How Are Hemorrhoids Diagnosed
Your doctor can tell if you have hemorrhoids by asking about your past health and doing a physical examination.
You may not need many tests at first, especially if you are younger than 50 and your doctor thinks that your rectal bleeding is caused by hemorrhoids. Your doctor may just examine your rectum with a gloved finger. Or your doctor may use a short, lighted scope to look inside the rectum.
Rectal bleeding can be a sign of a more serious problem, such as colon, rectal, or anal cancer. So if the first examination does not show a clear cause of your problems, your doctor may use a lighted scope to look at the lower third of your colon. Or your doctor may use another kind of scope to look at the entire colon to check for other causes of bleeding.
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
Are Bleeding Hemorrhoids Dangerous
For the most part, hemorrhoids are not dangerous. You may not even know you have them unless you see blood or feel a lump or stiffness around your anus.
However, do not take your hemorrhoids for granted, particularly if you have bleeding hemorrhoids. Not everything that causes blood in your stool is harmless, for example, colorectal cancer. You should see a hemorrhoid doctor or general practitioner as soon as possible.
Hemorrhoids do not cause cancer. However, cancer can cause many of the same symptoms as hemorrhoids, including bleeding.
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How To Remove External Hemorrhoids At Home
Some of the easiest ways to remove it at home include high-fiber foods in your diet, such as vegetables, whole grains, and vegetables. Also, try to take a warm bath every day.
Find good tropical medicines. You can apply over-the-counter ointments or a suppository that has hydrocortisone. Also, some pads have witch hazel or another numbing agent that will relieve the pain.
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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What Are The Symptoms
The most common symptoms of both internal and external hemorrhoids include:
- Bleeding during bowel movements. You might see streaks of bright red blood on toilet paper after you strain to have a bowel movement.
- Rectal pain. It may be painful to clean the anal area.
With internal hemorrhoids, you may see bright red streaks of blood on toilet paper or bright red blood in the toilet bowl after you have a normal bowel movement. You may see blood on the surface of the stool.
Internal hemorrhoids often are small, swollen veins in the wall of the anal canal. But they can be large, sagging veins that bulge out of the anus all the time. They can be painful if they bulge out and are squeezed by the anal muscles. They may be very painful if the blood supply to the hemorrhoid is cut off. If hemorrhoids bulge out, you also may see mucus on the toilet paper or stool.
External hemorrhoids can get irritated and clot under the skin, causing a hard painful lump. This is called a thrombosed, or clotted, hemorrhoid.
When Is More Invasive Treatment Necessary
Usually hemorrhoids can be managed with conservative treatment. In some case, however, more invasive treatment may be necessary. The most common reason internal hemorrhoids call for more invasive treatment is because symptoms persist despite conservative treatment.
Some patients also have severe enough symptoms to require medical intervention at the time of diagnosis. This includes patients with:
- Excessive bleeding, especially bleeding that leads to anemia
- Prolapsed hemorrhoids that cannot be manually reduced
- Strangulated hemorrhoids
- Signs of gangrene due to reduced or absent blood supply to the tissue
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Drink Plenty Of Water
Dehydration is a potential problem associated with constipation, since fluids or water is needed for fiber to travel smoothly through the digestive system. When you dont get enough water, bowel movements become hard and difficult to pass, and this will enlarge hemorrhoids and increase pelvic pressure.
A study published in the European Journal of Clinical Nutrition in 2003 indicated that fluid loss and fluid restriction can increase constipation, which worsens hemorrhoid symptoms. When considering how to make hemorrhoids go away fast, it is recommended to drink at least one glass of water during each meal or snack daily.
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What Type Of Doctor Should I See
Start with your usual general surgeon or family doctor. Because hemorrhoids are so common, most doctors will have a lot of experience discussing your symptoms and possible treatment.
If your situation calls for referral to a hemorrhoid specialist, your regular doctor will refer you to a hemorrhoid doctor, that is, a proctologist or gastroenterologist.
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How Are Hemorrhoids Treated
For most external hemorrhoids, home treatment is all you need. This includes slowly adding fiber to your meals, drinking more water, and using an ointment to stop itching. The same treatment can be used for most internal hemorrhoids. If your hemorrhoids are severe, you may need medical treatment to shrink or remove them.
When Should I See A Gi Doctor For Hemorrhoids
If you suspect you have hemorrhoids because youve found blood when you wipe, or your rectum feels sore, go see a gastroenterologist for peace of mind. A diagnosis of hemorrhoids may feel embarrassing, but its far preferable to the more serious conditions linked to a bleeding anus, such as anal cancer. And GI doctors are experienced in such matters so theres no need to feel any shame in the examination room.
A diagnosis also means you can pursue the right treatment. Hemorrhoids and anal fissures are often mistaken for each other, but they need to be handled differently.
You need to seek immediate medical attention if you experience anal pain that increases in intensity or spreads, or you have anal discharge or signs of an infection: raised temperature, fever, or chills.
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If Discomfort From Hemorrhoids Isnt Resolved Within A Week
When youve had persistent discomfort, pain, or itching for a week, its time to talk to a doctor. While some symptoms of hemorrhoids resolve on their own, others do not and can be treated by a doctor, so you dont have to live with the daily symptoms. Your doctor can recommend treatments that range from the conservative, like dietary and behavioral changes, or in-office procedures, such as rubber band ligation, to more invasive approaches like surgery.
How Can I Treat My Hemorrhoids
You can most often treat your hemorrhoids at home by
- taking a stool softener or a fiber supplement such as psyllium or methylcellulose
- drinking water or other nonalcoholic liquids each day as recommended by your health care professional
- not straining during bowel movements
- not sitting on the toilet for long periods of time
- taking over-the-counter pain relievers such as acetaminophen, ibuprofen, naproxen, or aspirin
- sitting in a tub of warm water, called a sitz bath, several times a day to help relieve pain
Applying over-the-counter hemorrhoid creams or ointments or using suppositoriesa medicine you insert into your rectummay relieve mild pain, swelling, and itching of external hemorrhoids. Most often, doctors recommend using over-the-counter products for 1 week. You should follow up with your doctor if the products
- do not relieve your symptoms after 1 week
- cause side effects such dry skin around your anus or a rash
Most prolapsed internal hemorrhoids go away without at-home treatment. However, severely prolapsed or bleeding internal hemorrhoids may need medical treatment.
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How Hemorrhoids Are Diagnosed By Your Doctor
See your doctor if you think you might have hemorrhoids, especially if you notice bleeding from your anus or rectum, or have bloody stools. Your doctor will want to rule out more serious problems that can cause bleeding from the anus or rectum, such as cancer.
Hemorrhoid symptoms may also be similar to those of other anal and rectal problems, including anal fissures, abscesses, warts, and polyps.
Your doctor will ask about your medical history and will ask you to describe your symptoms. Questions about your eating habits, toilet habits, and enema and laxative use are likely to come up.
Your doctor will also perform a physical exam to look for lumps or swelling, prolapsed internal hemorrhoids, external hemorrhoids, skin irritation, skin tags, and anal fissures, which are small tears in the anus that can result in itching and bleeding. This will involve a visual examination of the area.
Your doctor may also perform a rectal exam to diagnose internal hemorrhoids, check the muscle tone of your anus, and check for blood in the stool. This is done with a gloved, lubricated finger and a tool called an anoscope.
An anoscope is a type of endoscope a hollow, lighted tube that is inserted a few inches into the anus to help the doctor see any problems inside the lining of the rectum. This procedure is performed in the doctors office and doesnt require anesthesia.
Your doctor may also recommend additional tests to rule out other causes of bleeding, especially if you are over age 40.
Schedule An Appointment Today
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.
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About Dr David Heiman
Dr. David R. Heiman is Endoscopy Medical Director and a gastroenterologist at Florida Medical Clinics North Tampa location. He specializes in treating patients with conditions like hemorrhoids, IBS, GERD, and hepatitis, as well as performing endoscopies and colon cancer screenings. Dr. Heiman is dedicated to helping patients find treatment plans that work best for them and that address all of their medical concerns.
How Serious Are My Hemorrhoids
Treatment will depend on your symptoms, but typically,doctors will recommend conservativeoptions first.
Mild or occasional rectal bleeding may respond to changes in dietary habits, like upping your dietary fiber and drinking more water, Dr. Zutshi says. For periodic anal irritation caused by inflamed hemorrhoids, over-the-counter skin protective creams and warm sitz baths may help.
There are also some simple, in-office treatments for mild, on-and-off bleeding from internal hemorrhoids. Rubber band ligation is a commonly used procedure that involves placing little rubber bands above a hemorrhoid to cut off the blood supply. The hemorrhoid then shrinks and falls off.
This procedure is usually only used on smaller hemorrhoids,Dr. Zutshi explains. But larger internal hemorrhoids can still be easilytreated with minimally invasive surgery.
If the issue is large internal and external hemorrhoids, a more invasive surgery might be necessary. However, if its only skin tags, which are residual hemorrhoid tags, these are usually not treated, Dr. Zutshi says, as trimming them off is very painful, and residual bulges may still persist.
Occasionally, external hemorrhoids become very painful whenthey develop a clot in them, she explains. This is called a thrombosed hemorrhoid.If you see your doctor within a few days of onset, the clots can be removed,Dr. Zutshi says. Otherwise it takes a few weeks for the swelling and pain tosettle down.
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Questions To Ask Your Doctor
- Why do I have hemorrhoids?
- Are there any lifestyle changes I can do that can relieve or prevent hemorrhoids?
- I saw blood on toilet paper. Is this serious?
- Are having hemorrhoids a sign of another health condition?
- Will I always have hemorrhoids?
- Is there medicine I can take for hemorrhoids? Are there side effects?
Related Conditions And Causes Of Hemorrhoids
Gastrointestinal problems such as constipation and diarrhea can lead to or worsen hemorrhoids. The prolonged sitting or straining that may occur when you’re dealing with these issues puts pressure on the hemorrhoidal tissue.
Hemorrhoids also often develop during pregnancy. This is similarly due to greater pressure in the area but can also be due to an increase in blood volume and as a result of hormonal changes that increase the likelihood of swelling. Constipation during pregnancy is a common cause of hemorrhoids.
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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.
Its Crucial To Rule Out Other Problems Besides Hemorrhoids
Most people who have hemorrhoids discover them by either feeling the lump of an external hemorrhoid when they wipe after a bowel movement noticing drops of blood in the toilet bowl or on toilet paper or
feeling a prolapsing hemorrhoid after bowel movements.
With a history of symptoms, physicians like those of us at Alabama Colon & Rectal Institute, can make an accurate diagnosis on the basis of an examination of the anus and anal area. We want to identify the hemorrhoids, but its also very important that we rule out other causes of hemorrhoid-like symptoms, such as: anal fissures, fistulae, bowel disorders like ulcerative colitis, blood coagulation disorders, perianal skin diseases, infections, and tumors.
We want to stress that you should not assume that rectal bleeding is due to hemorrhoids, especially if you are over 40 years of age. Rectal bleeding can occur with other diseases, including colorectal cancer and anal cancer. If you have bleeding along with a noticeable change in bowel habits or if your stools change in color or consistency, consult your doctor. These types of stools can signal more extensive bleeding elsewhere in your digestive tract. Seek emergency care if you experience large amounts of rectal bleeding, lightheadedness, dizziness or faintness.
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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.