Rectal bleeding is reported by about 4% of the general population. Of the causes of bright red blood from the rectum about half are due to hemorrhoids. Many people with rectal bleeding think they have hemorrhoids, but there are many other, more serious causes of rectal bleeding.
Once the diagnosis of hemorrhoids is established there are a variety of home treatments, non surgical medical treatments, and surgical solutions ranging from laser to hemorrhoidectomy, a major surgery performed in a hospital with significant postoperative pain and with a 2 - 3 week recovery.
What are hemorrhoids? What do hemorrhoids look like?
Hemorrhoids are dilated blood vessels or veins in the anal canal. There are two types of hemorrhoids:
Internal hemorrhoids – These are located inside the rectum and usually don't hurt, but may bleed painlessly. . Hemorrhoids often cause no symptoms but can cause bright red blood from the anus and pain if thrombosed (clotted). Chronically bleeding internal hemorrhoids can lead to anemia and fatigue.
External hemorrhoids – These are located under the skin around the anus and usually cause rectal pain and bleeding with a bowel movement. External hemorrhoids can be painful if they bulge or rupture. Thrombosed hemorrhoids can be very painful but usually resolve with time.
What types of hemorrhoid treatment are there?
What are the non surgical treatments for hemorrhoids?
The mainstay of nonsurgical treatment for hemorrhoids is increased fiber in the diet, which softens stools and reduces straining during bowel movements. Symptomatic internal hemorrhoids can be treated with dietary changes, stool softeners, over-the-counter hemorrhoid cream or suppositories, and warm baths. Other nonsurgical measures include:
Sitz baths – This involves sitting in a tub of warm water several times a day for 10 to 15 minutes at a time. This can help soothe the area and reduce inflammation.
Topical creams and ointments – There are over-the-counter (OTC) creams that contain numbing agents or corticosteroids that can help with pain and swelling. Prescription creams may also be used.
What causes hemorrhoids?
The exact cause of symptomatic hemorrhoids is unknown. Several factors contribute to the development of hemorrhoids including:
Anatomy – Hemorrhoids develop when the anal cushions enlarge and descend into the anal canal. This may be due to an inherent weakness in the connective tissue or simply from prolonged sitting on the toilet.
Diet – A diet low in fiber can lead to hard stools that are difficult to pass, straining during bowel movements, and constipation. This can contribute to the development of hemorrhoids.
Pregnancy – Hemorrhoids are common during pregnancy due to the increased pressure on the anal cushions from the growing uterus.
Family history – If hemorrhoids run in your family, you may be more likely to develop them.
Chronic constipation or diarrhea – This can lead to straining during bowel movements and contribute to the development of hemorrhoids.
Anal intercourse – This can cause trauma to the anal cushions and lead to the development of hemorrhoids.
Obesity – This can contribute to the development of hemorrhoids by increasing the pressure on the anal cushions.
Sitting for long periods – This can contribute to the development of hemorrhoids by increasing the pressure on the anal cushions.
What is the prognosis for hemorrhoids?
The prognosis for hemorrhoids is generally good. Most people will not require surgery and can be treated with dietary changes, stool softeners, over-the-counter creams or suppositories, and warm baths. In some cases, surgery may be required to remove the hemorrhoids. Complications from surgery are rare but can include anal stenosis, fistula, incontinence, rectal prolapse, and recurrent hemorrhoids. With proper treatment, most people with hemorrhoids will experience a significant improvement
What is hemorrhoidectomy?
Hemorrhoidectomy is surgery to remove hemorrhoids. It is the last resort for treating internal hemorrhoids that are very large and prolapsing (protruding from the anus). It can also be used to treat external hemorrhoids that are causing extreme pain or bleeding. This type of surgery is usually performed under general anesthesia in a hospital setting. The recovery time from this type of surgery is usually 2-3 weeks.
What are the complications of a hemorrhoidectomy?
The main complication of a hemorrhoidectomy is postoperative pain. This can be managed with pain medication prescribed by your surgeon. Other potential complications include:
Anal stenosis – narrowing of the anal canal
Fistula – an abnormal connection between two organs
Incontinence – loss of control over bowel movements
Rectal prolapse – protrusion of the rectum through the anus
Recurrent hemorrhoids – new hemorrhoids may develop after surgery
What can I expect after a hemorrhoidectomy?
After a haemorrhoidectomy, you can expect to have some pain and bleeding. Your surgeon will prescribe pain medication to help with the pain. You may also have a tube called a catheter in your bladder to help drain urine while you are healing. Most people stay in the hospital for 1-2 days after surgery. You will be able to go home when you can urinate on your own and are having regular bowel movements. It is important to follow your surgeon's instructions on how to care for yourself at home. This will include taking it easy for the first few days, avoiding constipation and straining during bowel movements, and using sitz baths several times a day.
Are there non surgical alternatives to hemorrhoidectomy?
Yes, there are non surgical alternatives to hemorrhoidectomy. These are usually used in less severe diseases and include:
Dietary changes – increasing your intake of fiber can help to soften your stools and make them easier to pass. This can reduce the strain on your anal cushions and help to prevent hemorrhoids from developing.
Stool softeners – these can help to soften your stools and make them easier to pass. This can reduce the strain on your anal cushions and help to prevent hemorrhoids from developing.
Over-the-counter creams or suppositories – can help to soothe the pain and itching associated with hemorrhoids.
Warm baths – sitting in a warm bath several times a day can help to reduce the inflammation and pain associated with hemorrhoids.
For more severe diseases hemorrhoid embolization is being chosen by more and more people since it is an easy, short, outpatient procedure with very little recovery time.
How do Imaging & Interventional Specialists determine whether you could benefit from advanced, non surgical hemorrhoid treatments such as hemorrhoid embolization?
After a review of your medical history, a physical exam may be performed. Many of our patients have already been evaluated to determine the size, location, and type of their hemorrhoids. If needed we talk with other members of your care team and analyze your medical chart to determine what treatment plan best fits your clinical situation.
After a complete evaluation has been performed, the diagnosis of hemorrhoids made, and the grade, chronicity, and severity determined an Imaging & Interventional Specialist will discuss the best treatment options for you which may include hemorrhoid embolization.
Why choose Imaging & Interventional Specialists?
Imaging & Interventional Specialists are leaders in interventional radiology and experts in the minimally invasive procedures that will address your hemorrhoids.
Our physicians perform “pinhole” procedures every day offering this region's leading, world-class, state-of-the-art solutions for hemorrhoids. Our minimally invasive image-guided procedures are cutting-edge technology without the cutting, without the scalpel. You leave with a Band-Aid!
At Imaging & Interventional Specialists board-certified physicians offer in-house testing for diagnosis and to develop an individualized treatment program for your hemorrhoids