Hemorrhoids

Common, uncomfortable, and treatable in the office in a few minutes.

Hemorrhoids are swollen blood vessels in and around the anus and lower rectum. Nearly everyone has them; they become a problem when they enlarge, bleed, or cause pain. Straining, constipation, prolonged sitting, pregnancy, and heavy lifting all contribute.

People put off dealing with hemorrhoids for a long time, usually out of embarrassment. It is one of the most routine things we treat, and the treatment is quicker than most patients expect.

Symptoms

• Bright red blood on the tissue, in the toilet, or on the stool
• Itching or irritation around the anus
• Pain or discomfort, particularly when sitting
• A lump or swelling near the anus
• A feeling of incomplete emptying

Do Not Assume Bleeding Is Hemorrhoids

This is the important part of the page. Rectal bleeding is the most common symptom of hemorrhoids, and it is also a symptom of colorectal cancer, polyps, inflammatory bowel disease, and other conditions. The two can feel identical, and people frequently attribute months of bleeding to hemorrhoids without having anything examined.

Get evaluated rather than assuming — particularly if you are 45 or older, if the bleeding is new or changing, if you also have a change in bowel habits or unexplained weight loss, if the blood is dark or mixed into the stool, or if there is any family history of colorectal cancer. Confirming the cause is straightforward, and it is far better than finding out later that something else was responsible.

Treatment

Mild cases often settle with more dietary fiber, adequate fluids, not straining, avoiding long periods sitting on the toilet, and topical treatments. Treating underlying constipation matters more than most people realize, since it addresses the cause rather than the symptom.

Hemorrhoid Banding

When symptoms persist, rubber band ligation is usually the next step, and we perform it right in our office. A small band is placed at the base of the hemorrhoid, cutting off its blood supply so that it shrinks and falls away on its own within a few days.

The procedure takes only a few minutes. There is no sedation, so you can drive yourself, and most patients return to their normal routine the same day. Some patients need more than one session, since hemorrhoids are usually treated one at a time. A feeling of fullness or mild aching for a day or two afterward is normal.

A small number of patients have hemorrhoids that are better treated surgically, and we will tell you if that applies rather than putting you through repeated banding that is unlikely to work.