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Hemorrhoids Frequently Asked Questions

One of the most important facts to know about hemorrhoids is that we all have them. Hemorrhoids, also known as anal cushions, are blood vessels in the anal area that are covered by the lining of the rectum or by skin. They contribute to our body’s ability to control when we have bowel movements. When people “have hemorrhoids,” they are actually describing symptomatic hemorrhoids.

What symptoms are associated with hemorrhoids?

Depending on the type of hemorrhoid affecting a patient, there is a wide range of associated symptoms. Symptoms can include pain, bleeding, swelling, protrusion, or even itching. The best way to tell if hemorrhoids are causing your symptoms is to visit a colorectal surgeon for a detailed history and a focused physical examination.

Do hemorrhoids go away?

For some, hemorrhoids (especially small hemorrhoids) may go away after a few days or a week. Larger hemorrhoids may take longer to resolve. Some may not resolve without treatment. Therefore, if you are having trouble with hemorrhoids and they aren’t resolving on their own, we suggest you visit your doctor for treatment options.

Are there any medications to treat hemorrhoids?

There are several over-the-counter medications to treat mild symptoms associated with hemorrhoids. Preparation H is a low-dose topical steroid that can be used with or without a topical numbing medication, also called lidocaine. Stronger doses of these medications can also be prescribed by your colorectal surgeon after your office visit.

Fiber supplementation with Metamucil or other daily fiber supplements is also a cornerstone of the management of hemorrhoids. Increasing your daily intake of fiber and water will bulk your bowel movements and allow easier passage and less irritation of your hemorrhoids.

What if medications are not controlling my symptoms?

At Memorial Advanced Surgery, we provide several painless office-based treatments to treat moderate any even severe symptoms. One office based treatment is called rubber band ligation where a medical grade rubber band is placed over the symptomatic hemorrhoid to decrease its blood supply and decrease the amount of excess tissue associated with the hemorrhoid. This is very effective for symptomatic hemorrhoids, especially when the primary symptom is protrusion.

Another office-based treatment is injection sclerotherapy. An alcohol solution is painlessly injected to again decrease the blood supply of the hemorrhoid and create scarring that decreases and minimizes the amount of symptoms. This is especially effective for painless bleeding and can even be used in patients that have to be on chronic blood thinners, like Plavix or Coumadin.

What is the surgical management hemorrhoids?

Excisional hemorrhoidectomy, or removal of all the excess hemorrhoid tissue, is the most definitive treatment for hemorrhoidal disease. This surgery is performed on an outpatient basis, usually under sedation and local anesthesia. The excess tissue is removed and the defects are closed with absorbable sutures. Postoperative discomfort is managed with a combination of oral pain medication and Sitz baths. Patients can expect postoperative discomfort for about 3-5 days but they are able to restart a regular diet on the day of surgery. Patients are usually able to return to full activity, including strenuous exercise, about 2 weeks after surgery.

What other conditions could be causing my symptoms?

While the symptoms mentioned above are usually related to hemorrhoids, it is important to consider other diagnoses as well that can be commonly confused for symptomatic hemorrhoids. These can include an anal fissure, which is a tear in the skin around the anal area. Perianal or perirectal abscess can also commonly be confused with hemorrhoids. This is why it is important to have a colorectal surgeon evaluate you if the symptoms are present, because the management of these conditions is very different than hemorrhoidal disease. It is also very important to make sure that you are up to date on your screening colonoscopy as well to ensure that there is not a polyp or mass causing your symptoms.

Can hemorrhoids be prevented?

There are risk factors for hemorrhoids that can be prevented and others that cannot. Even if there is no sure-fire way to prevent hemorrhoids, there is plenty that you can do to reduce your risk. This includes: losing weight, getting enough fiber in the diet, not straining during bowel movements and not overusing laxatives. Unfortunately, as you age, the risk for hemorrhoids increases.

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