Hemorrhoids Specialist Questions and Answers
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Swollen veins in your anus and lower rectum are called hemorrhoids. Usually caused by pressure, they can develop inside the rectum or around the skin of the anus. They are common, but can cause a fair amount of discomfort.
We can ease the pain of your hemorrhoids at Vanguard Gastroenterology.
What Are Hemorrhoids?
When a vein swells in the anus and lower rectum, these are called hemorrhoids. Hemorrhoids are extremely common, with 3 of 4 adults developing hemorrhoids from time to time. They are usually caused by straining during bowel movements or from the increased pressure on these veins created during pregnancy.
The location of the hemorrhoid usually dictates the symptoms:
- Internal hemorrhoids — These occur inside the rectum. Patients usually can’t see or feel these, and they rarely cause any pain or discomfort. Sometimes strain or irritation when passing a stool can damage the hemorrhoid surface, causing it to bleed.
- External hemorrhoids — These hemorrhoids are under the skin around your anus. When these are irritated, they can itch and bleed. If blood pools in an external hemorrhoid and forms a clot, clinically called a thrombus, this can result in severe pain, swelling, inflammation, and a hard lump near the anus.
Who Is At Risk For Developing Hemorrhoids?
Pressure is the key factor in developing hemorrhoids. These are factors that can increase the pressure on the veins around your anus, causing them to stretch and swell:
- Straining during bowel movements
- Sitting for long periods of time on the toilet
- Chronic diarrhea
- Chronic constipation
- Low-fiber diets
- Anal intercourse
- Aging (support tissues weaken with age)
How Are Hemorrhoids Treated?
In many cases, home treatments can get a hemorrhoid to calm down and go away. These are some of those treatment options:
- High-fiber foods — Eating more fruits and vegetables can soften your stool and help you avoid straining.
- Topical treatments — Hemorrhoid creams or suppositories containing hydrocortisone can be effective.
- Warm bath/Sitz bath — Soak the area in plain warm water 10-15 minutes two or three times daily.
- Keep the area clean — Take a bath or shower to cleanse the skin around the anus. Pat the area dry or, better yet, use a hair drying.
- Don’t use dry toilet paper — Use moist flushable towelettes (read instructions on how many can be placed in one flushing) or moisten your toilet paper.
- Cold compresses — Apply ice or a compress to reduce swelling.
Procedures To Treat Hemorrhoids
There are a few options that we use at Vanguard Gastroenterology to more aggressively deal with persistent or overly painful hemorrhoids.
- External hemorrhoid thrombectomy — If you’ve developed a blood clot in an external hemorrhoid, we make an incision and drain the hemorrhoid. This works best if done within 72 hours of developing the clot.
- Rubber band ligation — We insert a small tool called a ligator through a lighted scope. We then grasp the hemorrhoid with forceps. We slide the ligator cylinder upward and this releases two rubber bands around the base of the hemorrhoid. These cut off the blood supply, causing the hemorrhoid to wither and drop off.
- Sclerotherapy — We inject a chemical solution into the hemorrhoid, which irritates the lining and causes it to shrink.
- Coagulation — Using laser, infrared energy, or heat, we cause the blood to coagulate and the internal hemorrhoid to harden and shrivel away.
Surgery For Hemorrhoids
Usually surgery is only used for large hemorrhoids or when all other non-invasive treatments are not successful. There are two basic methods.
- Hemorrhoidectomy — This is surgical removal of the excessive tissue that causes bleeding.
- Hemorrhoid stapling — This method of closing off the hemorrhoid blocks blood flow. It is used for internal hemorrhoids and involves less pain than a hemorrhoidectomy.
How Can I Prevent Hemorrhoids?
The best way to prevent the development of hemorrhoids is to keep your stools soft, so they are easily passed. Here are some ways to prevent hemorrhoids:
- Eat high fiber foods
- Drink plenty of fluids
- Consider fiber supplements such as Metamucil
- Don’t strain
- Go as soon as you feel the urge
- Don’t stay on the toilet for too long
Are Hemorrhoids Dangerous?
Hemorrhoids are painful, but rarely dangerous. There are two exceptions:
- Strangulated hemorrhoid — While cutting off the blood to a hemorrhoid is usually the way to shrink it, at times it can cause it to become strangulated, which is extremely painful.
- Anemia — If you have recurring hemorrhoids, this can lead to chronic blood loss that may cause anemia.