Getting rid of hemorrhoids

Piles (haemorrhoids)

Hospital treatment for piles

If there’s no improvement to your piles after home treatments, you may need hospital treatment.

Talk to your doctor about the best treatment for you. Treatment does not always prevent piles coming back.

Treatment without surgery

Common hospital treatments include:

  • rubber band ligation: a band is placed around your piles to make them drop off
  • sclerotherapy: a liquid is injected into your piles to make them shrink
  • electrotherapy: a gentle electric current is applied to your piles to make them shrink
  • infrared coagulation: an infrared light is used to cut the blood supply to your piles to make them shrink

You’ll be awake for this type of treatment, but the area will be numbed.

You should be able to go home on the same day.

If these treatments do not work, you may need surgery to remove your piles.

Surgery

Surgical treatments include:

  • haemorrhoidectomy: your piles are cut out
  • stapled haemorrhoidopexy: your piles are stapled back inside your anus
  • haemorrhoidal artery ligation: stitches are used to cut the blood supply to your piles to make them shrink

You’ll usually need to be asleep for this type of treatment and may need to stay in hospital for more than 1 day.

Hemorrhoids are a very common anorectal condition that affects millions of people around the world. Over half of all people will develop symptomatic hemorrhoids at some point, so it’s common to wonder how to get rid of hemorrhoids. Most patients are able to get rid of hemorrhoids with a high-fiber diet, herbal supplements and non-surgical medical treatments, such as my DIY Hemorrhoid Cream with Turmeric & Tea Tree Oil. (1)

Hemorrhoids are frequently seen in primary care clinics, emergency wards, gastroenterology units and surgical clinics, but how do you know when hemorrhoids have developed and when you should see a doctor? These are common concerns among people who develop hemorrhoids and don’t know how to deal with and treat the pain. Thankfully, there are natural treatments for how to get rid of hemorrhoids fast, and starting there may help relieve these literal pains in the butt.

What Are Hemorrhoids?

Now, you might be wondering why it’s so important to know how to get rid of hemorrhoids, especially if you’ve never experienced hemorrhoid symptoms before. Well, it’s because no one is immune to hemorrhoids.

I bet you didn’t know that we all have hemorrhoids, but it’s true. Hemorrhoids are normal cushions of tissue that are filled with blood vessels and found at the end of the rectum, just inside the anus. Together with a circular muscle called the anal sphincter, hemorrhoids help control bowel movement. When people say that they “have hemorrhoids,” what they really mean is that their hemorrhoids have become enlarged. Enlarged hemorrhoids are often associated with symptoms such as itching, mucus discharge or bleeding. Bleeding happens when hard stool damages the thin walls of the blood vessels in hemorrhoids.

The two basic types include internal and external hemorrhoids. Internal hemorrhoids are more common, and external hemorrhoids tend to feel like a large lump around the outside of the anus that can make sitting painful. Bleeding is fairly common with a swollen external hemorrhoid.

Swollen internal hemorrhoids might come out of the anus and can then be seen as soft lumps of tissue. These are called protruding or prolapsed hemorrhoids. Larger hemorrhoids can make it feel like something is pushing against the anus, which can make sitting very uncomfortable. (13)

Hemorrhoids are classified by grade, which is based on how severe they are:

  • Grade 1: Slightly enlarged hemorrhoids that cannot be seen from outside the anus.
  • Grade 2: Larger hemorrhoids that may come outside of the anus at times, like when passing stool, but then go back in on their own.
  • Grade 3: Hemorrhoids that come out of the anus when passing stool or engaging in physical activity and do not go back in on their own. They can only be pushed back inside the anus.
  • Grade 4: Hemorrhoids that are always outside the anus and can no longer be pushed back inside. A small bit of the anal lining may also come down from the lower rectum and out of the anus, which is known as rectal prolapse.

The most common symptom of hemorrhoids is anal bleeding, and chief complaints include a perianal mass protruding from the anus and anal discharge. Other symptoms of hemorrhoids include:

  • irritation and itching around the anus
  • fecal leakage
  • sensitive lumps in the anus
  • painful bowel movements
  • protrusion of skin during bowel movements
  • blood on toilet paper after having a bowel movement

A particularly painful form of Grade 4 hemorrhoids comes in the form of a thrombosed hemorrhoid. This refers to a (usually) external hemorrhoid that have no blood flow because the vein connected to them has a thrombosis (blood clot). The thrombosis responsible for a thrombosed hemorrhoid will often reabsorb within two to three weeks without major treatment. Pain originating from the swelling and inflammation of the hemorrhoid is usually worst in the first 24–48 hours after it develops.

People with hemorrhoids are at an increased risk of portal hypertension. (14) According to WebMD, “Portal hypertension is an increase in the blood pressure within a system of veins called the portal venous system. Veins coming from the stomach, intestine, spleen, and pancreas merge into the portal vein, which then branches into smaller vessels and travels through the liver.”

Many people find themselves wondering, “Do hemorrhoids go away?” Most swollen hemorrhoids do go away, given that you follow a wise regimen of diet and bathroom habits, as well as any other additional treatment methods recommended by your physician.

How long do hemorrhoids last? Hemorrhoid symptoms clear up within a few days for most people, but they may reoccur and/or require medical attention in some cases. If symptoms continue for more than a week or two and haven’t been improved by home treatment, it’s probably time to visit the doctor. For those who already have frequent hemorrhoids, dietary intervention may be one of the best ways to get rid of external and internal hemorrhoids once and for all.

Although people assume that any anal pain while using the toilet is hemorrhoids, there are a number of other anorectal disorders that can cause symptoms, including dermatologic diseases, diverticulitis, abscess and fistula, fissure, sexually transmitted diseases, warts, HIV, infections and inflammatory ulcers. These conditions will be ruled out by your doctor when you go for a rectal exam if they aren’t the cause.

Diverticulitis vs. Hemorrhoids

People are sometimes confused by the difference between diverticulitis and internal hemorrhoids. Diverticulitis is a condition in which sacs or pouches within the colon walls become inflamed and press into the colon. While some of the symptoms and root problems are similar to what causes hemorrhoids, diverticulitis tends to be a bit more serious and is related closely to age and poor dietary fiber intake.

Causes of Hemorrhoids

Researchers propose that degradation (or disintegration) of the supporting tissues of the anal cushions causes hemorrhoids to develop. There are some contributing factors for hemorrhoids, including:

  • being overweight
  • regularly lifting heavy objects
  • aging
  • pregnancy and giving birth
  • heredity
  • constipation or chronic diarrhea
  • faulty bowel function due to overuse of laxatives or enemas
  • spending excessive periods of time on the toilet

An increase in intra-abdominal pressure during pregnancy or when constipated and sitting on the toilet for a prolonged period of time while straining are major contributing factors for the development of hemorrhoids. Weakening of supporting tissue as a result of aging and genetics may also serve as another cause.

Many dietary factors, including a low-fiber diet, spicy foods and alcohol intake, have been implicated as possible causes of hemorrhoids symptoms as well, but the research proving this is inconsistent. It has also been published that Caucasians of higher socioeconomic class were afflicted with a greater frequency of hemorrhoids, but this data may be limited because it’s based on people’s health care-seeking practices. (15)

Conventional Treatment for Hemorrhoids

When you go to see a doctor for enlarged hemorrhoids, he or she will look at your anus to see if it’s inflamed and whether the hemorrhoids come out of the anus when you push or if they’re already outside. Depending on the severity of your symptoms, there are a number of examinations your doctor may choose to perform in order to make a diagnosis. Doctors typically do a digital rectal examination first, which involves gently inserting a finger into the anus with gloves and lubricant. The doctor will feel the inside of the anal canal using circular movements, which allows him to examine the sphincter muscles and the texture of the membranes lining the anus.

If your doctor believes that you do have enlarged hemorrhoids, she will most likely perform a proctoscopy next. This involves inserting a short tube with a light and lens on it (the proctoscope) that exams the membranes lining the rectum. The doctor is looking to see if there are enlarged hemorrhoids and how big they are. People tend to fear the pain and discomfort that come with these procedures, but they usually don’t hurt and do help your doctor make suggestions about how to get rid of hemorrhoids.

Most of the patients suffering from hemorrhoids have their symptoms alleviated through diet therapy, fiber supplements, hemorrhoid cream and medical treatments, such as sclerotherapy, rubber band ligation and infrared coagulation.

1. Sclerotherapy

Sclerotherapy is a procedure that involves injecting a chemical (the sclerosant) into a vein to destroy it. The sclerosant is used to damage the innermost lining of the vessel, which results in a clot that blocks the blood circulation in the vein. Over time, the vessel turns into scar tissue and fades away.

In 2010, a group of 338 Japanese medical institutions reported good results for sclerotherapy using aluminum potassium sulfate and tannic acid (ALTA). Upon injecting ALTA into grade 2, 3 and 4 hemorrhoids, of 3,519 patients, 98 percent reported positive effects within 28 days. The recurrence rate after two years was 18 percent, and complications included pyrexia, low blood pressure, perineal pain and rectal ulcers, but those were mild. (16)

2. Rubber Band Ligation

This procedure is used to remove a hemorrhoid with a rubber band. Your doctor inserts a small tool called a ligator through a lighter tube into the anal canal. Then the doctor grasps the hemorrhoid with forceps, slides the ligator’s cylinder upward and releases the rubber band around the base of the hemorrhoid. The rubber band cuts off the hemorrhoid’s blood supply and causes it to wither away.

A 2000 study published in Digestive Surgery found that rubber band ligation is a useful, safe and successful method for treating symptomatic second- and third-grade hemorrhoids and can be applied successfully in fourth-grade cases but with an increased rate of recurrence and additional treatments required. (17)

3. Infrared Coagulation

Infrared coagulation is a procedure that’s used for internal hemorrhoids. The doctor uses a device that creates an intense beam of infrared light to cause scar tissue and cut off the blood supply to the hemorrhoid. When the hemorrhoid dies, a scar forms on the anal canal below the lower rectum, and the scar tissue holds nearby veins in place so they can’t bulge into the anal canal.

A 2003 study compared infrared coagulation and rubber band ligation in terms of effectiveness and discomfort. Researchers found that postoperative pain during the first week after treatment was more intense in the band ligation group; pain and a feeling of constantly having to pass stool was also more intense with band ligation. Patients in the infrared coagulation group returned to work earlier, but they also had a higher recurrence or failure rate. Researchers concluded that band ligation, although more effective in controlling symptoms and obliterating hemorrhoids, is associated with more pain and discomfort to the patient — something to keep in mind when you’re looking for ways on how to get rid of hemorrhoids. (18)

4. Hemorrhoid Surgery

Surgical intervention is now less frequently performed than in the past, but it can be considered for patients with acute complications of hemorrhoidal disease or for those who were unable to treat hemorrhoids with other measures. Surgery for hemorrhoids, known as a hemorrhoidectomy, involves removing the hemorrhoid or the clot with a small incision. Having a hemorrhoidectomy is generally an outpatient procedure and involves a two to three week recovery period.

Having hemorrhoid surgery can seem frightening, but it is a relatively minor procedure that doctors recommend when all other treatment methods have failed.

How to Get Rid of Hemorrhoids

1. Improve Your Diet

Eat High-Fiber Foods

To get rid of hemorrhoids, it’s important that you avoid constipation and hard stool, which can be done by eating plenty of high-fiber foods to make stools soft. For how to get rid of hemorrhoids, the recommendation is 30–35 grams of fiber daily. Eat foods such as avocados, berries, figs, Brussels sprouts, acorn squash, beans, lentils, nuts, flaxseeds, chia seeds and quinoa. In clinical studies, high-fiber diets reduced the risk of persisting symptoms and bleeding by approximately 50 percent. (2)

Drink Plenty of Water

Dehydration can lead to constipation because water or fluids are required for fiber to travel smoothly through the digestive tract. Many studies, including one published in the European Journal of Clinical Nutrition, indicate that fluid loss and fluid restriction can increase constipation, which can worsen hemorrhoid symptoms. To relieve constipation and as a way for how to get rid of hemorrhoids, drink at least one glass of water with each meal and snack of the day. (3)

Eat Fermented Foods

Fermented foods like kefir, kimchi and raw, pastured yogurt can help provide the digestive system with healthy bacteria that are essential for proper elimination. Several studies have shown that fermented foods and probiotics improve intestinal tract health, synthesize and enhance the bioavailability of nutrients, modify gut pH and aid digestion. (4)

Limit Alcohol and Spicy Foods

Alcohol can be dehydrating and hard on the digestive system, making hemorrhoid symptoms worse. And spicy foods can intensify the symptoms of hemorrhoids. Some studies show that both alcohol and spicy foods consumption serve as risk factors for hemorrhoids, although the data isn’t consistent. To be safe, limit these foods until the hemorrhoids have cleared up. (5)

2. Practice Better “Toilet Habits”

Avoid Straining

Straining during a bowel movement can be painful and make hemorrhoid problems even worse. Don’t wait too long before going to the toilet. Pay attention to your body’s signals, and when you feel an urge to use the bathroom, go right away. Otherwise the stool will become harder, and this will automatically make you push harder. When you’re at the toilet, take your time and relax your body. (6)

Prevent Constipation

Constipation forces you to strain while using the bathroom, and that will increase the pain and inflammation of the hemorrhoid. To avoid constipation, drink plenty of fluids, engage in regular physical activity and eat high-fiber foods that make stools soft. These steps also help answer how to get rid of hemorrhoids or prevent them in the first place.

Avoid Prolonged Sitting on the Toilet

Spending too much time on the toilet can worsen hemorrhoids. Don’t read or distract yourself while using the bathroom; this only leads to more time spent straining. (Read: put the phone down.)

Clean Yourself Thoroughly

If stool is left behind after you wipe, it can aggravate hemorrhoids even more, which is why it’s important to cleanse yourself thoroughly after going to the bathroom. Do not, however, cleanse yourself too roughly or use soaps that contain harsh chemicals, alcohol or perfumes. Instead, use plain water to wipe yourself and then dry your bottom afterward. A sitz bath, which involves sitting in warm water for 10 minutes, twice daily, is helpful to patients with anal itching, aching or burning and is known as one of the best ways to get rid of hemorrhoids fast.

3. Take Helpful Supplements

Butcher’s Broom

Butcher’s broom can help reduce swelling and inflammation of hemorrhoids. A 2002 study conducted in Germany found that butcher’s broom was an effective means of treatment for patients suffering from chronic venous insufficiency, a condition where the flow of blood through the veins is inadequate, causing the blood to pool. (7)

Pycnogenol®

A 2010 study published in Phytotherapy Research investigated the efficacy of orally and topically applied Pycnogenol® hemorrhoid cream for the management of acute hemorrhoidal attacks in a controlled, randomized study with 84 subjects. Within less than 48 hours of an attack, patients were enrolled and their signs and symptoms were scored. The decrease in scores was significantly more pronounced in the Pycnogenol® group than in the control group given placebo. The study indicates that oral and topical Pycnogenol® helps to heal acute hemorrhoids. (8)

Horse Chestnut

Horse chestnut is commonly used as an herbal remedy for poor blood flow and swelling. According to research published in Alternative Medicine Review, horse chestnut has been shown to improve microcirculation, capillary flow and vascular tone, all of which are helpful for how to get rid of hemorrhoids. (9)

Witch Hazel

Witch hazel is a plant that’s used for its skin-healing, astringent and antioxidant properties. Topical application of witch hazel can help soothe hemorrhoids by reducing inflammation and pain.

Psyllium Husk

Psyllium husk is a natural source of pure fiber that’s sold in powder form. Studies suggest that plant fibers like psyllium husk can reduce the frequency of bleeding when using the bathroom and help avoid constipation or straining. When using psyllium husk, make sure to drink plenty of water.

A 2011 animal study published in Digestive Diseases and Sciences found that psyllium husk has a gut-stimulatory and laxative effect on mice, and at higher doses it has antisecretory (reducing the normal rate of secretion of a body fluid) and antidiarrheal activity. (10)

4. Try Beneficial Essential Oils

Cypress Oil

Cypress essential oil stops excess blood flow and promotes the clotting of blood. This is due to its hemostatic and astringent properties. Cypress oil helps with the contraction of blood vessels, and it tightens tissues. It’s also known to reduce anxiety, which can help to relieve constipation for some people. Use cypress topically by adding 3 to 4 drops to a cotton ball and applying to the area of concern. (11)

Helichrysum

Helichrysum essential oil helps stimulate the secretion of gastric juices that are needed to break down food and prevent digestive issues. It also serves as an anti-inflammatory agent when applied topically. To use helichrysum, rub two to three drops into the abdomen or area of inflammation. (12)

Hemorrhoids by the Numbers

  • Around 20 million people in the United States suffer from hemorrhoids (12.8 percent of U.S. adults).
  • In 2004, the National Institutes of Health noted that the diagnosis of hemorrhoids was associated with 3.2 million ambulatory care visits, 306,000 hospitalizations and 2 million prescriptions in the United States.
  • The peak incidence of hemorrhoids is between the ages of 45–65. Development of hemorrhoids before the age of 20 is unusual.
  • The risk of developing hemorrhoids is higher in white adults than in black adults, higher in women than in men and higher for women who are pregnant.

Precautions on How to Get Rid of Hemorrhoids

A common concern is that hemorrhoids increase the risk of colorectal cancer, but that’s not true. However, the two conditions do cause similar symptoms. This is why it’s important to mention your hemorrhoids to your health care provider. Even when a hemorrhoid is healed completely, a colonoscopy may be done to rule out other causes of rectal bleeding. According to the American Society of Colon and Rectal Surgeons (ASCRS), every person age 50 and older should undergo a colonoscopy to screen for colorectal cancer. (19)

Final Thoughts on How to Get Rid of Hemorrhoids

  • Hemorrhoids are a very common anorectal condition that affects millions of people around the world.
  • Enlarged hemorrhoids are often associated with symptoms such as itching, mucus discharge or bleeding. Bleeding happens when hard stool damages the thin walls of the blood vessels in hemorrhoids.
  • Avoidance of constipation is key when trying to get rid of hemorrhoids. It’s important that you don’t strain while using the bathroom, don’t sit for an excessive period of time and clean yourself thoroughly when finished.
  • Foods and herbal supplements that help relieve constipation can alleviate the symptoms of hemorrhoids. A high-fiber diet and drinking plenty of fluids are the most helpful dietary changes that you can make when it comes to how to get rid of hemorrhoids.
  • If non-medical treatments don’t work, there are relatively painless procedures that can be done to treat hemorrhoids. For extreme cases, an outpatient surgery called a hemorrhoidectomy may be required.

Hemorrhoid Treatments

Hemorrhoid Treatments

Overview

Hemorrhoids are swollen inflamed veins that can develop inside or outside the anus or rectum. These veins can get swollen when we strain to pass hard stools, so constipation often plays a role in developing hemorrhoids. Long periods of sitting or standing, or being overweight or pregnant can also cause hemorrhoids.

Hemorrhoids are common, and they affect men and women equally. Hemorrhoids can occur at any age but usually begin to be troublesome in people between the ages of 45 and 65. Once hemorrhoid symptoms develop, they often will recur. It is important to practice good lifelong preventative care to keep symptoms from recurring.

Mild to moderate hemorrhoids can usually be treated with home care. In severe cases, you may need to undergo a non-surgical procedure to cut off blood supply to shrink the hemorrhoid. If you need surgery to remove the hemorrhoid, we will perform a procedure called a hemorrhoidectomy.

Internal hemorrhoids develop inside the anal canal. External hemorrhoids develop near the anal opening. Both types can occur at the same time.

Screening and Diagnosis

To better understand your symptoms, we will ask you several questions about your medical history and perform an examination that might include:

  • Examining the outside of the anus.
  • Doing an exam of the rectum with a gloved finger to see if we feel a lump.
  • Placing a small plastic tube in the anus to look for hemorrhoids or other problems.

If you have rectal bleeding, we may recommend that you have a sigmoidoscopy or colonoscopy. Screening for colorectal cancer is recommended for everyone 50 and older, whether you have hemorrhoids or not. Check with your primary care physician about what screening test is best for you.

Symptoms

Hemorrhoid symptoms are usually minor, but they can become more severe if a blood clot forms inside the vein. Symptoms include the following:

  • Irritation or itching around the anus.
  • Bright red streaks of blood on stools or from the anus.
  • Mucus leaking from the anus.
  • Discomfort during bowel movements.
  • Tender lumps near the anus.
  • Pain from a clot in the hemorrhoid.

While itching around the anus may be a symptom of hemorrhoids, it is often caused by other conditions. If
the anus is not kept clean, itching may result.

Sometimes a hemorrhoid will actually protrude from the anus and can often be gently pushed back into place with your finger. While hemorrhoids can cause discomfort, they do not usually cause severe pain unless a blood clot forms in the vein, which is described as “thrombosed.” If this happens, you will feel a hard round lump the size of a grape or smaller. A thrombosed hemorrhoid is not dangerous but it can be extremely painful.

The pain from a thrombosed hemorrhoid is usually at its worst in the first 48 hours and will decrease by the fourth day. We may remove the hemorrhoid with minor surgery using local anesthetic. Removal is not required, however, since pain associated with thrombosed hemorrhoids usually gets better in 7 to 10 days.

If you have a lot of pain or pain that lasts more than a week you are likely to have an anal fissure. This is a tear in the anal skin that can be very slow to heal. Very careful long-term attention to good bowel hygiene usually allows it to heal. A prescription ointment such as nifedipine can be very helpful in allowing the fissure to heal.

A vague swollen, tender lump with fever could be an abscess or infection. Please call your primary care doctor immediately if you have these symptoms.

Home Care

You can usually manage mild to moderate hemorrhoids with home care. Often, patients develop hemorrhoids after straining during constipation or during frequent bowel movements with diarrhea. To treat hemorrhoids at home, try the following:

  • Drink plenty of water and take extra fiber. This is most important to keep your stools softer and more regular and help prevent straining and hard stools that lead to hemorrhoids.
  • Use premoistened tissues like baby wipes, Tucks, or damp toilet paper.
  • Wear cotton underwear and loose clothing.
  • Apply cold compresses or an ice pack to the anus as needed to help relieve itching.
  • Take Sitz baths (warm baths with just enough water to cover the anal area). Dry carefully afterwards. If the tissues remain wet, itching can increase.
  • Use over-the-counter hemorrhoid creams or suppositories.
  • Use zinc oxide, petroleum jelly, or over-the-counter hydrocortisone cream. These products may help with itching and irritation.
  • We may prescribe hydrocortisone cream or suppositories to decrease the irritation.

Most hemorrhoids respond to home treatments. If home treatment does not work or you have severe pain, a referral to a general surgeon is the next step.

Methods of Treatment

When home methods are not enough to cure hemorrhoids, there are treatment options that work by cutting off the blood supply to the hemorrhoid. This will make the hemorrhoid shrink or go away. These treatments are done on an outpatient basis and require little or no anesthesia. They include:

  • Rubber band ligation. One of the most successful nonsurgical procedures, most often used for small and medium hemorrhoids, involves tying off hemorrhoids with a rubber band deep inside the rectum.
  • Bipolar, infrared, and laser coagulation, which involves using heat, a laser, or an electrical current to create scar tissue around the hemorrhoids.
  • Sclerotherapy, a shot in the hemorrhoid that reduces swelling.
  • Cryosurgery, which involves freezing the hemorrhoid.

In some cases, you may need surgery for hemorrhoids (hemorrhoidectomy). Reasons for surgery include:

  • Nonsurgical treatment has failed.
  • Large internal hemorrhoids that remain bulging outside the anus.
  • External hemorrhoids that are still causing problems after home treatment.
  • A channel develops between the internal anus and the skin (anal fistula).

Surgery may be a good choice for large, internal hemorrhoids that remain bulging outside the anus. It is the only choice for external hemorrhoids that are causing symptoms and haven’t improved with home treatment.

Hemorrhoid surgery is usually done in the operating room with heavy sedation, spinal, or general anesthetic. Occasionally, it can be done in your doctor’s office.

After Your Surgery

Please follow these instructions after your anal surgery:

1. If you have been given a prescription for pain medication, take this as soon as you get home. Go to bed and rest until you take your first hot bath. You may also take Ibuprofen or other non-steroidal anti-inflammatory pain medications.

2. Remove dressing the day after surgery, or with your first bowel movement. Then sit in a tub of warm water (Sitz bath) for 15 minutes. Repeat Sitz baths after every bowel movement, and at least twice a day until the wound is closed, of if you are still sore. You can also take a warm shower if it is difficult for you to sit in a bathtub.

3. You can expect some drainage for several days. Use a dressing as needed to keep your clothing clean and the area dry. Sanitary napkins make excellent bandages in this area.

4. Keep your bowel movements soft and regular. Every day take a tablespoon of Metamucil or other bulk forming fiber preparation in a large glass of fruit juice or water. Follow this with another large glass of water.

5. You should feel better each day following surgery. If you experience problems, such as fever or increasing pain, contact your surgeon’s office, or the after-hours general advice line.

Risks

For most people, nonsurgical treatments are successful with very few risks. However, possible problems you may experience may include:

  • Pain or discomfort. Pain is usually minimal, and most people go back to work the next day. For some people, the pain may be so bad that they will not be able to do their normal activities for a day or so.
  • Bleeding, which may require another doctor visit to treat.
  • Temporary trouble urinating because of pain. If you are completely unable to urinate, call us immediately.
  • Infection or abscess.

Surgery is much more uncomfortable and has more risks than nonsurgical treatments. These risks include:

  • Pain, which may last for weeks. Passing bowel movements, even if they are soft, can be quite painful.
  • Bleeding, which may last for a few days. If the bleeding is severe, you may need treatment.
  • Being unable to urinate or pass stools. This may cause stools to become stuck in the anal canal (fecal impaction).
  • Leaking stool or gas, which can be permanent.
  • Infection.

In rare cases, a more serious problem may develop. Contact your surgeon immediately or come to the emergency room if you experience any of the following symptoms:

  • High fever
  • Very severe pain
  • Inability to urinate after hemorrhoid treatment

Lifestyle Management

Surgery usually cures a hemorrhoid. But the long-term success of hemorrhoid surgery depends a lot on how well you are able to change your daily bowel habits to avoid constipation and straining. There are steps you can take to help prevent hemorrhoids from recurring:

  • Try to keep your stools soft. Be sure to include plenty of water, fresh fruits, vegetables, and whole grains in your diet. Add two tablespoons of bran or a commercial fiber product such as Citrucel or Metamucil to your diet each day.
  • Avoid using laxatives because they may cause diarrhea, which can irritate hemorrhoids.
  • Exercise every day to promote regular bowel movements.
  • Avoid sitting or standing too much. This increases pressure in the hemorrhoids. Take frequent walking breaks.
  • Go to the bathroom as soon as you have the urge. Try not to strain during bowel movements. Remember to take your time and never hold your breath.
  • If you are pregnant, try sleeping on your side to relieve the pressure on your pelvic area.
  • Keep your anal area clean. Be gentle when cleaning yourself. Try not to scratch the area.
  • Avoid chemical creams, ointments, and scented paper products, as anal tissues are delicate and easily irritated. Soaps and laundry detergents can also cause irritation.
  • Avoid spicy or gas producing food.

Our banding procedure works by cutting off the blood supply to the hemorrhoid. This causes the hemorrhoid to shrink and fall off, typically within a day or so. You probably won’t even notice when this happens or be able to spot the rubber band in the toilet. Once the hemorrhoid is gone, the wound usually heals in a week or two.

During the first 24 hours, some patients may experience a feeling of fullness or a dull ache in the rectum. This can typically be relieved with an over-the-counter pain medication. A remarkable 99.8% of patients treated with our method have no post-procedure pain, however.

In fact, thanks to design improvements, our procedure has a ten-fold reduction in complications compared to traditional banding.

For one, our instruments are smaller, affording greater comfort for patients and better visibility for physicians. Unlike other devices, they are also single use and 100% disposable.

In most cases, banding can take place during your first appointment. After all, once you know what the problem is, why wait to get relief?

WHAT TO EXPECT

The first appointment will consist of, at a minimum, a consultation with a physician. During diagnosis, we may perform a digital exam as well as an anoscopy, a visual examination of the lower bowel using a small lighted tube.

If the diagnosis is hemorrhoids, treatment can in some cases start immediately. In the event of multiple hemorrhoids, often the largest, most symptomatic hemorrhoid is banded first. Additional appointments are then scheduled to treat the remaining hemorrhoids at two week intervals with a final check-up three weeks later. In some cases, you might be recommended to have a colonoscopy or sigmoidoscopy test prior to, or after, the banding procedure. If you’ve already had a colonoscopy done recently, please bring the full report of the procedure with you if have not had it done at our practice.

Sometimes patients have both an anal fissure and hemorrhoids. If this applies to you, our protocol is to treat the anal fissure first. Then, once that problem is resolved, we can proceed with the hemorrhoid removal procedure. Treating these conditions one at a time is important for determining which symptoms relate to which problems.

After Care

Following hemorrhoid banding, we recommend that you avoid lifting or strenuous activity for the remainder of the day and resume full activity the next day. You can have normal bowel movements during this time, but you may want to soak in a bath or use a bidet for a gentler cleansing of the anal opening.
Soon you’ll be feeling much better, but you’ll need to make some changes to prevent future problems. Straining due to constipation should be diligently avoided, so be sure to drink seven or eight glasses of water (around 50 ounces) a day and get at least 20 grams of natural fiber in your diet. We can give you more information and handouts about high-fiber foods in our office. You can also add two tablespoons of natural oat or wheat bran to your diet. (Metamucil, Benefibre, flax or other soluble fiber may be helpful as well.)

We also recommend that you not sit longer than two minutes on the toilet. If you can’t have a bowel movement in that time, come back later. This two-minute rule can help keep you from straining during bowel movements without realizing it. Finally, when traveling by air, stay hydrated, avoid alcohol, eat fiber and walk around when you can.

TREATMENT COMPARISON

The CRH O’Regan System is appropriate for an estimated 90% of hemorrhoid patients. Only the most severe cases require surgery (hemorrhoidectomy), which is just one more reason not to delay treatment. If you wait too long – and your hemorrhoids grow too large – your non-surgical options decrease.

The chief complaint about conventional rubber banding – which demonstrates superior long-term results over other non-surgical methods – has been pain in 4-29% of cases. In contrast, only 0.2% of patients treated with our advanced technique experience post-procedure pain. Our method is also faster, more accurate and has virtually no downtime.

Over the years, a number of new treatments have been devised for hemorrhoids, but none has outperformed the CRH O’Regan System. Among them are infrared photocoagulation, or the use of lasers to burn the hemorrhoid tissue, and stapled hemorroidectomy, a surgical variation that uses a circular stapler device to life and remove the hemorrhoid.

Procedure Average Procedure Time Average Time Off Work Pain Medication Required Pre/Post
CRH O’Regan System 30 seconds – 1 minute 0-1 Day No
Conventional Rubber Banding 5 – 10 minutes 0-3 days Often Prescribed
Infrared Coagulation (IRC) 30 seconds – 3 minutes O – 1 day Yes
Stapled Hemorrhoidectomy 15 – 90 minutes 1 – 10 days Yes
Conventional Hemorrhoidectomy 45 – 90 minutes 10 – 14 days Yes

FREQUENTLY ASKED QUESTIONS

What are hemorrhoids?
Hemorrhoids are swollen veins located in the lower rectum or anus. There are two types of hemorrhoids: internal and external. Depending on the location, symptoms may include pain, inflammation, itching, and a feeling of fullness following a bowel movement. Additionally, there may be bright red blood covering the stool, on the toilet tissue or in the toilet bowl.
What causes hemorrhoids?
Hemorrhoids result from an increase in pressure in the veins of the rectum. This may be caused by constipation, pregnancy, childbirth, obesity, heavy lifting, long periods of sitting, or diarrhea. In Western countries, constipation is associated with diets low in fiber and high in fat.
Who gets hemorrhoids?
Hemorrhoids affect both men and women. The incidence of hemorrhoids increases after age 30, and by age 50, about half of the population will have experienced the condition.
How does the procedure work?
A small disposable syringe-like device is used to attach a tiny rubber band around the internal hemorrhoid – with the blood supply cut off, the hemorrhoid falls off.
Can you treat external hemorrhoids?
Yes. Most hemorrhoidal symptoms are from dilated internal hemorrhoids and or anal fissures. The banding of internal hemorrhoids usually shrinks the external hemorrhoids as well and is highly effective in relieving the symptoms of pain and bleeding. After banding is completed there may be an external component or skin tag that persists, but usually they do not cause much in the way of symptoms. An acute thrombosis of an external hemorrhoid can be very painful. This usually resolves with frequent warms baths, stool softeners, adding fiber to the diet, and avoidance of straining. The banding procedure would be done a few weeks after this resolves.
How many bands are necessary?
There are three sites where hemorrhoids form frequently, and it is not uncommon for all three sites to require treatment. We generally only band one hemorrhoid site at a time in separate visits, as multiple bandings have been found to increase complications. Also, some extreme large hemorrhoids may require additional banding sessions. Thus, as many as six bands total may be used in severe cases, but one to three is standard.
Is it effective?
Yes it is 99.1% effective, and the best thing is that it is non-surgical, so there is no pain, medication or recovery time needed. Most of our patients go back to work the same or next day.
How long will this take?
The procedure takes about 60 seconds, but the entire visit is about 15-30 minutes.
Is the procedure covered by Insurance?
The procedure is covered by most insurance plans, including Medicare. As insurance coverage varies, however, we would need to verify your particular insurance.
Will it hurt?
No. Thanks to our improved instrument and technique, band placement is painless. You may experience a feeling of fullness or dull ache in the rectum for the first 24 hours, but this can generally be relieved by over-the-counter pain medication. A recent study of our banding technique shows that 99.8% of patients experience no post-procedure pain.
Will I have to miss work or other activities?
Your first appointment in our office will probably be the longest, as it involves a consultation, medical history and diagnosis. We suggest you allot up to an hour. Subsequent treatment sessions will be shorter, around 15-30 minutes total. After a hemorrhoid banding procedure, we recommend that you rest the remainder of the day at home and resume full activity the next day. However, many patients with office jobs find they can return to work immediately following their appointment.
Will I need to do any preparation at home prior to the procedure?
No prep is needed prior to the procedure.
Will I need a driver or can I drive home myself?
You will not need a driver, in fact most patients return to normal activity immediately following the procedure. One always does need a ride, however, if a banding is done in conjunction with a sedated colonoscopy test.
Will the hemorrhoids come back after the treatment?
With proper dietary changes the hemorrhoids should not return.

For more information please visit www.crhsystem.com

How to Get Rid of Hemorrhoids

How can I treat hemorrhoids at home?

While a case of the piles can disappear as quickly and randomly as it popped up, there are a few home remedies you can try to prevent future occurrences or help move things along if you’re currently dealing with a flare-up.

For starters, put away your phone. If you’re among the 75% of Americans who admit to using their phones while on the toilet, heed this warning: Your habit of scrolling through your social media feed while on the can may prolong your pushing and straining when you go number two. It’s better to do your business and then be on your way.

Another preventive measure is to up your water intake (a good idea anyway) and increase your fiber to keep your plumbing working properly. If you’re really constipated, you can consider an over-the-counter laxative or stool softener as well.

For uncomfortable hemorrhoids, Schmaing suggests pain-relieving creams, witch hazel, warm sitz baths or moist towelettes to help soothe the affected area.

“If these treatments are ineffective, a healthcare provider may be able to prescribe other creams or medications,” she adds.

When should I worry about hemorrhoids?

Let’s say you’ve waited it out and tried home remedies to no avail. If your hemorrhoids are still bothering you after several days, it may be time to seek out a medical professional.

Your doctor will check to make sure you’re actually experiencing hemorrhoids and not something else like a digestive disorder, inflammation of the colon, intestinal bleeding or colon cancer.

If it’s really just pesky piles that refuse to go away, you can ask about minimally invasive options to help them resolve more quickly. The most common of these procedures is a rubber band ligation, where a rubber band is placed around an internal hemorrhoid to cut off its circulation, but other choices range from an injection to use of an infrared light.

With the right amount of care, hopefully you’ll be back to your regularly scheduled programming in no time.

Are you considering home remedies for your hemorrhoids? If you want a natural remedy to help shrink them down, here’s what you need to know.

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“First, realize that hemorrhoids normally do not hurt, but may bleed painlessly, says colorectal surgeon Massarat Zutshi, MD.

She says that if they do hurt, the hemorrhoids may have moved to the outside of the anal canal (or prolapsed) during a bowel movement and become enlarged. If, in addition, hemorrhoids develop a blood clot, (or become thrombosed), they can become especially painful.

There are many ways people may try to shrink down painful hemorrhoids, which might be helpful at best or harmful at worst.

But before you try home treatments, proper diagnosis is critical. “It’s important to see your doctor for bleeding, especially if you have never had hemorrhoids before,” Dr., Zutshi says.

Here are seven possible home treatments for hemorrhoids. Dr. Zutshi comments about each:

1. Sitz baths

Generally, experts recommend people with painful hemorrhoids sit in warm water for 15 minutes, several times a day — especially after a bowel movement.

Doctor’s advice: Yes, this is one of the best treatments. A sitz bath is generally available at a local pharmacy; this small bowl fits right over your toilet and offers a convenient way to soak and soothe the area.

2. Witch hazel

Witch hazel is reputed to reduce pain, itching and bleeding until hemorrhoids fade out. There isn’t much scientific support for its use but it does contain tannins and oils that may help bring down inflammation and slow bleeding. Supporters say it tightens the skin as a natural anti-inflammatory.

Doctor’s advice: It’s OK to use directly on the hemorrhoids.

3. Apple cider vinegar

Some people say that apple cider vinegar can bring instant relief to hemorrhoids, reducing itching and pain.

Doctor’s advice: Don’t use this remedy as it may burn the skin with overuse and exacerbate problems.

4. Psyllium husk

Psyllium husk is a supplement that helps increase your fiber intake, and softens stools to make them easier to pass. Be careful not to increase fiber too much, too quickly, as it may also cause gas or stomach cramping.

Doctor’s advice: Use this to soften stool and make bowel movements more regular. It won’t affect hemorrhoids at a local level, but it does regulate your bowels. Be sure to drink plenty of water if you take this supplement.

5. Aloe vera

The anti-inflammatory properties of aloe vera may help soothe inflammation of hemorrhoids. Although research isn’t available for its use for hemorrhoids specifically, it has shown some benefit for other inflammatory skin conditions.

Doctor’s advice: This is safe to try if it’s pure aloe (and not in a cream with other ingredients).

6. Tea tree oil

Some people say the antiseptic and anti-inflammatory properties of tea tree oil may reduce swelling and itching caused by hemorrhoids. Some early research found that a gel made with tea tree oil decreased symptoms, but studies are lacking.

Doctor’s advice: Don’t try this remedy as it isn’t well studied.

7. Epsom salt and glycerin

This less-known home treatment can help painful hemorrhoids. Use these simple ingredients to make a compound that you apply directly to the inflamed area:

  1. Mix 2 tablespoons of Epsom salt with 2 tablespoons of glycerin.
  2. Apply the mixture to a gauze pad and place it on the painful area.
  3. Leave this application on the area for 15 to 20 minutes.
  4. Repeat every four to six hours until the pain eases.

Doctor’s advice: Yes, I recommend this treatment.

Remember, to help treat and prevent hemorrhoids it’s important to eat enough fiber (25 grams a day for women, 38 grams a day for men) and to drink at least eight glasses of water a day. These dietary changes can make stool easier to pass and keep the problem from recurring.

Premier Surgical Associates

How To Get Rid Of Internal Hemorrhoids

Friday, April 15th, 2016 | Written by Premier Hemorrhoid Treatment Center Staff

Riddle: What’s one thing that most people don’t want to talk about but many people have experienced, and is sometimes the butt of a joke? Hemorrhoids! The humorist writer Dave Barry says that a person knows he’s “middle aged” when hemorrhoid jokes stop being funny.

But all kidding aside, hemorrhoids aren’t such a laughing matter when you actually have them. Hemorrhoids are extremely common and are caused by a number of factors such as genetics, pregnancy, or sitting for long periods of time just to name a few.

According to Dr. C. Stone Mitchell, Medical Director of the Premier Hemorrhoid Treatment Center, hemorrhoids are swollen veins in your anus and rectum. “It’s a venous pressure issue. We live on earth and there’s gravity, which increases venous pressure,” says Dr. Mitchell. “We can’t change that.”

An internal hemorrhoid is located inside the rectum, but may protrude out of the anus with increased pressure or straining, often during bowel movements. An external hemorrhoid appears as a bump or bulge under the skin around your anus. Depending on the location of the hemorrhoid, symptoms may include pain, throbbing, itching, or bleeding. If the hemorrhoid is external or a protruding internal, creams and salves might result in temporary relief of swelling or throbbing. However, they don’t solve the root cause, which is internal hemorrhoids. Thankfully, there’s a painless, non-surgical option for removing them.

The Premier Hemorrhoid Treatment Center offers a non-surgical hemorrhoid removal procedure. The in-office treatment, called Infared Coagulations (IRC), uses an infrared laser that generates short bursts of warm light, causing the hemorrhoid to shrink and recede. The procedure can typically be done in a minute, and is effective in eliminating hemorrhoids 95% of the time. While two to four separate treatments may be required, the procedure requires no anesthesia and no down time.

Dr. Mitchell says, “People think they need a referral from another doctor to come to us, but they don’t. The procedure doesn’t require any pre-testing, and it’s pretty obvious for most patients that they have a hemorrhoid. Most people also don’t realize that the procedure is typically covered by insurance.”

Dr. Mitchell and his team see about 100-120 patients per month, and he says many come in afraid because they’ve heard horror stories about older ways of surgically removing hemorrhoids. “But we’re good at putting people at ease, and they usually leave with big smiles saying they wished they’d done this sooner,” he says.

If it’s time for you to stop living with discomfort from hemorrhoids, call Premier Hemorrhoid Treatment Center in Knoxville, the only dedicated non-surgical hemorrhoid treatment center in East Tennessee, today at (865) 588-9952 or request an appointment online.

Tags: hemorrhoid remedies, Hemorrhoid Treatment, Infrared Coagulation, nonsurgical treatment of hemorrhoids, treating the source of hemorrhoids

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Hemorrhoids represent vascular structures or piles found in the region of the anal canal. The main purpose of hemorrhoids is to provide a form of cushion appropriate for stool control and bowel movement. However, inflamed or swollen hemorrhoids represent a disease that can either occur in the rectum or close to the outer region of the anus or the surrounding skin. Hemorrhoids that occur in the rectum are internal hemorrhoids while those found close to the anus are external hemorrhoids.

Even though the exact cause of hemorrhoids is unknown, factors like diarrhea and constipation promote to the existence of the disorder. The condition also occurs more common among pregnant women. However, the disorder has no serious threats as concepts like lifestyle change and home treatments prove appropriate in dealing with the disorder. We have a complete guide on How to Get Rid of Hemorrhoids Fast? Causes, Symptoms & Treatments.

The Causes of Hemorrhoids.

The specific cause of the occurrence of hemorrhoids is unknown. Nonetheless, there are various factors related to increased chances of the occurrence of the condition in a patient. First, the experience of irregular and uncontrolled bowel habits like diarrhea or constipation promote the existence of the disease. Also, the lack of proper exercise and workout schedules combined with poor eating habits also contributes to the occurrence of hemorrhoids. You can also read Diverticular Disease – Symptoms, Causes and Treatments.

Excessive inter-abdominal pressure like the one experienced in prolonged straining also contribute to realized hemorrhoids. Pregnancy, for instance, includes a lot of inter-abdominal pressure that explains the high rate of hemorrhoids among pregnant women. Prolonged sitting and obesity also promote existence of hemorrhoids. Other causes of hemorrhoids include aging, genetics, and the lack of valves located in the hemorrhoid veins.

The Signs and Symptoms of Hemorrhoids.

Hemorrhoids categorize either as internal or external among patients. However, many people suffering from the disorder have a combination of the two. At least 40% of recorded patients with the disorder, on the other hand, recorded to experiencing little if any significant symptoms.

External Hemorrhoids

External hemorrhoids occur around the skin in the anal region. Some of the symptoms associated with external hemorrhoids include:

  • Discomfort and pain around the anus.
  • Bleeding.
  • Swelling.
  • Irritation and swell build up around the anal region.
Internal Hemorrhoids

The internal hemorrhoids occur in the inner part of the rectum. Even though not visible, a person can detect the presence of the hemorrhoids if:

  • The patient experiences bleeding through bowel movements where the stool remains covered with blood. The patient, however, experiences no pain.
  • In different occasions the hemorrhoid surface from the rectum to the external anal opening. The process promotes irritation and pain.

Thromboses hemorrhoids

In different cases, blood may ooze out of the external hemorrhoid to form a clot. Some symptoms of the disorder include:

  • Inflammation.
  • Severe pain.
  • Lump formation around the anal region.
  • Swelling.

The Treatment of Hemorrhoids

Proper treatment and management of hemorrhoids can take on different approaches. The conservative method, for instance, promotes self treatment approaches like the observation of a proper diet while procedural treatment involves the use of chemotherapy or rubber-band litigation.

Conservative Management Treatment

Conservative management treatment involves self-treatment approaches patients could implement in the comfort of their homes to reduce the occurrence of hemorrhoids. The incorporation of a diet rich in fiber, for instance, promotes easier digestion compared to a low fiber diet. Fiber supplements are also essential to treating and preventing the occurrence of hemorrhoids as the fiber content of a diet helps to improve the digestive system. With proper digestion, the body, in turn, reduces the strain placed on the hemorrhoids during bowel movement.

Proper consumption of oral fluids also helps to prevent the occurrence of hemorrhoids. Oral fluids help to keep the body hydrated. The hydration is also important for the digestion process, which, in turn, promotes smooth bowel movements that do not involve excess strain. Rest and the intake of anti-inflammatory drugs also helps to reduce the occurrence of the disorder. The treatment of hemorrhoids also requires the patient to spend less time in the toilet to prevent strain in any situation.

Patients also need to pass stool immediately they get the urge. Holding stool for long periods could promote to its dryness. Dry stool, in turn, is hard to pass out and may contribute to the occurrence of hemorrhoids. It is also vital to avoid long sitting periods, especially in the toilet. Excess sitting in the toilet puts a lot of pressure on the anal veins that could promote the existence of hemorrhoids. Therefore, it is important to spend as little time as possible in the toilet.

Active participation in physical exercises and routines is also recommended for dealing with the disorder. Long periods without physical exercise contribute to increased pressure on veins. Increased pressure contributes to a lot of straining. Actively participating in various forms of physical exercise, however, not only prevents constipation but also reduces the pressure placed on veins.

Physical exercises, on the other hand, also helps to reduce body weight that promotes proper digestion. Proper digestion is important in preventing diarrhea or constipation that inevitably reduce hemorrhoids.

Procedural Management Treatment

Hemorrhoids can also get cured through the use of various office-based approaches. The rubber band litigation, for instance, is the procedure of using elastic bands on hemorrhoids. The placement of the rubber band high enough from the pectinate line prevents any intense pain through the process. The band, in turn, prevents blood flow to the hemorrhoid. The hemorrhoid then falls off in at least five days of application through withering. The cure rate realized through the procedure is high despite few cases of complication.

Surgery for hemorrhoids is effective only when other forms of treatment completely fail in dealing with the disorder. Some of the surgical processes involved include excision hemorrhiodectomy only applicable in severe cases. Other approaches like doppier-guided and stapled hemorrhoidectomy involve minor operations that deal with the intermediate and mild cases of the disease.

Hemorrhoid disorder is a disease affecting the anal region. The disorder is common among many people. Even though its main cause remains unknown, some causes include pregnancy, obesity, consumption of low-fiber diets, and constipation or diarrhea. The disorder is manageable through the incorporation of a high fiber diet and proper exercise. In more serious cases of the disorder, the use of the rubber-band ligation or surgery can prove effective in dealing with hemorrhoids.

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