Continue Learning About Hemorrhoids
Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.
When To See A Gastroenterologist
In the U.S., it is estimated that by age 50, about half of the population has experienced one or more of the classic symptoms of hemorrhoids. But only about 4.4% seek treatment for the condition at any one time.
It’s fine to start with over-the-counter treatments, says Dr. Dacha.
“There are quite a few over-the-counter treatments that are available for treatment,” says Dr. Dacha. “These include steroids like Preparation H, Proctofoam cream and Perineal Ice Packs. Then there is a sitz bath that can shrink the hemorrhoids. So there are quite a few over-the-counter options available for patients.”
If none of those work, it’s time to see a gastroenterologist. Here are some tell-tale signs:
- Rectal bleeding
What Treatment Methods Are Used By Hemorrhoid Specialists
A visual examination by a primary care doctor is often enough to diagnose a simple case of hemorrhoids, which can then be treated by using:
- corticosteroid cream, which can help to reduce swelling and pain
- hemorrhoid cream containing lidocaine, which helps to reduce pain
- stool softeners designed to minimise straining and constipation
Other useful home treatments include:
- applying witch hazel with a cotton swab
- wearing cotton underwear
- avoiding perfumed and coloured toilet tissue
- avoiding scratching the area
- using a warm-water Sitz bath to relieve the symptoms
In more complex cases, these treatments may not be enough to cure the problem. Where surgery is a recommended option, it will usually involve one of these procedures:
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How Do You Treat Hemorrhoids
Simple preventive measures can reduce your risk of hemorrhoids in North Carolina. Simple home remedies include the following:
- Exercise regularly. Obesity is a significant risk factor when it comes to hemorrhoid development, and regular exercise can help you stimulate your bowels. Aim to get at least 20 minutes of moderate exercise each day.
- Sit on cushions. Sitting on a soft surface rather than a hard surface can help reduce swelling and reduce the pressure.
- Facilitate regular bowel movements. Holding stool in can lead to increased pressure and straining during bowel movements. Scheduling time to go to the bathroom or going to the bathroom immediately can reduce hemorrhoid risk.
The Right Doctor Will Listen & Answer Your Questions
A doctor should listen to your questions and concerns and answer them in a way you understand. They will also help you understand your treatment options and feel comfortable discussing the problem.
After treatment, your doctor should thoroughly go over aftercare and how you can treat yourself at home to lessen symptoms and heal.
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What To Expect At Your Appointment
Surgery, where the excess tissue causing the blood is removed, is only required in a small number of hemorrhoids cases. Such removal is known as hemorrhoidectomy.
In any event, if the symptoms don’t go away, Dr. Dacha urges people to see a doctor, not only to confirm a diagnosis of hemorrhoids, but also to eliminate other possible diseases.
How Can You Prevent Hemorrhoids
Eat high-fiber foods fruits, vegetables and whole grains which softens the stool, increases its bulk and prevents the sort of straining that can cause hemorrhoids. Try to consume at least 25 to 35 g of high-fiber foods a day.
If you’re not able to keep up with the dietary intake, Dr. Dacha recommends over-the-counter fiber supplements like psyllium or methylcellulose . He also says patients can also take stool softeners like docusate sodium, which keep the stool soft and increase the number of bowel movements.
Exercise is also a good idea. In conjunction with a good diet, staying active can help prevent constipation by reducing pressure on veins, which sometimes occur from standing or sitting for long periods. Taking off excess weight that can contribute to hemorrhoids often helps.
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Lifestyle Changes For Managing Hemorrhoids
You may help prevent hemorrhoids from forming or from worsening with some lifestyle changes. These changes include:
- Do not strain while moving your bowels.
- Limit the amount of time you spend on the toilet.
- Increase fiber in your diet. Fiber helps give stool bulk so it can be moved through your intestines, and it also helps water remain in the stool so it does not become dry and difficult to pass.
- Increase fluid intake. Drink six to eight glasses of water and other liquids to help keep your stool soft.
- Exercise regularly. This will help regulate and stimulate your bowels.
- Apply topical ointments. OTC creams and suppositories can help relieve pain and reduce swelling.
Doctors Who Treat Hemorrhoids
Every year, millions of people suffer from hemorrhoids, and need to seek medical attention. Hemorrhoids are very common, and their symptoms may range from very mild to quite severe. If you are suffering from hemorrhoids, and if the symptoms are moderate to severe, or if they do not respond to simple measures, you should seek medical advice and care. A hemorrhoid treatment doctor will be able to assist you in determining which methods of treatment are right for your individual situation.
Most hemorrhoid treatment doctors will begin by prescribing a topical ointment that can be applied directly to the affected area. If the hemorrhoid is located internally, they may provide you with a suppository instead. These methods help treat the symptoms associated with hemorrhoids, such as itching, irritation and swelling. Most will numb the area, making it easier to continue your normal activities.
In addition to medication, your hemorrhoid treatment doctor may also recommend that you change your toilet paper until the condition clears up. This is due to the fact that even the softest toilet paper can irritate a hemorrhoid, causing it to become inflamed. This increases the risk for infection, as well as increased pain. Soft, moist wipes are usually recommended until the hemorrhoid is gone.
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When To See A Doctor For Hemorrhoids
It aroused so much dread in the Middle Ages it was assigned a patron saint through whom prayers could be sent seeking divine intervention.
Hundreds of years later, hemorrhoids remains one of the most undesirable of conditions: It makes your backside hurt or itch. Sitting comfortably is no longer easy. Bleeding sometimes accompanies bowel movements.
Fortunately, there are now plenty of over-the-counter remedies to treat the condition. But when those home remedies don’t work, medical treatment becomes extremely important.
So when should you see a gastroenterologist? Dr. Sunil Dacha, a Houston Methodist gastroenterologist, is here to explain the appropriate time to schedule an appointment as well as how to prevent and treat hemorrhoids at home.
Those reasons can include chronic constipation, straining during bowel movements and prolonged sitting on the toilet. All interfere with blood flow, which causes it to pool and enlarge the vessels. Pregnancy, when the enlarging uterus presses on the veins, is another cause. Obesity can predispose people toward it. And the risk increases as you get older.
Look For Board Certification In Colon And Rectal Surgery
The American Board of Colon and Rectal Surgery holds certified surgeons to the highest standards. There are very stringent educational, experiential, and testing requirements they must meet, in addition to passing the written Qualifying examination and the oral Certifying examination from the American Board of Surgery.
A board certified specialist will have at least four years of medical school in addition to at least five years of extensive general surgery training. In addition to all that, they will also undergo an additional year or more of supervised colon and rectal specialty training in an accredited fellowship program under the supervision of a certified specialist. This translates into a much higher level of operative and treatment experience than a general practitioner.
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When To Consider Hemorrhoid Removal Surgery
Your doctor may decide that you are a good candidate for hemorrhoid removal surgery if:
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You have combined internal and external hemorrhoids.
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You have additional anorectal conditions that require surgery.
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Youve had minimally invasive procedures or other treatments that have not corrected the problem.
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You have significant amounts of bleeding from your hemorrhoids.
- You have a hemorrhoid with that recur after less invasive treatments.
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Research And Statistics: Who Gets Hemorrhoids
Hemorrhoids are very common in both men and women, affecting about 1 in 20 Americans. The most common time to get hemorrhoids is between ages 45 and 65. Hemorrhoids are also common in pregnant women.
By age 50, about half of us have experienced hemorrhoid symptoms, such as itching, bleeding, and rectal pain. At any given time, about 10 million Americans roughly 4 percent of adults have hemorrhoids. Its estimated that 75 percent of Americans will have hemorrhoids at some point in their lives.
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Surgical Procedures For Hemorrhoids
Our board-certified colon and rectal surgeons use the latest surgical techniques to treat hemorrhoids. These include:
- Hemorrhoidectomy. Hemorrhoidectomy is a procedure to remove your hemorrhoid. You may receive local anesthesia with sedation or general anesthesia depending on surgical technique that is used and your specific situation.
- Stapled hemorrhoidopexy. This procedure cuts off blood flow to an internal hemorrhoid using staples.
What Kind Of Doctor Should I See About My Hemorrhoids
If you’re having some of the characteristic symptoms of hemorrhoids – swelling, bleeding, or pain – you may want to visit your regular doctor first. Often, hemorrhoids are mild and can be treated with certain lifestyle changes. If your doctor sees indications of a more complicated case of hemorrhoids or a more serious condition, they may refer you to a specialist like a gastroenterologist or a colon and rectal surgeon.
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Hemorrhoid Treatment In A Doctors Office With Or Without Surgery
Medical procedures may be needed for hemorrhoids that dont go away with home treatments.
Painful external hemorrhoids can be excised during an office visit following a shot of local anesthetic to numb the area.
For internal hemorrhoids, a few office procedures may be considered. In rubber band ligation, the most common hemorrhoid procedure performed in the United States, the doctor places a small rubber band around the base of the hemorrhoid, cutting off the hemorrhoids blood supply. The hemorrhoid typically shrinks and falls off within about a week, though several quick follow-up visits may be required to completely get rid of the hemorrhoid.
Other procedures include sclerotherapy, in which a chemical injected into the hemorrhoid causes scar tissue to form, shrinking the hemorrhoid and infrared coagulation, in which an intense beam of infrared light causes the scar tissue to form, cutting off the blood supply and shrinking the hemorrhoid.
If you have a large external hemorrhoid, both internal and external hemorrhoids, or an internal hemorrhoid thats prolapsed , a surgical operation called a hemorrhoidectomy may be necessary, though few patients require this procedure.
Another option that aims to reduce postoperative pain is a stapled hemorrhoidopexy, in which a device pulls the hemorrhoidal tissue upward and to its normal position, stapling it in place.
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When To See A Doctor About Hemorrhoids
Talking about rectal problems like hemorrhoids can feel embarrassing. But this common problem affects an estimated 3 in 4 Americans sometime during their lifetimes half of them by the time they turn 50.
With hemorrhoids being such a widespread problem, its no surprise that local drugstores have plenty of treatments promising to help. But what if over-the-counter treatments dont help? Can medical care solve your problem and relieve your discomfort?
At Paonessa Colon & Rectal Surgery, we say, Yes. And the good news? Getting medical hemorrhoid treatment doesnt always mean you need surgery. In fact, you can rest easy knowing that most of the time, it doesnt.
Board-certified general surgeon and proctologist Nina J. Paonessa, DO, leads our team. Shes a specialist who is well-known for her medical expertise as well as her passion for making her patients feel comfortable when addressing this sometimes embarrassing condition. Dr. Paonessa is also the only female colorectal surgeon in Ocean and Monmouth counties, New Jersey.
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Are You A Good Candidate For Hemorrhoid Removal
The goal of hemorrhoid surgery is to remove the enlarged hemorrhoid tissue and relieve rectal pain, itching and bleeding. But surgery is not your only option. Hemorrhoid treatments include lifestyle changes, minimally invasive procedures, and surgery. Use the following information as a guide in making the decision to have hemorrhoid removal surgery.
Hemorrhoid Care At Allegheny Health Network: Why Choose Us
Our colorectal surgeons successfully treat minor to severe types of hemorrhoids in less-invasive ways. They can treat many hemorrhoid symptoms with an outpatient procedure in our offices, which allows you to be home resting just hours after treatment.
People also choose us for our:
- Extensive colorectal training: Our surgeons are board-certified by the American Board of Colon and Rectal Surgery. Not every physician who treats hemorrhoids has this certification. It denotes a high level of training and the ability to provide an expert level of care.
- Surgical expertise: Our surgeons use sophisticated robots and techniques to safely treat hemorrhoids in difficult-to-reach locations. These innovations help you experience significant symptom relief for longer.
- Symptom relief sooner: Our expertise coupled with same-day appointments help provide quick diagnoses so you can feel relief sooner â sometimes the same day we evaluate your symptoms.
- Convenience: We offer diagnosis and treatment services at several hospitals and outpatient clinics in the surrounding community. This means you can get comprehensive hemorrhoid care, close to home.
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Who To See For Hemorrhoids
In most cases, your family doctor or primary care physician can help you manage hemorrhoids. However, if your hemorrhoids are severe, you may need to see a doctor, such as a colorectal surgeon or a gastroenterologist. These specialists can provide more advanced hemorrhoid treatment, such as:
- Rubber band ligation: A surgeon places a special medical-grade rubber band round the base of the hemorrhoid to cut off blood circulation. Within a week, the end of the hemorrhoid shrivels and falls off, leaving behind scar tissue.
- Hemorrhoidectomy: This is an out-patient surgical procedure to remove hemorrhoids.
- Hemorrhoid stapling: Used primarily for internal hemorrhoids, this procedure uses a stapling tool that removes tissue.
- Sclerotherapy: This involves an injection of a chemical solution directly into the hemorrhoid to shrink it.
- Infrared photocoagulation: Used only for internal hemorrhoids, this procedure directs an infrared light toward the hemorrhoid tissue to cause scars, which block blood flow to the hemorrhoids.
- Electrocoagulation: Similar to infrared photocoagulation, this procedure uses electric current to cause scar tissue.
Some people may be embarrassed to speak with their doctor about hemorrhoids, but the condition is so common that your doctor will not be surprised if you bring it up. Theres no need to live with the pain and discomfort of hemorrhoids. Prompt treatment will allow you to live your life more comfortably.
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.
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Seek An Experienced Specialist
While you want a specialist who works with the most cutting-edge treatments, you also want someone who has the experience to know what will work based on the details of your specific case. According to the American Board of Surgery, this is not a general practitioner. General practitioners may only see a few cases a year, and general surgeons may only see a few hemorrhoidectomies, fistulotomies, and other similar procedures each year. Without regularly handling these conditions, the rate of misdiagnosis or improper treatment is much higher.
This again highlights the benefits of choosing a specialist, and one who has extensive colorectal surgical experience such as that required to obtain board certification. This experience improves the outcome every step of the way, from routine screenings, to prescribing the right medical treatments, to performing surgery when necessary.
Seeing A Doctor For Hemorrhoids
Visiting an expert would be the best course of action when the hemorrhoid symptoms dont improve after a week under home care.
Getting a professional evaluation is imperative, not just for getting the correct treatment for hemorrhoids but also to rule out other, often quite severe diseases that also cause rectal bleeding.
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