Hemorrhoids occur in about 4% of the population and usually resolve themselves spontaneously. Symptomatic hemorrhoids affect about 1% of the population.
What do hemorrhoids look like?
Hemorrhoids are dilated blood vessels that form in the anal canal. They can be internal, forming above the junction between the anus and rectum, or external, forming below this junction.
Are there different types of hemorrhoids?
Yes, there are two types called internal and external hemorrhoids. Internal hemorrhoids are often painless unless they prolapse (protrude) through the anus and become irritated by bowel movements. Prolapsed hemorrhoids may stretch down until they bulge outside of the anal canal. External hemorrhoids are usually painful unless thrombosed (when the blood within them clots).
An internal hemorrhoid can become prolapsed when its blood vessels swell and the surrounding tissues become weak. Prolapsed internal hemorrhoids usually stretch down until they bulge outside of the anal canal.
What causes hemorrhoids?
The main cause of symptomatic hemorrhoids is increased pressure in the veins of the anal canal. This pressure may be related to:
- Straining during bowel movements
- Anal intercourse
- Sitting on the toilet for long periods
- Chronic constipation or diarrhea
- A sedentary lifestyle
This pressure causes swollen veins in turn causing hemorrhoids thus leading to mild pain and even severe pain.
How do I know if I have hemorrhoids?
What are the typical symptoms caused by hemorrhoids?
The main symptom of hemorrhoids is rectal bleeding - bright red blood - during bowel movements. You may notice blood on your stool, in your toilet bowl, or on the toilet paper after wiping. Most symptoms of hemorrhoids include:
- Anal itching
- Pain and irritation around the anus
- Swelling around the anus
- A lump near the anus
If you have any of these symptoms, it's important to see your doctor so they can rule out other more serious causes of anal bleeding, such as colorectal cancer.
How are hemorrhoids diagnosed?
Hemorrhoids are usually diagnosed by a physical examination. Anoscopy, sigmoidoscopy, or colonoscopy may be used to rule out other causes of bleeding such as colorectal cancer.
Do hemorrhoids go away on their own?
In most cases, hemorrhoids go away on their own or with home treatment within a few days. However, some hemorrhoids may become so large and swollen that surgery is needed to remove them. Other medical procedures to decrease blood flow to hemorrhoids are also becoming more popular since they are easy, outpatient procedures. One such procedure is hemorrhoid embolization (also called the 'emborrhoid' technique).
What is the best way to get rid of hemorrhoids?
The best way to get rid of hemorrhoids is to use at-home treatments such as increasing your fiber intake, drinking plenty of fluids, and using over-the-counter (OTC) creams or ointments. If your symptoms don’t improve with home treatment, you may need one of the following non-surgical treatments to reduce symptoms.
Proctoscopy may be used to evaluate internal hemorrhoids. This is done by inserting a short, rigid tube with a light and camera at its tip into the anal canal and rectum.
What treatment options do I have for hemorrhoids?
Many people with hemorrhoids do not seek medical attention unless symptoms become unbearable. However, there are many treatments available for hemorrhoids, both surgical and non-surgical.
What are my non surgical options to treat my hemorrhoids?
Non-surgical medical treatments include:
- Dietary changes: Eating a high-fiber diet and drinking plenty of fluids (six to eight glasses a day) can help soften your stool and make it easier to pass. This will also reduce the straining that can cause hemorrhoids. Some high-fiber foods include beans, nuts, whole-grain bread, and cereals. More fiber does soften stool.
- Fiber supplement: If you're not getting enough fiber in your diet, your doctor may recommend a supplement such as psyllium husk (Metamucil), methylcellulose (Citrucel), or wheat dextrin (Benefiber).
- Stool softeners: These can help reduce constipation by making it easier to have a bowel movement. Examples include docusate sodium (Colace) and lactulose.
- Topical treatments: These can be applied directly to the hemorrhoids to help soothe the irritation and pain. Examples include witch hazel, aloe vera, and capsaicin cream (Zostrix), astringents, protectants.
- Warm sitz baths: Sitting in a warm bath for 10-15 minutes several times per day can help to reduce swelling and pain. Add baking soda, Epsom salts, or colloidal oatmeal to the water to help soothe your skin.
- Hemorrhoid creams and ointments: These can be applied directly to the hemorrhoids to help soothe the irritation and pain. Examples include Preparation H, Anusol, and Tucks pads.
- Over-the-counter pain relievers: These can help relieve pain and inflammation associated with hemorrhoids. Examples include acetaminophen (Tylenol), ibuprofen (Advil), and naproxen (Aleve).
- Ice packs or cold compresses: These can help reduce the swelling of hemorrhoids.
- Analgesics: Over-the-counter pain relievers such as acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Aleve) can help relieve the pain of hemorrhoids.
- medical procedures to decrease blood flow to hemorrhoids such as hemorrhoid embolization (the 'emborrhoid' technique) is an emerging, same-day, outpatient non surgical treatment
In some cases, more aggressive treatments may be necessary. These include injection therapy, infrared coagulation, and rubber band ligation.
Surgery is generally reserved for cases with extreme pain and persistent bleeding that do not respond to nonsurgical treatment options. Hemorrhoidectomy, performed by colon and rectal surgeons, is the most common surgical procedure used to treat hemorrhoids. This involves the removal of the hemorrhoids from the lower rectum with a scalpel or laser. After a hemorrhoidectomy, you may feel pain and have a sensation of fullness in your lower abdomen. You may also bleed for up to four weeks after surgery. . Recovery from surgery usually takes one to two weeks.
How do Imaging & Interventional Specialists determine whether you could benefit from an advanced, non surgical hemorrhoid treatment 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.