Options For Hemorrhoid Removal
Again, depending on the severity of the hemorrhoid, some hemorrhoid can be removed without surgery but some might require professional medical assistance which also probably will include minor surgery.
Mild internal hemorrhoid can be removed without surgery. Especially if you are relatively young in age and also it is your first time experiencing hemorrhoid. The steps for removing internal hemorrhoid that you can try before thinking of seeing a doctor are listed as below:
- Drink more water
- Avoid sitting down for too long
- Engage to bowel movement right when the urge come
- Do not delay bowel movement as it will harden your stool
- Prevent yourself from sitting down in the toilet for too long
- Taking medication that can soften your stool
- Sitz bath
For external hemorrhoid, all the above points are also applicable for healing from the inside. However, some additional steps might be added:
What If I Need A Hemorrhoidectomy
If rubber band ligation or another similar in-office procedure does not help or if you have large protruding hemorrhoids that make you a poor candidate for this type of treatment you may require a hemorrhoidectomy.
A traditional hemorrhoidectomy is an invasive surgery that takes a week or more of recovery before you can return to work and your regular activities. It also requires general anesthesia. Still, it is the most effective method of getting rid of problematic hemorrhoids.
The surgeon completes this procedure by making an incision around the inflamed tissue and removing the involved blood vessels. Hemorrhoidectomies are typically performed as day surgery, and patients return home the same day. Complications or reactions to anesthesia may call for overnight hospitalization.
While traditional hemorrhoidectomies are very effective and most patients are pleased despite the long recovery time, a newer alternative is being used by some doctors to treat prolapsed internal hemorrhoids. Known as a stapled hemorrhoidopexy or PPH, this procedure utilizes a special stapler to tack the inflamed tissue back into its natural position. Over the following days, the inflamed tissue returns to its original size, eliminating symptoms.
Should I See A Doctor For Internal Hemorrhoid Symptoms
Symptoms of internal hemorrhoids require a visit to the doctor to rule out more serious causes and to get the fastest relief possible. While hemorrhoid symptoms typically arent an emergency medical situation, the symptoms should be concerning enough to encourage you to schedule an appointment sooner rather than later. Hemorrhoid symptoms are similar to the early symptoms of a number of more serious conditions, including colon cancer and inflammatory bowel disease.
It is important to note that some internal hemorrhoid symptoms do call for an immediate trip to see your doctor or visit to the emergency room. These includes acute or excessive bleeding, and prolapsed hemorrhoids that cannot be pushed back inside manually.
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Less Invasive Treatment Options
Hemorrhoidectomies are generally reserved for the most severe cases or when other, less invasive treatment methods have failed. These milder treatments include the following.
Getting regular exercise and not straining, especially when you go to the bathroom, can help you avoid irritating the hemorrhoids.
Diet is also a factor. Try increasing your fluid intake and reducing consumption of fats. Add more fiber with fruits, vegetables, and whole grains. You can also take fiber supplements.
To ease symptoms such as swelling, itching, and pain, you can try the following remedies:
- Topicals. Over-the-counter hemorrhoid creams, pads, or suppositories can ease symptoms. Look for products that contain hydrocortisone, lidocaine, or witch hazel.
- Baths. Relax in a plain, warm bath. A sitz bath that fits on the toilet seat can also be helpful. You can soak for 10 to 15 minutes several times a day.
- Oral medications. Use OTC anti-inflammatories and pain relievers.
- Stool softeners. OTC stool softeners can help you avoid straining when you move your bowels.
Be sure to read labels and use only as directed. If you have any concerns at all, review your OTC medications with your doctor or pharmacist.
Minimally invasive treatments to get rid of painful hemorrhoids include the following:
Surgical removal of hemorrhoids may be an option if:
Whats The Procedure Like
Hemorrhoidectomy takes place in a hospital setting. Its usually an outpatient procedure, but in some cases, it may require an overnight stay.
Pre-op instructions will advise you when to stop eating, which is usually 6 to 8 hours before surgery. You wont be able to drive immediately, so be sure to arrange transportation home.
An IV will be inserted into your arm for medications to prevent infection, swelling, and bleeding. Youll need either general anesthesia or local anesthesia with sedation to help you sleep through the procedure.
Once youre asleep, the surgeon will insert a scope into the anal canal for closer examination of internal hemorrhoids. Theyll then cut the hemorrhoidal tissue with a scalpel or laser and close the wound with dissolvable sutures. This is called a closed hemorrhoidectomy.
In some cases, such as when theres a high risk of infection or the area is very large, the incision isnt sutured. This is called an open hemorrhoidectomy.
Another procedure, called hemorrhoidopexy, is somewhat less involved than hemorrhoidectomy. The surgeon uses staples to block blood flow, remove excess tissue, and lift hemorrhoids into a better position. This procedure comes with a greater risk of recurrence and rectal prolapse.
Once the surgeon is done, youll be moved to a recovery area where your vital signs will be monitored for several hours.
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Procedure For Prolapse And Hemorrhoids
PPH is also called a stapled hemorrhoidectomy. The doctor will use a stapler-like device to reposition the hemorrhoids and cut off their blood supply. Without blood, they’ll eventually shrivel and die.
It can treat hemorrhoids that have and have not prolapsed, or slipped down out of the anus.
This procedure moves the hemorrhoid to where there are fewer nerve endings, so it hurts less than a traditional hemorrhoidectomy. You’ll also recover faster and have less bleeding and itching. And there are generally fewer complications.
Hemorrhoidectomy For Thrombosed External Hemorrhoids
THOMAS J. ZUBER, M.D., Saginaw Cooperative Hospital, Saginaw, Michigan
Am Fam Physician. 2002 Apr 15 65:1629-1632.
External hemorrhoids represent distended vascular tissue in the anal canal distal to the dentate line. Persons with thrombosed external hemorrhoids usually present with pain on standing, sitting or defecating. Acutely tender, thrombosed external hemorrhoids can be surgically removed if encountered within the first 72 hours after onset. Hemorrhoidectomy is performed through an elliptic incision over the site of thrombosis with removal of the entire diseased hemorrhoidal plexus in one piece. Caution must be exercised to avoid cutting into the muscle sphincter below the hemorrhoidal vessels. Infection after suture closure is rare secondary to the rich vascular network in the anal area. Stool softeners must be prescribed postoperatively to help prevent tearing at the suture line. Training and experience in general and skin surgery are necessary before the physician attempts this procedure unsupervised.
External hemorrhoids often develop in healthy young persons and may suddenly become thrombosed. Persons with thrombosed external hemorrhoids usually present with pain on standing, sitting or defecating. The thrombosis is slowly absorbed by the body during the course of several weeks. A resolving thrombosis may erode through the skin and produce bleeding or drainage.
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What Happens During A Haemorrhoidectomy
A haemorrhoidectomy is performed under a general anaesthetic, so you won’t be awake during the surgery.
There are several types of haemorrhoidectomy procedure:
- The haemorrhoids can be cut away.
- The haemorrhoids can be pulled back inside the rectum and stapled in place.
- The arteries supplying blood to the haemorrhoids can be closed to help them shrink.
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
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What Treatments Have The Lowest Recurrence Rate
When someone comes into our office and we diagnose them with hemorrhoids, our first line treatment for minor or moderate cases is often at-home treatment. It includes topical medication, sitz baths, stool softeners, and a change to a higher fiber diet. While this is often very effective in stopping symptoms and giving hemorrhoids time to resolve, it does little to prevent future recurrences unless you stick to the diet and other recommended lifestyle changes.
More severe cases or those that do not improve during at-home treatment may require a non-operative treatment. Many of these can be done in our office. They include techniques such as painless injections called sclerotherapy, or rubber band ligation. In most cases, non-operative techniques cause less postoperative pain than invasive surgical procedures, but also have a higher recurrence rate. This is because sclerotherapy and banding are each more of symptomatic relief, rather than curative treatment. When they do recur, we may be able to treat them with diet and over-the-counter medications.
Procedures For Hemorrhoids Treatment
Some hemorrhoids can’t be managed with conservative treatments alone, either because symptoms persist or because an internal hemorrhoid has prolapsed. Fortunately, a number of minimally invasive hemorrhoid treatments are available that are less painful than traditional hemorrhoid removal and allow a quicker recovery. These procedures are generally performed in a surgeon’s office or as outpatient surgery in a hospital.
Band it. The most commonly used hemorrhoid treatment in the United States is rubber band ligation, in which a small elastic band is placed around the base of a hemorrhoid . The band causes the hemorrhoid to shrink and the surrounding tissue to scar as it heals, holding the hemorrhoid in place. It takes two to four procedures, done six to eight weeks apart, to completely eliminate the hemorrhoid. Complications, which are rare, include mild pain or tightness , bleeding, and infection. Other office procedures include laser or infrared coagulation, sclerotherapy, and cryosurgery. They all work on the same principle as rubber band ligation but are not quite as effective in preventing recurrence. Side effects and recurrence vary with the procedure, so consult your physician about what’s best for your situation.
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Treatment Of Ruptured Hemorrhoids
Ruptured hemorrhoid with excessive per rectal bleeding usually happens from the external hemorrhoid. The primary treatment option is to have the hemorrhoid removed, known as hemorrhoidectomy. It is considered as the most effective approach for this issue with rapid recovery and quickly return to daily activities. Depending on the severity, surgery can be arranged as a Day Surgery procedure or outpatient procedure without hospitalization.
What If Hemorrhoids Are Found During A Colonoscopy
Many different aspects of a patient’s medical history are considered during diagnosis. For a relatively healthy and normal individual complaining of minor rectal bleeding, bumps on the anus or nearby, and general anal-rectal discomfort, doctors will almost always initially suspect hemorrhoids.
Hemorrhoids become increasingly more of an issue for older adults, men and women alike. Hemorrhoids also pop up during pregnancy, especially the third trimester and following delivery. These variables are weighed if a patient reports itching, burning, and feeling uncomfortable in certain positions.
To ensure that the patient is experiencing hemorrhoids, doctors can perform a digital or visual examination. A digital exam is when the doctor inserts his or her lubricated and gloved finger inside the rectum to determine if inflammation or an internal hemorrhoid is present. A visual exam is completed for external hemorrhoids.
In rare instances, a colonoscopy may be ordered if a patient reports recurrent rectal bleeding or hemorrhoids that seem to be frequently occurring. Hemorrhoids also have a tendency to happen at the same age a colonoscopy is required. These two issues may coincide, and your doctor may need one to be completed regardless.
Perhaps you have already had a colonoscopy performed, and your doctor has informed you of the results. If hemorrhoids have been found internally during the colonoscopy, your doctor will advise you on different methods of treatment.
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Simple Painless Hemorrhoid Treatment Without Surgery
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Hemorrhoids are a common cause of discomfort, affecting 75 percent of people within their lifetime. They can also be uncomfortable to talk about, and many people seek the temporary relief provided by ointments and creams in the hope their hemorrhoids will simply go away so they can avoid the prospect of painful surgery. Now, Capital Health offers patients another option: hemorrhoid banding with the CRH ORegan System.
The CRH ORegan System is a non-surgical treatment option for hemorrhoids that is fast, painless, and proven to be effective, with minimal risk of complications, said Dr. Michael Kalina, board certified general surgeon at Capital Health Surgical Group. With no preparation or sedation required, the procedure can be performed in as little as 60 seconds. Patients can drive themselves to and from the appointment and immediately return to their daily lives.
Banding is the most common non-surgical hemorrhoid removal treatment in use today. A rubber band is placed around the base of the symptomatic hemorrhoid to stop blood flow to the tissue, which then dries up and falls off on its own in a week or two . Where conventional banding equipment uses metal-toothed forceps to grasp the hemorrhoid, the CRH ORegan System uses gentle suction to reduce the risk of pain and bleeding.
Treating Hemorrhoids At Home
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Severity Of Ruptured Hemorrhoids
If the hemorrhoid bursts, an emergency care must be sought. The serious complication thats caused by excess blood loss are dizziness, faintness or even hypotension/shock. However, per rectal bleeding can also be a particular sign of other disease conditions, such as colorectal and anal canal cancer. Owning to the fact that these conditions mutually share the certain presentations, careful physical examination and subsequent appropriate diagnostic tests conducted by expert specialists are highly recommended.
Once the hemorrhoid bursts, an immediate care should be provided as to follow the steps:
- Gentle compression using clean soft cloths or sanitary napkins to stop the bleeding.
- Apply cold compression or cold sitz bath to reduce the inflammation and to stop the bleeding.
If per rectal bleeding persists and the following symptoms develop: palpitation, dizziness, faintness and cold hands and/or feet, an immediate medical attention must be obtained.
Surgery For Internal Hemorrhoids
Internal hemorrhoids are located inside the rectum and are not typically visible. They usually cause painless rectal bleeding and are graded 1 to 4 based on their extent that the swollen tissue bulges out of the anuswhat’s known as prolapse.
For internal hemorrhoids, the whole hemorrhoid is usually cut out and removed. This is called a conventional hemorrhoidectomy. Based on the surgeon’s preference, a scalpel, scissors, electrocautery , or a more advanced device may be used to remove the hemorrhoid.
A procedure called a stapled hemorrhoidopexy may also be performed to remove internal hemorrhoids. With this technique, no incision is made. Instead, the hemorrhoid is lifted and stapled back into the anal canal using a special circular stapling device.
A stapled hemorrhoidopexy may result in less post-surgical pain than the conventional approach. However, with the former, the hemorrhoids are more likely to return.
An additional option for internal hemorrhoid removal is a surgical procedure called doppler-guided transanal hemorrhoidal artery ligation . The surgeon inserts a special tube called an anoscope a few inches into the anus to locate each hemorrhoid’s arterial blood supply. This is called an anoscopy.
The blood supply is closed off in a process called ligation.
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Enlarged Hemorrhoids: What Surgical Procedures Are Used To Treat Hemorrhoids
Sometimes the symptoms of enlarged hemorrhoids are so bad that treating the symptoms alone is no longer enough. Then there are various procedures that can be done to remove the tissue that is causing problems.
Hemorrhoids are normal cushions of tissue filled with blood vessels, found at the end of the rectum, just inside the anus. If they become enlarged, they can cause unpleasant symptoms. The most suitable type of treatment will mainly depend on the size of the hemorrhoids and the severity of symptoms. Each approach has its own advantages and disadvantages. Depending on the procedure, side effects can occur some more severe than others.
Sclerotherapy and rubber band ligation are generally carried out as day procedures, without an anesthetic. If someone has grade 3 or grade 4 hemorrhoids, doctors often recommend surgery. A general or local anesthetic is usually needed for this. You then have to stay in the hospital for a few days, and stay off work for some time too.