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Hemorrhoids are incredibly common and can be successfully managed with the right treatments. If youre concerned you have hemorrhoids or if theyre not improving, schedule an appointment with Dr. Heiman in Tampa, FL, today.
Disclaimer: This blog is not intended to substitute professional medical advice. Always talk with your doctor before starting or stopping medications or treatments.
Dietary Changes And Self Care
If constipation is thought to be the cause of your haemorrhoids, you need to keep your stools soft and regular, so that you donât strain when passing stools.
You can do this by increasing the amount of fibre in your diet. Good sources of fibre include wholegrain bread, cereal, fruit and vegetables.
You should also drink plenty of water and avoid caffeine .
When going to the toilet, you should:
- avoid straining to pass stools, because it may make your haemorrhoids worse
- use moist toilet paper, rather than dry toilet paper, or baby wipes to clean your bottom after passing a stool
- pat the area around your bottom, rather than rubbing it
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If You Notice Bleeding Before During Or After Bowel Movements
If you notice blood before, during, or after bowel movements, you should seek medical care. Bleeding during bowel movements may be associated with hemorrhoids, but it could also be . Call your doctor so you can get an accurate diagnosis and rule out anything life-threatening. Your doctor can help you identify and address the cause of your bleeding. And if its hemorrhoids, they can offer treatment, relief, and suggestions to help you prevent hemorrhoids from recurring.
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Gradually Increase Your Fiber Intake
Most of us dont get in enough fiber everyday, but adding more high-fiber foods like beans, broccoli, whole grains, and fresh fruit to your diet can help you avoid constipation and stay regular. This in turn reduces the chances that youll find yourself straining and further irritating your hemorrhoids, says Dr. Thomas. Aim for 20 to 30 grams of fiber a day, and consider taking a fiber supplement that contains psyllium or methylcellulose to help you hit your daily goal. If youre typically low on fiber-rich foods, though, take your timesuddenly upping your intake may make you gassy.
When To Seek Medical Advice
See your GP if you have persistent or severe symptoms of haemorrhoids. You should always get any rectal bleeding checked out, so your doctor can rule out more potentially serious causes.
The symptoms of haemorrhoids often clear up on their own or with simple treatments that can be bought from a pharmacy without a prescription . However, speak to your GP if your symptoms don’t get better or if you experience pain or bleeding.
Your GP can often diagnose haemorrhoids using a simple internal examination of your back passage, although they may need to refer you to a colorectal specialist for diagnosis and treatment.
Some people with haemorrhoids are reluctant to see their GP. However, theres no need to be embarrassed, because GPs are very used to diagnosing and treating haemorrhoids.
Read more about diagnosing haemorrhoids.
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Doctor Care For Hemorrhoids
Medical attention isnt only for thrombosed hemorrhoids. If a week of at-home care doesnt relieve your hemorrhoid problem, its a good idea to schedule an appointment with your doctor. You should also have an exam if theres bleeding involved. That can be a symptom of several different conditions, some of which are more serious than others.
After diagnosing you with hemorrhoids, your doctor may suggest continuing with at-home care or moving on to surgical intervention, particularly if youve repeatedly dealt with thrombosed hemorrhoids. The most common surgical procedure for this condition is hemorrhoidectomy, which involves excising the affected tissue from the body.
Recovering from a hemorrhoidectomy can be painful. If you have internal hemorrhoids in addition to the external ones, your doctor may recommend treating the internal ones first. Sometimes, addressing internal hemorrhoids solves the external problem as well. Rubber band ligation is a minimally invasive procedure for getting rid of internal hemorrhoids.
After the symptoms of an external hemorrhoid go away, you may be left with a harmless skin tag. Your doctor can remove the tag through a quick in-office procedure.
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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.
Image: LuisPortugal/Getty Images
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Hemorrhoids Treatment: Rubber Band Ligation
The principle of rubber band ligation is to encircle the base of the hemorrhoidal clump with a tight rubber band. The tissue cut off by the rubber band dies, and is replaced by an ulcer that heals with scarring.
A similar procedure was described in 460 BC by the Greek physician Hippocrates:
And hemorrhoids you may treat by transfixing them with a needle and tying them with very thick and woolen thread, for application, and do not foment until they drop off, and always leave one behind and when the patient recovers, let him be put on a course of Hellebore.
Rubber band ligation can be used with first-, second-, and third-degree hemorrhoids, and may be more effective than sclerotherapy. Symptoms frequently recur several years later, but usually can be treated with further ligation.
The most common complication of ligation is pain. However, bleeding one or two weeks after ligation or bacterial infection in the tissues surrounding the hemorrhoids may occur.
Are External Hemorrhoids Painful
External hemorrhoids can be painful. They are usually most painful immediately following a bowel movement or after straining or lifting.
They may be especially painful if they develop a blood clot, which is known as a thrombosed hemorrhoid. If medical professionals can lance and drain the clot within of development, the pain will ease immediately. If not, the clot will likely dissolve on its own, and the pain will ease in time.
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When Hemorrhoid Surgery May Be Necessary
Very few people fewer than 10 percent of all adults who see a doctor because of symptomatic hemorrhoids will require a surgical operation.
Surgery to remove hemorrhoids is called a hemorrhoidectomy.
Your doctor may recommend a hemorrhoidectomy if:
- You have large external hemorrhoids
- You have both internal and external hemorrhoids
- An internal hemorrhoid has prolapsed
- You have excessive bleeding
In a hemorrhoidectomy, the doctor makes a small incision to remove the hemorrhoid and surrounding tissue before closing the wound with stitches.
A hemorrhoidectomy is performed in an operating room and can be done under general anesthesia, in which you are unconscious and unable to feel pain.
Hemorrhoidectomy is associated with postoperative pain, but the procedure is successful for 95 percent of cases.
More recently, another option aimed at avoiding the postoperative pain of a hemorrhoidectomy has become available, called a stapled hemorrhoidopexy. A circular stapling device pulls the hemorrhoidal tissue upward and to its normal position, stapling it in place. The staples eventually fall out over time.
According to a study published in the journal Techniques in Coloproctology, in the long term, patient satisfaction, resolution of symptoms, quality of life, and functional outcome appeared similar among patients after stapled hemorrhoidopexy and hemorrhoidectomy. But other sources note that stapling has been associated with a greater risk of recurrence and rectal prolapse.
How A Doctor Can Help
Doctors can recommend medical treatments and procedures that can reduce or get rid of hemorrhoids. Some of these procedures can be done right in a doctors office and involve very little discomfort.
- Medicated creams/ointments. If an OTC hemorrhoid cream isnt enough, doctors can prescribe stronger creams and ointments.
- Minimally-invasive procedures. There are some minimally-invasive procedures that a doctor can do in their office or in an ambulatory surgery center that typically doesnt require anesthesia or long recovery times. Some of these procedures include rubber band ligation, sclerotherapy injections, and laser/infrared coagulation treatments.
- Thrombectomy. For severe cases that develop blood clots and cause a lot of pain, your doctor can perform an external hemorrhoid thrombectomy to remove the hemorrhoid. Thrombectomies are most effective when performed no more than 72 hours after severe symptoms emerge.
- Surgery. There are several surgical options available when other treatments and procedures havent worked or if you have very large hemorrhoids. If youve struggled to find relief, talk to your doctor to learn if surgery is right for you.
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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.
What Are The Treatments For Hemorrhoids
If at-home treatments for hemorrhoids donât help you, you may need a medical procedure. There are several different procedures that your provider can do in the office. These procedures use different techniques to cause scar tissue to form in the hemorrhoids. This cuts off the blood supply, which usually shrinks the hemorrhoids. In severe cases, you may need surgery.
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What Causes Internal And External Hemorrhoids And Simple Ways To Treat Them
Hemorrhoids are usually caused by increased pressure due to pregnancy, being overweight, or straining during bowel movements. By midlife, hemorrhoids often become an ongoing complaint. By age 50, about half the population has experienced one or more of the classic symptoms, which include rectal pain, itching, bleeding, and possibly prolapse . Although hemorrhoids are rarely dangerous, they can be a recurrent and painful intrusion. Fortunately, there’s a lot we can do about hemorrhoids.
Who Can Get External Hemorrhoids
Hemorrhoids are more likely to affect an individual if eitherof your parents has had them. Hemorrhoids may be more common in women who arepregnant.
Hemorrhoids can develop as you grow old because of increasedpressure developed by sitting for long periods of time. Anything that causesyou to strain during bowel movements can create external hemorrhoids.
Your doctor can help you figure out whats causing yourhemorrhoids.
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Advanced Treatment For Hemorrhoids
Even with the treatments listed above, there are some situations that may require medical treatment – especially if your hemorrhoids are recurrent!
Fortunately, even if your doctor determines treatment is necessary, you have many options, as there are several procedures that can be done in an office visit that do not require a separate surgery or anesthesia. Even if your case requires surgical treatment, most options are minimally invasive.
After a physical exam, your doctor will make a decision about what treatment may be necessary based on the location and severity of your hemorrhoids. If you have internal hemorrhoids, a colonoscopy may also be required. There might also be complications and risks to assess, such as whether you are taking a blood thinner or may be at risk for sepsis, which can be a risk with procedures like a hemorrhoidopexy.
In a hemorrhoidopexy or a sclerotherapy, the vein is left in place. Rather than removing it, the vein is fixed in place or sealed, depending on the procedure. Doctors typically only recommend these kinds of operations if your hemorrhoids have not responded to conservative treatment.
In a hemorrhoidectomy, the bulging or prolapsed vein is removed to prevent further bleeding and discomfort. A hemorrhoidectomy can be performed to mitigate both internal and external hemorrhoids. Typically, anesthesia is required for the surgery, though you will typically be released that day.
Prevention Of External Hemorrhoids
Here are some methods of preventing hemorrhoids:
- Dont strain during bowel movements. Sitting on the toilet for an extended period of time is not recommended.
- Take steps to avoid constipation. Consuming high-fiber foods, drinking plenty of water, and taking fiber supplements, stool softeners, or laxatives are all examples to avoid constipation.
- Dont do any heavy lifting. Try not to overwork yourself.
- Consult a healthcare professional for any risks and complications. If youre pregnant, have a weakened immune system, or are taking blood-clotting drugs, talk to your doctor about your risk of constipation or hemorrhoids.
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How Can You Prevent Constipation
To avoid constipation and straining during bowel movements, people are often advised to change their diet, drink plenty of fluids, and get enough exercise. High-fiber foods like fruits, cereals, vegetables and legumes are generally recommended to try to make stools softer.
Studies suggest that plant fibers such as psyllium husk can reduce the frequency of bleeding. Whether or not they relieve other symptoms too hasnt been well studied. People who use psyllium husk must make sure that they drink enough fluids. But fiber can also cause diarrhea, which in turn leads to hemorrhoids being irritated even more by frequent bowel movements.
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How Do Doctors Treat Hemorrhoids
Doctors treat hemorrhoids with procedures during an office visit or in an outpatient center or a hospital.
Office treatments include the following:
- Rubber band ligation. Rubber band ligation is a procedure that doctors use to treat bleeding or prolapsing internal hemorrhoids. A doctor places a special rubber band around the base of the hemorrhoid. The band cuts off the blood supply. The banded part of the hemorrhoid shrivels and falls off, most often within a week. Scar tissue forms in the remaining part of the hemorrhoid, often shrinking the hemorrhoid. Only a doctor should perform this procedureyou should never try this treatment yourself.
- Sclerotherapy. A doctor injects a solution into an internal hemorrhoid, which causes scar tissue to form. The scar tissue cuts off the blood supply, often shrinking the hemorrhoid.
- Infrared photocoagulation. A doctor uses a tool that directs infrared light at an internal hemorrhoid. Heat created by the infrared light causes scar tissue to form, which cuts off the blood supply, often shrinking the hemorrhoid.
- Electrocoagulation. A doctor uses a tool that sends an electric current into an internal hemorrhoid. The electric current causes scar tissue to form, which cuts off the blood supply, often shrinking the hemorrhoid.
Outpatient center or hospital treatments include the following:
Sometimes complications of hemorrhoids also require treatment.
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Medical Treatments For External Hemorrhoid
Your doctor may recommend a surgical procedure called a hemorrhoidectomyif you have a more severe case of external hemorrhoids. An external hemorrhoidis removed with a laser, scalpel, or cautery equipment.
Depending on the type of surgical procedure and requirement,your doctor will most likely use a local anesthetic for this treatment.
Prescription drugs for external hemorrhoids are occasionallyrecommended by physicians. These are some of them:
- nitroglycerine topical ointment, 0.4 percent
Prognosis For External Hemorrhoids In The Long Run
External hemorrhoids are a prevalent problem. As the bodyreabsorbs the blood clot inside the protruding blood vein, they usually go awayon their own in a couple of days or weeks.
Your doctor may prescribe surgical excision of externalhemorrhoids in severe conditions.
If your external hemorrhoid disappears on its own, a skintag may remain, which you should have removed.
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When Is It Time To Seek Medical Care For Hemorrhoids
Drinking more water, eating more fiber, and taking over-the-counter medications may help hemorrhoids to resolve on their own at home. However, often a doctor can help you get effective relief faster than you might on your own. And, in some cases, your symptoms could indicate a condition more serious than hemorrhoids. Thats why its always better to be safe than sorry and get your hemorrhoids evaluated sooner rather than later.
How To Treat Hemorrhoids And When You Should See Your Doctor
Pregnancy also can weaken these tissues, which is why pregnant women often experience hemorrhoids. Other potential causes include chronic constipation or diarrhea, straining during bowel movements and sitting on the toilet for extended periods. Also, frequently lifting heavy objects may increase the likelihood of hemorrhoids.
What are the symptoms of hemorrhoids?
Hemorrhoid symptoms vary depending on whether the inflamed veins are external or internal.
While hemorrhoids are not dangerous, they can develop complications. An external hemorrhoid may become infected or develop blood clots. Internal hemorrhoid bleeding may lead to anemia, or a low red blood cell count.
How are hemorrhoids treated at home?
In many cases, hemorrhoids will go away on their own within a few days, including prolapsed hemorrhoids. You can help reduce the irritation by eating more high-fiber foods, such as whole grains and green, leafy vegetables and drinking plenty of fluids .
Try to avoid straining during a bowel movement, as this can make hemorrhoids worse. A fiber supplement or gentle stool softener may help.
If you have pain, try taking a warm bath or a sitz bath, which is a shallow plastic tub that allows you to sit in just a few inches of water. Sitz baths are available over the counter adding Epsom salt may help to soothe the irritation. Be sure to dry the area thoroughly after a bath.
When to see the doctor
If at-home remedies do not provide relief, it may be time to see a doctor.
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