What Doctor Should I Go To For Hemorrhoids

Things That Increase Your Risk

• Constipation or diarrhea that does not go away. These conditions may lead to straining with bowel movements.
• Being overweight
• A family history of hemorrhoids. You may inherit the tendency to get them.
• Being age 50 or older. Half of people who are older than 50 seek treatment for hemorrhoids.
• Pregnancy and labour and delivery. As the fetus grows during the last 6 months of pregnancy, blood volume and pressure on pelvic blood vessels increase. The strain of labour also can cause hemorrhoids to start or get worse.
• Liver disease, heart disease, or both. These conditions may cause blood to back up in the pelvis and abdomen.

Can Hemorrhoids Be Prevented Or Avoided

Just about everyone has hemorrhoids at some time. But some things may make you more likely to get them. People whose parents had hemorrhoids may be more likely to get them. Pregnant women often get hemorrhoids because of the strain from carrying the baby and from giving birth. Being very overweight or standing or lifting too much can make hemorrhoids worse.

If Your Symptoms Continue Worsening

While many home remedies may provide temporary relief of inflammation, pain, or discomfort caused by hemorrhoids, they dont necessarily cure the issue. Thats why its important to seek medical care for hemorrhoids, especially if your symptoms get worse. On top of treating your hemorrhoids, your doctor can help you reduce the chances of another hemorrhoid flare-up by discussing things like your diet, staying hydrated, and changing your bathroom habits.

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Bleeding During Bowel Movements

There are many underlying causes of rectal bleeding, including hemorrhoids. Blood associated with internal hemorrhoids is typically bright red, causes no pain, occurs with bowel movements, and may be mild to moderate in amount.

You cant assume, however, that your symptoms are due to hemorrhoids. If youve never been diagnosed with hemorrhoids or have noted a change in the characteristics of the bleeding youve associated with hemorrhoids, see a doctor for an accurate diagnosis.

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What Additional Qualifications Are Required By Hemorrhoid Specialists

After finishing medical school, a hemorrhoid specialist will complete a four-year residency in order to train in a major discipline, such as the vascular field or in gastroenterology. Once licensed to practice in one of these fields, a hemorrhoid specialist must then undertake a two-year fellowship to acquire the skills and specialist knowledge this area of medicine demands.

The Leading Medicine Guide’s quality assurance is ensured by the following acceptance prerequisites.

• At least 10 years of experience in medical treatment
• Mastery of modern diagnostic and surgical procedures
• Representative number of annual surgeries, treatments and therapies
• Outstanding focus of treatment in their special field
• Active member of a leading national medical society
• Managerial position
• Active participation in medical conferences, symposia etc.
• Research and teaching
• Quality management

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When To Call Your Doctor

Even if you think its from hemorrhoids, you should call your doctor about any rectal bleeding. Its also a symptom of colon polyps, colitis, Crohns disease, diverticulitis, and colorectal cancer. Anal fissures can also cause pain and bleeding. So youll want to make sure you get the right diagnosis and treatment.

If your hemorrhoids are very painful or arent getting better after youve tried treating them yourself, let your doctor know.

What Is A Hemorrhoid

A hemorrhoid is essentially an engorged or swollen blood vessel, says Sameet Shah, D.O., a gastroenterologist at Mountainside Medical Group.

Hemorrhoids can be inside or outside your body. With external hemorrhoids, you can see them and they tend to hurt. With internal hemorrhoids, you dont see or feel them, but a symptom might be bleeding during a bowel movement.

The most common cause of hemorrhoids is due to constipation or straining while using the toilet. Women are prone to hemorrhoids during pregnancy and after giving birth because of the increased pressure on the pelvic floor and hormonal changes that can lead to constipation. Children and adolescents can also get hemorrhoids.

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When Should I Worry About My Hemorrhoids And See A Doctor

You should see a doctor when youre suffering from any of the following symptoms:

• Bleeding from the anus, reddish or tar-colored stools, or spots of blood on your toilet paper.
• Pain in your rectum or anus.
• Milder symptoms like itching that dont stop after a week.
• A feeling of being full in your rectum even after youve had a bowel movement.
• Leaking stool.
• Any tissue coming out of your anus .

While hemorrhoids are generally mild, you should see a doctor to at least rule out anything more serious.

Classification Of Internal Hemorrhoids:

• Grade 1 A hemorrhoid is present but only visualized by a doctor with ansocopy or colonoscopy. The hemorrhoid does not extend out the anus.
• Grade 2 The hemorrhoid extends out of the anus with a bowel movement or with straining. After your BM, the hemorrhoid goes back inside on its own.
• Grade 3 The hemorrhoid extends out of the anus with a bowel movement or with straining. You have to manually push the hemorrhoid back inside the anus. If you have this, you should seek medical attention, but it is not urgent.
• Grade 4 A hemorrhoid extends outside the anus and are not able to be manually pushed back inside. If you have this seek medical attention immediately. There are significant potential complications.

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Maintaining A Healthy Weight

Being overweight is another factor that may contribute to the development of haemorrhoids. You can lose weight by exercising regularly, eating a low-fat diet and moderating your alcohol intake.

More information about food and nutrition is available in our healthy eating section and from the Nutrition Australia website.

When Exactly Is The Right Time To Do This

It is perfectly okay to head to your hemorrhoid doctor if you experience hemorrhoids irrespective of the extent of the pain and location of the hemorrhoid.

However, due to how common hemorrhoids are, many people will often elect to try some self-medications that are usually effective in controlling and treating the condition.

External hemorrhoids can very painful especially if they become thrombosed .

If your hemorrhoids do not shrink or relief you after a few applications with everyday solutions like Tuck pads or Witch hazel pads, it just might be time to go to see your doctor.

If you experience any type of rectal bleeding, and pass stool that look maroon in color, it is a sign of continued bleeding and a Doctor should be visited in this case also.

If you initially developed an internal hemorrhoid and the lump inside the anus enlarges or becomes more painful it is best to see a doctor.

You should also consult on your hemorrhoids when a tissue from inside the anal canal bulges out. This is called a prolapsed hemorrhoid.

If it does not return or you cannot push it back in manually, you should immediately see a doctor.

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In Which Specialist Field Are Hemorrhoid Specialists Active

Hemorrhoids, which are commonly known as piles, occur as vascular structures in the area of the anal canal. When present in their usual condition as pillow-like clusters of veins, they function as cushions that facilitate stool control. However, the term “hemorrhoid” specifically describes these same structures in their diseased state when they have become swollen and inflamed a condition to which they are often prone due to their rich blood supply.

Hemorrhoid symptoms will typically be referred to a family physician or a similar general practitioner. However, if complications occur, it may be necessary to refer the case to other specialists. These may include one or more experts from the fields of cardiovascular disease, or diseases of the digestive system, including:

• a hemorrhoid specialist, whose training specifically relates to this type of disease
• a gastroenterologist, who deals with diseases of the digestive system
• a proctologist, who treats disease in the rectum, anus and colon
• a colorectal surgeon, whose specialism is surgery within the rectal area of the digestive system
• a vascular surgeon, whose focus is diseases involving blood vessels
• an oncologist, whose opinion may be sought if there is a need to investigate a possible cancer

What To Expect At Your First Appointment

For your appointment, please:

• arrive 15 minutes ahead of your appointment time to complete necessary paperwork.
• bring your insurance card.
• make sure our clinic has access to any medical records, imaging scans, or colonoscopy reports that were completed outside U of U Health.

During your visit, our specialist will:

• ask about your medical history and discuss your health concerns.
• check your anus and surrounding area for external hemorrhoids.
• perform a rectal exam to check for internal hemorrhoids or anything else out of the ordinary.
• use a small speculum inserted in the anus to check for internal hemorrhoids.
• provide information about your diagnosis, answer your questions, and discuss the best course of treatment for your needs.

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Treatment And Medication Options For Rectal Prolapse

Treatment for rectal prolapse depends on the severity of your symptoms. Sometimes prolapses resolve on their own. Initially your healthcare provider might work with you to manage the constipation that might be causing the prolapse through adding fiber to your diet and keeping hydrated. Your doctor might work with you to avoid straining during bowel movements. Kegel exercises to strengthen the pelvic muscles might also be advised.

If none of these strategies help, surgery is usually required especially if youre experiencing recurrent episodes.

Surgery can keep rectal prolapse from happening again. Two types of surgical procedures are typically used to treat rectal prolapse:

• Abdominal repair Surgery to fix rectal prolapse is usually done through the belly. Abdominal surgery for rectal prolapse usually involves making a small cut in the lower abdomen. The surgeon will then pull the rectum upward and attach it to a small bone in the lower back so that it cant slip out again.
• Rectal repair In this type of surgery, the surgeon works through the anus rather than making an incision in the abdomen. This surgery is often performed on older patients or those with more medical problems.

The two most common rectal procedures are:

Common Causes Of Hemorrhoids

Hemorrhoids are common, and although theyre often associated with constipation and pregnancy, these arent the only causes. Although the precise mechanism isnt known, theres a correlation between increased pressure on the area, and thinning of tissues that contribute to creating the swollen veins that make up hemorrhoids.

Hemorrhoids can be caused by:

• Constipation Chronic constipation can cause you to strain, but even when you do pass stools, they can be very hard and dehydrated, putting pressure on the delicate tissues of your anus.
• Severe straining The action of straining hard on the toilet can cause pressure in the anal area.
• Obesity Obesity and sitting down for long periods of time are both risk factors for hemorrhoids, as it bears increased pressure on the anus.
• Aging As you become older, the tissues supporting the blood supply to the anus weaken and begin to stretch, making you more susceptible to developing hemorrhoids.
• Pregnancy As the pregnancy progresses, the weight of the baby puts pressure on the anal region, making hemorrhoids more likely.

Many of these risk factors can be alleviated by drinking plenty of water, exercising, and eating a healthy diet rich in fiber to aid digestion.

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Personal Stories About Treating Hemorrhoids

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I have had hemorrhoids for many years, but they have never bothered me much. Once in a while they hurt or bleed, and I know that it’s time to pay more attention to my diet and drink some extra water. My new doctor and I talked about them during my last visit. She asked if I had ever considered having them treated, and we talked about the pros and cons of my options. I decided that since they don’t bother me very much, and because I know what to do if they flare up, I will just keep managing them as I have been. I can always have treatment later if they get worse.

John, age 40

Because I sit all day at work, my hemorrhoids can be a big inconvenience. I get plenty of fibre and water in my diet, but they are still bothering me. My doctor and I agreed that it would be reasonable for me to try the rubber band treatment. I will still have to watch what I eat and drink to keep my stools soft, but I hope that the treatment will take care of most of the pain so I can be more comfortable at work.

Genevieve, age 50

Ricardo, age 38

Barbara, age 47

Hemorrhoid Treatment At Home

Hemorrhoid symptoms can be uncomfortable but there are several at-home remedies may help relieve the pain and discomfort. These include:

• Take a warm bath or sitz bath for 10 to 15 minutes after each bowel movement.
• Clean your anal area gently with warm water each day.
• Do not use alcohol-based or perfumed cleaning wipes around your anus. These cause drying and irritation.
• Moisten toilet tissue before using it to clean after a bowel movement.
• Apply cold compresses to your anus.
• Use stool softeners.
• Take over-the-counter pain relievers, including acetaminophen or nonsteroidal anti-inflammatory drugs , such as ibuprofen or naproxen.

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When To Seek Care For Hemorrhoids

Most cases of hemorrhoids do not require immediate care, but you should visit your provider for any discomfort or worsening symptoms. Your provider will work with you to identify proper treatment and make sure your symptoms are not due to a larger health issue .

Seek care right away if you:

• experience severe pain around your anus, or during bowel movements.
• have rectal bleeding, which may indicate more severe underlying conditions that require treatment.
• have symptoms that worsen or persist after one week.
• notice any unusual changes in the tissue in or around your anus.

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Medical Treatment For Your Hemorrhoids

Dr. Rivas develops personalized hemorrhoid treatment plans after completing a thorough examination. The treatments we recommend may depend on the type of hemorrhoids, as well as your symptoms. Initially, we may suggest lifestyle changes to ease your pain, such as increasing your intake of fiber and water to improve bowel movements and sitz baths to alleviate pain and discomfort.

However, when at-home treatments fail, Dr. Rivas may suggest a procedure to destroy or remove your hemorrhoids, such as:

• Rubber band ligation
• Infrared, laser, or bipolar coagulation
• Thrombectomy

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Internal Hemorrhoids Vs External Hemorrhoids

There are two main types of hemorrhoids:

Internal Hemorrhoids These hemorrhoids develop inside the lower rectum. Internal hemorrhoids usually don’t hurt, but they often bleed painlessly, resulting in bright red blood you might notice when you go to the bathroom and wipe.

Most of the time, internal hemorrhoids are not visible to the naked eye. But in some cases, internal hemorrhoids may protrude through the anus, which is known as becoming prolapsed. When this happens, they will usually shrink back inside the rectum on their own. Protruding hemorrhoids can become irritated and itchy, and patients may find it difficult to clean themselves after a bowel movement.

Internal hemorrhoids are categorized by how prolapsed they are, which helps determine how they should be treated.

Grade 1 hemorrhoids means there is no prolapse. A prolapse that goes back in by itself is categorized as grade 2. Prolapse that needs to be pushed back in by the patient is considered grade 3. Grade 4 is when the prolapse cant be pushed back in.

External Hemorrhoids These hemorrhoids develop under the skin around the outside of the anus. They can be itchy or painful, and may feel lumpy.

External hemorrhoids are called thrombosed hemorrhoids when a blood clot develops within the hemorrhoid. The increased pressure can be very painful, especially within the first 48 hours after it develops.

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Hemorrhoid Symptoms And Diagnosis: Internal And External Hemorrhoids

Itching, pain, and bleeding in the anal area are common signs of hemorrhoids.

Itching, pain, and bleeding in the anal area are common signs of hemorrhoids.

Thinkstock

Hemorrhoids occur when veins in the skin around the anus or in the lower rectum get swollen and inflamed. Its not exactly clear what causes people to get hemorrhoids, but there are some common, accepted risk factors and conditions that lead to their development.

Aging can decrease muscle tone in the area, weakening the tissue and causing hemorrhoids to bulge, while obesity and pregnancy can increase the risk for hemorrhoids due to increased pressure on tissue in the area.

Repeated straining to make a bowel movement, as well as constipation, are also associated with hemorrhoids.

Hemorrhoids are generally not dangerous or life-threatening, but they may be painful.

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How Are They Treated

For most external hemorrhoids, home treatment is all you need. This includes slowly adding fibre to your meals, drinking more water, and using over-the-counter ointments for a limited time to stop itching. You also may use stool softeners. The same home treatment can be used for most internal hemorrhoids.

If your internal hemorrhoids are severe, you may need other treatment. The doctor may tie off the hemorrhoids with rubber bands or scar the tissue around the hemorrhoids. These treatments reduce the blood supply to the hemorrhoids so that they shrink or go away.

Surgery to remove hemorrhoids may be done if other treatments dont work.

Healthy habits can help you prevent hemorrhoids or keep them from getting worse. Eat foods that have lots of fibre, such as fruits, vegetables, and whole grains. Also, drink plenty of water, and get plenty of exercise.