The lower GI tract
Hemorrhoids are swollen and inflamed veins around the anus or in the lower rectum. The rectum is the last part of the large intestine leading to the anus. The anus is the opening at the end of the digestive tract where bowel contents leave the body.
External hemorrhoids are located under the skin around the anus. Internal hemorrhoids develop in the lower rectum. Internal hemorrhoids may protrude, or prolapse, through the anus. Most prolapsed hemorrhoids shrink back inside the rectum on their own. Severely prolapsed hemorrhoids may protrude permanently and require treatment.
What are the symptoms of hemorrhoids?
The most common symptom of internal hemorrhoids is bright red blood on stool, on toilet paper, or in the toilet bowl after a bowel movement. Internal hemorrhoids that are not prolapsed are usually not painful. Prolapsed hemorrhoids often cause pain, discomfort, and anal itching.
Blood clots may form in external hemorrhoids. A blood clot in a vein is called a thrombosis. Thrombosed external hemorrhoids cause bleeding, painful swelling, or a hard lump around the anus. When the blood clot dissolves, extra skin is left behind. This skin can become irritated or itch.
Excessive straining, rubbing, or cleaning around the anus may make
symptoms, such as itching and irritation, worse.
Hemorrhoids are not dangerous or life threatening. Symptoms usually go away within a few days, and some people with hemorrhoids never have symptoms.
What causes hemorrhoids?
Swelling in the anal or rectal veins causes hemorrhoids. Several factors may cause this swelling, including
- chronic constipation or diarrhea
- straining during bowel movements
- sitting on the toilet for long periods of time
- a lack of fiber in the diet
Another cause of hemorrhoids is the weakening of the connective tissue in the rectum and anus that occurs with age.
Pregnancy can cause hemorrhoids by increasing pressure in the abdomen, which may enlarge the veins in the lower rectum and anus. For most women, hemorrhoids caused by pregnancy disappear after childbirth.
How are hemorrhoids treated?
Simple diet and lifestyle changes often reduce the swelling of hemorrhoids and relieve hemorrhoid symptoms. Eating a high-fiber diet can make stools softer and easier to pass, reducing the pressure on hemorrhoids caused by straining.
Fiber is a substance found in plants. The human body cannot digest fiber, but fiber helps improve digestion and prevent constipation. Good sources of dietary fiber are fruits, vegetables, and whole grains. On average, Americans eat about 15 grams of fiber each day.3 The American Dietetic Association recommends 25 grams of fiber per day for women and 38 grams of fiber per day for men. 3
Doctors may also suggest taking a bulk stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel).
Other changes that may help relieve hemorrhoid symptoms include
- drinking six to eight 8-ounce glasses of water or other nonalcoholic fluids each day
- sitting in a tub of warm water for 10 minutes several times a day
- exercising to prevent constipation
- not straining during bowel movements
Over-the-counter creams and suppositories may temporarily relieve the pain and itching of hemorrhoids. These treatments should only be used for a short time because long-term use can damage the skin.
Non-Surgical Hemorrhoid Removal:
Hemorrhoid banding, or rubber band ligation, is a fast non-surgical procedure to hemorrhoid treatment. Unlike a hemorrhoidectomy, it does not require sedation or post-operational care nor is a temporary relief like home remedies.
There are a few different types of bandings and they include:
Traditional banding: This process uses a metal-toothed clamp to grab the afflicted tissue and pull it away from the anal wall, allowing your physician to place a rubber band around the hemorrhoid. The metal device can often cause bleeding and pain. One of the criticisms of band ligation using these more traditional techniques is a higher frequency of pain after patients have been treated. With the design of the patented CRH O’Regan System, significant pain is NOT a frequent problem, as less than 1% of patients treated with the CRH O’Regan System experience significant pain!
Endoscopic banding: This procedure is the most complicated and expensive of the banding techniques. It typically requires fasting, bowel preparation and sedation much like what is needed for colonoscopy. A flexible scope is placed inside the rectum, and a band is placed through the scope. In addition to being more expensive, time consuming and inconvenient because of the preparation required, there is also typically a higher incidence of significant pain after this type of procedure.
The CRH O'Regan System: CRH uses a disposable ligator to
create a soft, gentle suction that pulls the appropriate tissue into it.
Then, the rubber band can easily and painlessly be placed around the base of
the hemorrhoid, where no pain-causing nerve endings are present.
While these banding options can provide complete removal of your hemorrhoid symptoms, we believe the CRH System offers the best, quickest, safest, most effective and most comfortable solution for hemorrhoid patients.
To learn more about this procedure click this link to view the video.
If at-home treatments do not relieve symptoms, medical treatments may be needed. Outpatient treatments can be performed in a doctor’s office or a hospital. Outpatient treatments for internal hemorrhoids include the following:
- Rubber band ligation. The doctor places a special rubber band around the base of the hemorrhoid. The band cuts off circulation, causing the hemorrhoid to shrink. This procedure should be performed only by a doctor.
- Sclerotherapy. The doctor injects a chemical solution into the blood vessel to shrink the hemorrhoid.
- Infrared coagulation. The doctor uses heat to shrink the hemorrhoid tissue.
Large external hemorrhoids or internal hemorrhoids that do not respond to other treatments can be surgically removed.
3- Slavin JL. Position statement of the American Dietetic Association: health implications of dietary fiber. Journal of the American Dietetic Association. 2008;108(10):1716–1731.
Your procedure will be performed at this facility:Athens Endoscopy, LLC: Report directly to suite 2 of the same building as Athens Gastroenterology Center, PC. The main number for Athens Endoscopy, LLC is (706) 433-0788.
If you have any questions or wish to schedule an appointment, please do not hesitate to call the office at (706) 548-0058. Remember that we usually require that you see a primary care physician (your family doctor or PCP) before we can schedule you. If you are having a medical emergency, get medical attention immediately at your nearest healthcare provider:
This informational material is taken from the National Digestive Diseases Information Clearinghouse, a division of the U.S. Department of Health and Human Resources.
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