More than one million Americans per year are affected by hemorrhoid disease and more than half the population will develop symptomatic hemorrhoids.
Unfortunately, many people suffer in silence, rather than discussing hemorrhoid treatment with their doctor.
Hemorrhoids are itchy, swollen veins in the anal canal. Though the condition can be painful and frustrating, it’s usually treatable and not serious.
Hemorrhoids can be caused by many things. Common causes include:
The symptoms you experience with hemorrhoids depends on the type of hemorrhoid you have. The two types are:
External Hemorrhoids – External hemorrhoids occur when blood pools under the skin, forming a hard lump. They can be painful, unlike internal hemorrhoids. Other symptoms of external hemorrhoids include bleeding in stool and itching.
Internal Hemorrhoids – The most common symptom of internal hemorrhoids is rectal bleeding. Other symptoms include itching, skin irritation and discomfort while passing bowel movements.
Mild Symptoms
Symptomatic hemorrhoids which are associated with mild pain and swelling can usually be treated by:
A thrombosed external hemorrhoid is usually very painful. The treatment depends on the severity and duration of the symptoms. Rarely, if the pain is not severe, treatment with the above measures and pain medication may be all that is required. If the pain is significant or not improving, then the hemorrhoid can be removed in the office. The procedure is performed through a small incision using local anesthesia.
The treatment of internal hemorrhoids depends on the extent of the symptoms. For larger hemorrhoids that prolapse or bleed, several office procedures as well as surgery are available for treatment.
Rubber Band Ligation – This common office procedure is for the treatment of internal hemorrhoids that protrude with bowel movements. A small rubber band is placed around the hemorrhoid, cutting off its blood supply. This causes the hemorrhoid to die and fall off in several days. This procedure sometimes causes bleeding when the hemorrhoid and rubber band fall off and may produce some mild discomfort.
Injection Sclerotherapy – This method is used to treat bleeding hemorrhoids that do not protrude. A chemical is injected into the hemorrhoid and causes it to shrivel up. The procedure is painless.
Hemorrhoidectomy – This is a surgical procedure in which the hemorrhoids are removed. It is indicated for hemorrhoids that do not respond to office treatments, are too large for office treatments, or prolapsed hemorrhoids that cannot be pushed back inside. This simple procedure is as an outpatient procedure under general, spinal, or epidural anesthesia. A period of rest and recovery is required after the surgery. Medications to soften bowel movements and pain medication are prescribed. Bowel movements do not affect healing. Warm soaks to clean the anal area and provide pain relief are also recommended. The recurrence rate after a hemorrhoidectomy is extremely low, making it the best method for the permanent relief of symptomatic hemorrhoids.
Infrared Coagulation (IRC) – This office procedure also used commonly, causes scarring and retraction of protruding hemorrhoids. It reduces symptoms of prolapse and bleeding. IRC treatment is painless and takes only a few seconds to perform.
Transanal Hemorrhoidal Dearterialization-Hemorrhidectomy (THD) – THD is an effective treatment for internal hemorrhoids using a minimally-invasive, doppler guided technique. The doppler is used to locate the source of the blood flow to the hemorrhoid. A suture is then placed to effectively cut off the blood supply. The internal hemorrhoids then shrink. Like the PPH, this hemorrhoid operation results in less pain than traditional procedures because it is performed above the “pain” line inside the anal canal.
Procedure for Prolapse and Hemorrhoids (PPH) – This innovative, minimally-invasive procedure is a surgical technique that reduces the prolapse of hemorrhoidal tissue. Using a circular stapling device, the procedure essentially “lifts up,” or repositions the tissue lining the anal canal, and reduces blood flow to the internal hemorrhoids. The internal hemorrhoids then typically shrink within four to six weeks after the procedure. This hemorrhoid operation results in less pain than traditional procedures because it is performed above the “pain” line inside the anal canal. This procedure also requires an anesthetic and is usually an outpatient procedure.
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