What Are Hemorrhoids?
Hemorrhoidal tissue is part of normal anatomy. Everyone has internal hemorrhoids and external hemorrhoids. Internal hemorrhoids are not sensitive to pain. External hemorrhoids are covered by skin and are sensitive. Sometimes the hemorrhoidal tissue becomes enlarged and can cause pain or bleeding. Sometimes hemorrhoidal tissue can come out of the rectum and be felt when wiping or having a bowel movement. This is called a prolapsed hemorrhoid. They can sometimes cause irritation and itching around the anus. Hemorrhoids can be caused by excessive straining, constipation, diarrhea, lifting or increased abdominal pressure such as in pregnancy.
How Can We Help?
We will obtain a history of your symptoms and perform an examination in the office. If your disease is mild then we may recommend dietary therapy – such as increasing fiber in your diet, drinking water and exercising. The recommended amount of dietary fiber is 25 grams per day for women and 30 grams per day for men. Gradually increase the amount of fiber you eat (to prevent gas and cramping) until you achieve this goal. The goal is to avoid constipation or diarrhea. Most people should have 1-2 soft well-formed bowel movements every day.
If your hemorrhoids are more severe then we will either perform an office based procedure or schedule a procedure in the operating room. If you have internal hemorrhoids, we can perform rubber band ligation. This involves examining the inside of your anus and putting a rubber band around the excess tissue which cuts the blood supply off to the hemorrhoid. In 5-7 days, the hemorrhoid will fall off with the band. You may notice a small amount of bleeding. If you are on blood thinners such as Coumadin, Pradaxa or Plavix, you may not be a candidate for this office procedure.
The majority of external thrombosed hemorrhoids will resolve with time. The best surgical candidates present prior to 72 hours with no lessening of the pain. After 72 hours, the clots begin to soften spontaneously and shrink. If you are symptomatic, we can inject a local anesthetic and remove the hemorrhoidal tissue. It is important that the tissue is removed as lancing the hemorrhoid is associated with recurrence. Occasionally the hemorrhoids need to be removed in the operating room if they are large.
Who to Contact
Dr. Charlie Jones and Dr. Susan Hagen are general, vascular and thoracic surgeons with over 30 years of experience. To make an appointment, please call 303-443-2123.