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Hemorrhoids

Overview

Hemorrhoids are blood vessels in the lower rectum and around the anus. They often result from straining to have bowel movements, constipation, and increased pressure on the lower rectum. They also can result from pregnancy, aging with weakness of the tissues, and diarrhea. Hemorrhoids can be either internal or external, depending on their location.

Diagnosis

The most common symptoms of hemorrhoids are rectal bleeding, itching, rectal pain and swelling, thrombosis, or protrusion of hemorrhoids during bowel movements. It is important that symptoms are checked by a colon and rectal surgeon because other conditions like anal or rectal cancer can also present in a similar way.

Treatment

Non-Surgical Treatments

High fiber diet and fiber supplementation is usually recommended along with increased water intake. Avoidance of straining and hard stools or loose stool as well. Sitz baths with warm water will also be helpful. Most of the hemorrhoids will respond to topical treatments with creams and ointments and improve in a matter of days. The swelling usually will take longer to improve.

Surgical Treatments

Hemorrhoidectomy

Removal of hemorrhoids, often both internal and external, during general anesthesia in the operating room. This is usually accompanied by more pain compared to the other surgical options for hemorrhoids.

Rubber Band Ligation

A band is placed at the base of the hemorrhoid, which will fall off 5-7 days later. The hemorrhoid will regress because of a lack of blood supply. This method is painless but some patients exhibit discomfort or pressure for 24h. This method of treatment of hemorrhoids has great success rates and very high patient satisfaction. It takes place in an office setting due to lack of pain. In general, patients can return to work the same day.

THD (Transanal Hemorrhoidal Dearterialization)

Is a newer method of treating hemorrhoids which involves suturing of the hemorrhoids to interrupt the blood flow under Doppler guidance. It is done in operating room settings under anesthesia. It is highly successful and carries significantly less pain when compared to hemorrhoidectomy. The entire procedure is done on the inside of the rectum, leaving no scars on the outside.

Click Here For More Information on THD

ASCRS: Hemorrhoids

National Digestive Diseases Information Cleaninghouse: What are hemorrhoids?

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