Treating hemorrhoids: Everything you wanted to know but were afraid to ask.

by David E. Stein, MD, Colorectal Surgeon and Regional Chief of Surgery in the Baltimore region at MedStar Health
October 23, 2020

You may be surprised to hear that everyone has hemorrhoids. In fact, I often introduce the topic to my medical students by walking around the room and pointing to unsuspecting individuals exclaiming, “I know you have hemorrhoids!”

Did you know you have #Hemorrhoids? Everyone does, but they’re practically invisible until they become inflamed. On the #LiveWellHealthy blog, Dr. Stein shares everything you wanted to know about hemorrhoid treatment but were afraid to ask: https://bit.ly/2Tn10At.

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So, what are hemorrhoids?

Hemorrhoids are a normal part of the anal canal that help us to control bowel function. There are two locations where hemorrhoids can be found. Internal hemorrhoids exist within the lining of the rectum and anal area, or the inside of the body. In contrast, external hemorrhoids are located on the outside of the body where the skin has very sensitive nerve endings.

When hemorrhoids become inflamed, they can become extremely painful, especially if they’re located externally. Unfortunately, over 10 million people suffer from inflamed hemorrhoids every year. How can something so small cause so much pain and discomfort?

Symptoms of hemorrhoids.

Hemorrhoid symptoms vary based on which ones are causing the problem.

External hemorrhoids often bring on abrupt excruciating—and sometimes debilitating—pain. Bleeding and a formed clot that stretches the skin of the anal area are the cause of the pain.

Internal hemorrhoids are graded on a scale of one to four, with painful symptoms that increase as the grade does. They’re rarely painful, although you can experience some bleeding and burning.

  • Grade 1: Painless rectal bleeding
  • Grade 2: Pain and discomfort from prolapsing or protruding from the anal opening
  • Grade 3: Pain and discomfort from prolapsing or protruding from the anal opening that requires you to manually push them back inside
  • Grade 4: Pain and discomfort from hemorrhoids that are stuck in the prolapsed position and generally require surgery

It’s important to note that some symptoms may be similar to other conditions, such as colon cancer. If you are over the age of 40 and experiencing bleeding, talk to your doctor about getting screened for colon cancer to rule out anything life-threatening.

Causes of hemorrhoids.

A lack of fiber. There are a variety of things that can cause hemorrhoids to inflame, but the most common reason is a lack of fiber in your diet. The United States Department of Agriculture (USDA) recommends that women eat a minimum of 25 grams of fiber and men consume over 30 grams of fiber every day. Yet many of us don’t eat enough fiber.

Irregular bathroom habits. Still, even if you eat enough fiber, it’s possible to develop an inflamed hemorrhoid. Constipation, straining, and irregular bowel habits are also common causes of hemorrhoids. That’s why expecting women are also prone to developing inflamed hemorrhoids—as if they don’t suffer enough uncomfortable symptoms during pregnancy. Individuals with Inflammatory Bowel Disease (IBD) may also be at an increased risk of developing hemorrhoids.

Genetics. Unfortunately, if your parents frequently developed inflamed hemorrhoids, there’s a greater likelihood that you will, too. Over fifty percent of patients with hemorrhoids have a family history of dealing with the same affliction.

Treating hemorrhoids.

Sometimes, people with inflamed hemorrhoids don’t experience any symptoms. Other times, symptoms may dissipate quickly as hemorrhoids can resolve themselves within a few days. However, for some unlucky individuals, the only way to get hemorrhoid relief is by seeking treatment from a doctor.

Treating hemorrhoids at home.

Over-the-counter medications like Preparation H may offer some pain relief for hemorrhoids. But unless you modify your fiber intake, they’ll probably keep coming back. If you have internal hemorrhoids, I will almost always recommend diet modifications to incorporate more fiber. A high-fiber diet is the best way to eliminate and prevent most cases of hemorrhoids, as fiber helps to regulate bowel movement. 70% of the time, eating more fiber will relieve symptoms of internal hemorrhoids.

Consider upping your fiber intake with the following high-fiber foods:

  • Berries
  • Nuts
  • Legumes
  • Veggies
  • Whole grains

Treating hemorrhoids at the doctor.

No one dies from hemorrhoids. But if you’ve had one, you may wish that you had! Living with persistent hemorrhoid pain is miserable and there are many treatment options available so you don’t have to. Treatment options vary based on the location and severity of your hemorrhoid.

Treatment for internal hemorrhoids.

When dietary adjustments don’t relieve pain, you may benefit from a quick, in-office procedure to remove internal hemorrhoids grading one or two. Called rubber band ligation, this simple procedure involves placing a small rubber band around the hemorrhoid to help it naturally fall off within ten days. It can be uncomfortable, but it’s not painful and it’s extremely effective.

If neither diet nor rubber band ligation provide relief, there are numerous surgical options that, while painful, are effective in eliminating hemorrhoids. These include:

  • Hemorrhoidectomy: When a large piece of skin is prolapsing every time you go to the bathroom, you may need surgery to remove hemorrhoids. An anesthetic will help to keep you comfortable during the procedure. However, you will likely experience pain for about two to three weeks of recovery.
  • Stapled hemorrhoidopexy: This procedure pulls the hemorrhoids back into their usual position with the use of a stapling device. The recovery is significantly less painful than the classic excision.
  • Hemorrhoid artery ligation: This new technique uses ultrasound to detect blood vessels supplying the hemorrhoids. Then, your doctor will suture the arteries so no blood enters the hemorrhoids, causing them to shrink.

Treatment for external hemorrhoids.

If you have an external hemorrhoid and see a doctor within three to four days of experiencing symptoms, your doctor can treat it using a procedure called thrombosis. During thrombosis, your doctor will numb the area before removing the inflamed hemorrhoid, resulting in instant relief. Unfortunately, if you’ve experienced symptoms for at least five days, the best thing to do is wait it out as the clot inside the hemorrhoid is likely already going away.

The new Surgical Pavilion at MedStar Franklin Square Medical Center.

If you need surgery for hemorrhoid relief, our new patient-centered Surgical Pavilion is now open. This 82,000-square-foot facility was designed with input from doctors, surgeons, nurses, technicians, and staff who understand the features and amenities that will make your surgery the best experience it can be. The spacious building offers ample suites for privacy, comfort, and social distancing, as well as large operating rooms equipped with state-of-the-art technology to facilitate collaboration across specialties.

While it’s important to be cautious while COVID-19 is still around, you need to take care of your health. If you have painful symptoms that suggest you may have an inflamed hemorrhoid but you’re not sure, talk to your doctor. Your doctor can help to rule out polyps or something more serious while suggesting your best treatment options if you have a confirmed hemorrhoid. If surgery is your best option, you can count on MedStar Health to provide the highest levels of care in a safe environment.

Want to learn more about how the new Surgical Pavilion at MedStar Franklin Square Medical Center can help with hemorrhoids?
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Category: Health Innovation, Living Well     Tags: hemorrhoidsmedstar franklin square medical center