When Do Hemorrhoids Require Medical Intervention
Your hemorrhoids can be an embarrassing topic to discuss with anyone, even your doctor. But hemorrhoids are common and affect 5% of adults in the United States every year, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Its estimated, in fact, that as many as three in four adults will experience problems with hemorrhoids at some point in their lives.
Though you can find many treatments for hemorrhoids at your local pharmacy, home remedies dont help everyone. At Rivas Digestive Center, located in Hollywood, Florida, our expert gastroenterologist, Dr. John Rivas, wants you to know when its time to get medical help for your hemorrhoids.
How Is Rectal Bleeding Diagnosed
When you see a doctor for rectal bleeding, youll be asked a series of questions to help identify the cause. These can include when the rectal bleeding began, any foods you ate prior to the onset of symptoms, if you were constipated, and if you were straining during your bowel movement.
Your doctor will also perform a full medical exam and take your medical history.
Tests that may help determine the cause of rectal bleeding include:
- Colonoscopy, in which a long, flexible tube with a tiny camera on its tip is inserted into the rectum. This allows your doctor to view the inside of the entire colon and look for any abnormalities, notes the Mayo Clinic.
- Sigmoidoscopy, in which a healthcare provider uses a sigmoidoscope, a flexible tube with a light and camera, to view the lower part of your colon and rectum. This test can help diagnose bowel disorders and cancer, per the Mayo Clinic.
- Fecal occult blood test, which is a lab test to detect hidden, or occult, blood in stool. The test can be done in a few different ways, either by the patient collecting stool samples and returning them to their doctor or a lab, or using a flushable pad or tissue that changes color when blood is present, according to the Mayo Clinic.
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.
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Will My Doctor Use A Colonoscopy To Diagnose My Hemorrhoid
If your doctor feels something unusual or wants to look further to ensure accuracy in their diagnosis, they may perform a colonoscopy.
A colonoscopy gives your doctor the ability to examine your entire colon. A colonoscopy is performed at a medical treatment center or hospital under anesthesia.
During the procedure, your doctor will insert a small medical camera into the rectum to look closer at what is going on inside the rectum.
Who Is At Risk For Hemorrhoids
Hemorrhoids are caused by increased pressure in the lower rectum and are extremely common, affecting nearly 75 percent of adults at some point in their lives. Hemorrhoids are more likely to occur in older people because the tissues that support the veins in your rectum and anus stretch and weaken as you age. Other causes of hemorrhoids include:
Read Also: How To Tell If You Have Hemorrhoids
Types Of Hemorrhoids: Internal And External
Hemorrhoids are either internal or external.
Internal Hemorrhoids These hemorrhoids develop inside the rectum and are not usually visible to the naked eye. Internal hemorrhoids generally don’t hurt, but they often bleed painlessly.
In some cases, internal hemorrhoids may protrude through the anus and can be seen, which is known as becoming prolapsed. When this happens, they will usually shrink back inside the rectum on their own or can be pushed back in.
External Hemorrhoids These hemorrhoids develop under the skin around the outside of the anus. These are the most uncomfortable hemorrhoids and can be itchy or painful, and may feel lumpy. When a blood clot forms within an external hemorrhoid, this is known as a thrombosed hemorrhoid, which can result in severe, ongoing pain. Sometimes clots dissolve on their own, but if they dont, your doctor can remove the clot, a procedure thats most effective if done within 72 hours of the clot forming.
Causes And Risk Factors Of Hemorrhoids
Several conditions and habits are thought to cause hemorrhoids:
- Chronic constipation or diarrhea
- Straining too hard during bowel movements
- Sitting on the toilet for a long time
Straining, constipation, and prolonged sitting can all affect the blood flow in the area, causing blood to not move at its expected rate within the vessels, leading to hemorrhoids.
Factors that raise your risk of developing hemorrhoids:
- Lack of fiber in the diet.
- Obesity: Being overweight can put pressure on the hemorrhoidal tissue.
- Aging: As we get older, the connective tissue in the rectum and anus becomes weaker, potentially resulting in bulging hemorrhoids.
- Pregnancy: As the fetus grows and puts pressure on the abdomen, the veins in the rectum and anus may become enlarged. The problem typically goes away after birth.
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Hemorrhoidal Artery Ligation And Recto Anal Repair
Hemorrhoidal Artery Ligation and Recto Anal Repair is a new procedure in which a miniature Doppler sensor is inserted in the anus to detect the arteries supplying blood to hemorrhoids. The surgeon can pinpoint the arteries supplying the hemorrhoids and can tie them off to cut the blood supply. The hemorrhoids are reduced almost immediately and within weeks, are no longer noticeable. The procedure is effective and virtually painless, but it is not simple.
Mayo Clinic: âHemorrhoids: Diagnosis and treatment.â
Institute for Quality and Efficiency in Health Care: âEnlarged hemorrhoids: What procedures can be done?â
UCSF Center for Colorectal Surgery: âHemorrhoids.â
Albuquerque, A. World Journal of Gastrointestinal Surgery, September 2016.
How Do Doctors Check For Hemorrhoids
There are many methods for diagnosing hemorrhoids. Your Doctor may be able to tell that you have an external hemorrhoid by simply looking while internal hemorrhoids can be diagnosed by using a few procedures to examine your rectum and anal canal.
One of the ways of checking for internal hemorrhoids is by digital examination .
In this procedure, your doctor will put some medical gloves on and insert a lubricated finger into your rectum.
Your doctor will then proceed to see if there is anything unusual such as lump and growths and the result from this examination will suggest if there is need for further testing.
A visual inspection may be needed in some cases as internal hemorrhoids are often very soft. During a visual exam, an anoscope, sigmidoscope or proctoscope may be used.
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Who To See For Hemorrhoids
In most cases, your or primary care physician can help you manage hemorrhoids. However, if the hemorrhoids are severe, you may need to see a hemorrhoid doctor, such as a or a . These providers 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.
: This is an out-patient surgical procedure to remove the 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 towards the 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 wont 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 Do Hemorrhoids Need Surgery
While hemorrhoids are a pain, the good news is most do not require surgery and can be managed through other treatments, changes in diet, or at home remedies.
Surgery for hemorrhoids is usually only performed for severe cases, such as when home remedies arent working, emergencies , or when they become so bothersome or painful that they impact your lifestyle.
Minimally Invasive Hemorrhoid Treatments
There are several options to treat hemorrhoids that cause very little pain, if any, and have a quick recovery time. In most cases, patients can go back to work within a day.
These hemorrhoids treatments are usually performed in a doctors office or as an outpatient procedure in a hospital.
Rubber Band Ligation, or banding, is a common procedure to treat internal hemorrhoids. A small elastic band is placed around the base of the hemorrhoid cutting off its blood supply, which causes the hemorrhoid to shrink. Most cases require two to four procedures done about two months apart.
Most people dont feel pain during the procedure but may feel some mild discomfort.
Sclerotherapy involves injecting the hemorrhoid with a solution that causes the hemorrhoid to shrink. It is typically performed in a doctors office with patients feeling little pain or discomfort.
While this procedure isnt painful, most people will experience mild discomfort or some cramping.
What About Surgery For Severe Hemorrhoids?
Are You A Candidate For Hemorrhoid Surgery?
Also Check: How To Treat Large Hemorrhoids
How To Find A Hemorrhoids Doctor Near Me
There are many ways to find a hemorrhoid doctor in your area. For starters, your primary care physician is a great place to start.
Not only can they treat your hemorrhoids, they can refer you to a specialist if there is a need.
Because some insurance companies require a referral to cover the expenses associated with specialists, you may be required to see your general practitioner first.
Although hemorrhoids are extremely common, most patients dont like to talk about the fact that they have them.
Close family members you are comfortable with may have suggestions for a hemorrhoid doctor.
If you dont feel comfortable talking to a family member about hemorrhoid treatment, there are many online websites that review medical providers.
Search for hemorrhoid doctors near me online. Online review sites like Yelp and Google can show real reviews from patients who have experience working directly with the provider you are looking at.
Do some research on the provider and their medical practice.
You want to find a hemorrhoid doctor that has both the ability to treat your condition effectively and the experience to give you the confidence in your provider.
When Should You Go To The Doctor For Hemorrhoids
Again, before assuming that your condition is hemorrhoids, it’s a good idea to see your doctor for an examination. After all, it’s difficult to take a look for yourself. If there is any bleeding, severe pain or fecal incontinence , you should definitely see the doctor. A large amount of bleeding or the sudden onset of severe pain means you should seek medical treatment immediately.
Recommended Reading: What Is The Best Home Remedy For Hemorrhoids
The Side Effects Of Calmovil
Product safety is our #1 priority. Calmovil products contain only natural ingredients from herbs and plants that are considered safe. Although numerous customers use Calmovil products each day since 2008, no serious side effects have been reported. As with other supplements you should not use Calmovil products if you are pregnant or nursing because the effects on fetus have not been studied. You should not take Calmovil Vein & Colon formula while on blood thinning medication or when suffering from a bleeding disorder.
Signs Your Hemorrhoids Warrant A Doctor’s Visit
Your doctor may also check for blood in the stool, examine the muscle tone of your anus, and perform a rectal exam to diagnose internal hemorrhoids. This is done in the doctor’s office with a gloved, lubricated finger and an anoscope . Your doctor may also recommend additional tests to rule out other causes of bleeding, especially if you are over age 40.
Recommended Reading: What Type Of Doctor Takes Care Of Hemorrhoids
Noticing An Anal Bulge That Retracts After Passing Stools
When you have internal hemorrhoids, they can prolapse your anal opening during a bowel movement. At first, the tissue may retract on its own, or you can easily push it back inside. But a prolapse can worsen over time and can eventually cause significant irritation, bleeding, itching, and pain as this internal tissue becomes trapped outside of your anus.
Get early treatment to prevent a prolapse from growing worse.
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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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.
What Type Of Doctor Should I Go To For My Hemorrhoids And Urinary Problems
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Hemorrhoid Treatment At Home
Hemorrhoid symptoms can be quite uncomfortable but there are several treatments you can do at home that may help relieve the pain and discomfort.
Take a warm bath or sitz bath for 10 to 15 minutes after each bowel movement.
Clean around your anal area gently each day with warm water.
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.
You may help prevent hemorrhoids from forming or from worsening with some lifestyle changes as well. They include:
Dont while moving your bowels.
Limit the amount of time sitting 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 doesnt get too dry and difficult to pass.
Increase fluid intake. Drink 6 to 8 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. Over-the-counter creams and suppositories can help relieve pain and reduce swelling.
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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The Right Doctor For The Right Procedure
Its also important that you search your insurances website for doctors that are within your network. This will help prevent out-of-network charges and other out-of-pocket fees. When you have a list of doctors, its a good idea to meet with them to determine if they are right for you and your needs.
Its a good idea to ask friends and family if they have had experience with these doctors to get an idea of their experience as well as research the doctors license and any potential complaints against them.
Depending on the severity of the hemorrhoids, the doctor you pick depends on their specialty: