fever may occur.<\/li>\n<\/ul><\/div>\n<h4 class=\"KoteiPage_SubTitle KoteiPage_SubTitle--sub\">Anal Fissure<\/h4>\n<p class=\"KoteiPage_Text\">An anal fissure occurs when the anus is torn due to straining during bowel movements. It is characterized by intense pain and bright red blood on the toilet paper after defecation.<\/p>\n<p class=\"KoteiPage_Text\">For this reason, bowel habit management is important. Constipation should be avoided. Ointments are an effective treatment.<\/p>\n<div style=\"width:100% !important; max-width:260px !important; margin:18px 0 18px 0 !important; padding:0 !important; background:transparent !important; box-shadow:none !important; border:none !important;\">\n    <a href=\"http:\/\/www.heartfull.or.jp\/kano\/wp-content\/uploads\/2015\/09\/9c6cbf655975b36152f68611b03c6368.jpg\" style=\"display:block !important; width:fit-content !important; max-width:100% !important; margin:0 !important; padding:0 !important; line-height:0 !important;\"><br \/>\n      <img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.heartfull.or.jp\/kano\/wp-content\/uploads\/2015\/09\/9c6cbf655975b36152f68611b03c6368.jpg\" alt=\"Anal fissure symptoms\" width=\"178\" height=\"117\" style=\"display:block !important; width:auto !important; max-width:100% !important; height:auto !important; margin:0 !important; padding:0 !important; border-radius:6px !important;\" \/><br \/>\n    <\/a>\n  <\/div>\n<div class=\"Pg_TextBlock\">\n<ul class=\"Pg_InfoList\">\n<li class=\"Pg_InfoList_Item\">Pain persists during and for some time after bowel movements.<\/li>\n<li class=\"Pg_InfoList_Item\">Bleeding is usually limited to a small amount on the toilet paper.<\/li>\n<\/ul><\/div>\n<h3 class=\"KoteiPage_SubTitle\">Seven Rules to Prevent Piles<\/h3>\n<div class=\"Pg_TextBlock\">\n<ol class=\"Pg_InfoList\">\n<li class=\"Pg_InfoList_Item\">Take a bath every day.<\/li>\n<li class=\"Pg_InfoList_Item\">Keep the anal area clean.<\/li>\n<li class=\"Pg_InfoList_Item\">Prevent constipation and diarrhea.<\/li>\n<li class=\"Pg_InfoList_Item\">Do not strain excessively on the toilet.<\/li>\n<li class=\"Pg_InfoList_Item\">Keep the lower back and pelvic area warm.<\/li>\n<li class=\"Pg_InfoList_Item\">Avoid sitting for prolonged periods.<\/li>\n<li class=\"Pg_InfoList_Item\">Consume stimulants such as alcohol, pepper, and mustard in moderation.<\/li>\n<\/ol><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Proctological Surgery Piles and Proctological Surgery Piles, also known as hemorrhoids, are one of the anal co [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-gairai-kano-en.php","meta":{"_acf_changed":false,"footnotes":""},"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heartfull.or.jp\/kano\/wp-json\/wp\/v2\/pages\/8798"}],"collection":[{"href":"https:\/\/www.heartfull.or.jp\/kano\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.heartfull.or.jp\/kano\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.heartfull.or.jp\/kano\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.heartfull.or.jp\/kano\/wp-json\/wp\/v2\/comments?post=8798"}],"version-history":[{"count":7,"href":"https:\/\/www.heartfull.or.jp\/kano\/wp-json\/wp\/v2\/pages\/8798\/revisions"}],"predecessor-version":[{"id":10840,"href":"https:\/\/www.heartfull.or.jp\/kano\/wp-json\/wp\/v2\/pages\/8798\/revisions\/10840"}],"wp:attachment":[{"href":"https:\/\/www.heartfull.or.jp\/kano\/wp-json\/wp\/v2\/media?parent=8798"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}