Hemorrhoids are a pain and a very common ailment.  Millions of Americans currently suffer from hemorrhoids and more than half the population will develop hemorrhoids at some point, usually after age 30.

For many people hemorrhoids may go away on their own after a few days, but for others hemorrhoids can become a recurring and painful problem.  Even though hemorrhoids are very common, the average person will suffer in silence for a long period before seeking medical care.

What are hemorrhoids?

Often described as “varicose veins of the anus and rectum”, hemorrhoids are enlarged, bulging blood vessels in and about the anus and lower rectum.  They can be internal or external, and some people may have both types at the same time.  External hemorrhoids are more likely to cause pain and itching when irritated while internal hemorrhoids are generally painless but can cause bleeding.

External hemorrhoids develop near the anus and are covered by very sensitive skin. If a blood clot develops in one of them, a painful swelling may occur. The external hemorrhoid feels like a hard, sensitive lump. It bleeds only if it ruptures.

Internal hemorrhoids develop within the anus beneath the lining. Painless bleeding and protrusion during bowel movements are the most common symptom.  However, an internal hemorrhoid can cause severe pain if it is completely prolapsed – meaning it protrudes from the anal opening.

What causes hemorrhoids?

Many factors can contribute to hemorrhoids.  Just the upright posture of humans alone forces a great deal of pressure on the rectal veins, which sometimes causes them to bulge.

Other factors include:

• Aging
• Chronic constipation or diarrhea
• Pregnancy
• Heredity
• Faulty bowel function due to overuse of laxatives or enemas; straining during bowel movements
• Spending long periods of time on the toilet

Whatever the cause, the tissues supporting the veins stretch. As a result, the veins dilate and their walls become thin and bleed. If the stretching and pressure continue, the weakened veins protrude.

Signs of hemorrhoids

If you notice any of the following, you could have hemorrhoids:

• Bleeding during bowel movements
• Protrusion during bowel movements
• Itching or pain in the anal area
• Sensitive lump(s)

Do hemorrhoids lead to cancer?

No. There is no relationship between hemorrhoids and cancer.

However, some symptoms of hemorrhoids, particularly bleeding, are similar to those of colorectal cancer and other diseases of the digestive system. Therefore, it is important consult a physician specially trained in treating diseases of the colon and rectum to rule out anything more serious. Do not rely on over-the-counter medications or other self-treatments.  See a colorectal surgeon first so your symptoms can be properly evaluated and effective treatment prescribed.

How are hemorrhoids treated?

For mild symptoms over the counter pain relievers like Tylenol or Ibuprofen can help with pain and swelling.  Other remedies include:

• Eliminating excessive straining during bowel movements reduces the pressure on hemorrhoids and helps prevent them from protruding
• Icing the area for 10 minutes followed by placing a warm compress on the area for another 10 to 20 minutes
• Taking a sitz bath several times a day
• Using baby wipes or moistened towels like Tucks pads, after a bowel movement

To keep hemorrhoids away we suggest patients eat foods with plenty of fiber, drink enough water, exercise regularly and avoid standing for long periods of time.

With these measures, the pain and swelling of most symptomatic hemorrhoids will decrease in two to seven days, and the firm lump should recede within four to six weeks. In cases of severe, persistent pain, your CRS physician may elect to remove the hemorrhoid containing the clot with a small incision. Performed under local anesthesia in an outpatient setting, this procedure generally provides relief.

Severe hemorrhoids may require special treatment, many of which can also be performed on an outpatient basis.

Treating severe hemorrhoids

For most people hemorrhoids will resolve on their own, but for others medical treatment may be necessary.  If you are suffering from recurring or severe hemorrhoids talk to your CRS physician about available treatments which may include:

Ligation, or rubber band treatment, which can be effective to treat internal hemorrhoids that protrude with bowel movements.  A small rubber band is placed over the hemorrhoid cutting off its blood supply. The hemorrhoid and the band fall off in a few days and the wound usually heals in a week or two. This procedure sometimes produces mild discomfort and bleeding.

Injection and coagulation can also be used on bleeding hemorrhoids that do not protrude. Both methods are relatively painless and cause the hemorrhoid to shrivel up.

When is hemorrhoid surgery necessary?

Hemorrhoidectomy, or surgery to remove hemorrhoids, is the best method for the permanent removal of hemorrhoids.  It is usually recommended in cases where:

• Clots repeatedly form in external hemorrhoids
• Ligation fails to treat internal hemorrhoid
• The protruding hemorrhoid cannot be reduced
• Or there is persistent bleeding

A hemorrhoidectomy removes excessive tissue that causes the bleeding and protrusion and is done under anesthesia.  Depending on the circumstances it may require hospitalization and a period of rest.  Laser hemorrhoidectomies do not offer any advantage over standard operative techniques. They are also quite expensive, and contrary to popular belief, are no less painful.

If you are suffering from hemorrhoids or experiencing bleeding, please contact us at (804) 249-2465 for our Stony Point location, (804) 559-3400 for our Hanover location or (804) 288-7077 for our West End location to schedule you an appointment.