Every Americans suffer with hemorrhoid problem at least once in life time. Hemorrhoids can be painful, cause frequent bleeding and local hygiene issues. Fortunately, Colon and Rectal Care Center of Phoenix provides state-of-the-art hemorrhoid treatment services to patients from throughout Valley at their comfortable and modern offices in Glendale and North Phoenix.

What Are Hemorrhoids?

Hemorrhoids are enlarged “varicose veins of the anus and rectum,” These enlarged, bulging blood vessels are present in and around the anus and lower rectum. Every person is born with hemorrhoids.

Hemorrhoids get enlarged by stretch from the supporting tissues around anus and lower rectum. When excessive stretch happens, vessels expand, the wall thins out and bleeding occurs. When the stretching and pressure continue, the weakened vessels protrude.

What Are Different Types Of Hemorrhoids?

-Internal

-External

The two types of hemorrhoids, external and internal, refer to their location. 

External Hemorrhoids:

External (outside) hemorrhoids form near the anus and are covered by sensitive skin. They are usually painless unless a blood clot (thrombosis) forms or they become very swollen. 

What Is Thrombosed External Hemorrhoids?

Thrombosed external hemorrhoids are blood clots that form in an outer hemorrhoid in the anal skin. If the clots are large, they can cause significant pain. A painful anal mass may appear suddenly and get worse during the first 48 hours. The pain generally lessens over the next few days. You may notice bleeding if the skin on top opens. 

Internal Hemorrhoids:

Internal (inside) hemorrhoids form within the anus beneath the lining. Painless bleeding and protrusion during bowel movements are the most common symptoms. However, an internal hemorrhoid can cause severe pain if it is completely prolapsed. This means it has slid out of the anal opening and cannot be pushed back inside. 

What are different Grades Of Internal Hemorrhoids?

Internal hemorrhoids are classified by their degree of prolapse, which helps determine management:

Grade One: No prolapse

Grade Two: Prolapse that goes back in on its own

Grade Three: Prolapse that must be pushed back in by the patient

Grade Four: Prolapse that cannot be pushed back in by the patient (often very painful)

What Are Different Causes Of Hemorrhoids?

The exact cause of hemorrhoids is unknown. A lot of pressure is put on human rectal veins due to our upright posture, which can potentially cause bulging. Other contributing factors include:

• Aging

• Chronic constipation or diarrhea

• Pregnancy

• Heredity

• Straining during bowel movements

• Faulty bowel function due to overuse of laxatives or enemas

• Spending long periods of time on the toilet (e.g., reading)

What Are Symptoms Of Hemorrhoids?

Any of the following may be a sign of hemorrhoids:

• Bleeding during bowel movements

• Protrusion of skin during bowel movements

• Itching in the anal area

• Pain in the anal area

• Sensitive lump(s)

What are treatment options of hemorrhoids?

Nonsurgical Treatment:

It is important that symptoms are checked by a colon and rectal surgeon first before you try self-treatments. They will perform a thorough examination and recommend treatment. Mild symptoms can be relieved frequently without surgery. With nonsurgical treatment, pain and swelling usually decrease in two to seven days. The firm lump should recede within four to six weeks.

Treatment includes:

• Eating a high-fiber diet and taking over-the-counter fiber

  supplements (25-35 grams of fiber/day) to make stools soft, formed and bulky.

• Avoiding excessive straining to reduce the pressure on hemorrhoids

  and help prevent protrusion.

• Shortening time on the toilet to only 1 to 2 minutes to help prevent

  protrusion

• Drinking more water to help prevent hard stools and aid in healing.

• Taking warm tub baths (sitz baths) for 10 to 20 minutes, a few times

  per day to help the healing process.

Surgical Treatment:

If pain from a thrombosed hemorrhoid is severe, your physician may decide to remove the hemorrhoid and/or clot with a small incision. These procedures can be done at your physician’s office or at the hospital under local anesthesia.

Rubber Band Ligation Of Internal Hemorrhoids:

LEAST INVASIVE PROCEDURE FOR INTERNAL HEMORRHOIDS

• For Bulging, bleeding, internal hemorrhoid

• Rubber band applied at the base of the hemorrhoid

• About seven days later, the banded hemorrhoid has fallen off,

  leaving a small scar at its base 

How Rubber Band Ligation surgery for piles helps to treat Hemorrhoids?

• The small rubber bands placed to the base of the vein to cuts the blood supply to the piles.

• The hemorrhoids then dry and fall off along with the rubber band on its own with stools.

• The time take for the hemorrhoids to dry after the rubber bands may vary and can take anywhere from one to two weeks.

What it feels like after undergoing Rubber Band Ligation surgery for piles?

• Slight discomfort can be felt in the bottom region after the procedure. This discomfort might last for a few days.

• Felling of urge to go to bathroom is normal after rubber band and last for few hours.

• Slight bleeding might occur when going to the toilet. This is not a cause to worry as it is normal.

• Feeling constipated is also normal after undergoing this procedure.

What are the advantages of Rubber Band Ligation Surgery for Piles?

• It is an outpatient procedure and does not require any hospitalization.

• The entire treatment time takes few minutes.

• May need 2-3 sessions

• The chances of recurrence of hemorrhoids are less in this procedure and often controls symptoms.

Other less common Options:

Injection and Coagulation: This method can be used on internal hemorrhoids that do not protrude. Both methods are fairly painless and cause the hemorrhoid to shrivel. Several treatments may be needed. This cannot be used for external hemorrhoids.

Hemorrhoids stapled and sutured: These methods can shrink internal tissue but cannot be used for external hemorrhoids. These procedures are generally more painful than rubber band ligation but less painful than hemorrhoidectomy.

Hemorrhoidectomy

This is the most complete surgical method for removing extra tissue that causes bleeding and protrusion. It is done for both internal and external hemorrhoids under anesthesia using sutures. Depending on the case, hospitalization and a period of rest may be required.

Hemorrhoidectomy is considered when:

1. Clots repeatedly form in external hemorrhoids

2. Ligation is not effective in treating internal hemorrhoids

3. The protruding hemorrhoid cannot be reduced

4. There is chronic bleeding

How Hemorrhoidectomy surgery helps to treat Hemorrhoids?

• This procedure involves incising the hemorrhoids causing veins and suturing it back up.

• This procedure has least recurrence rate.

What it feels like after undergoing Hemorrhoidectomy surgery?

• Pain is very common after the surgery as the entire hemorrhoid tissues have been completely removed.

• But we inject long acting numbing medicine around the anus to keep it numb for 48-72 hours.

• The pain might last a few weeks after the hemorrhoidectomy procedure which is anyway normal.

What are the advantages of Hemorrhoidectomy Surgery for Piles?

• The probability of hemorrhoids returning or recurrence is least compared to other methods of hemorrhoid treatments.

Do Hemorrhoids Lead To Colorectal Cancer?

Hemorrhoids do not increase the risk of colorectal cancer nor cause it. However, more serious conditions can cause similar symptoms. Even when a hemorrhoid has healed completely, your colon and rectal surgeon may request other tests. A colonoscopy may be done to rule out other causes of rectal bleeding. Every person age 45* and older should undergo a colonoscopy to screen for colorectal cancer.  

*In 2018, secondary to new data on the increased risks of colon cancer in those under 50, the American Society of Colon and Rectal Surgery changed recommendations to consider starting screening at age 45.