Hemorrhoids
Hemorrhoids are “cushions” in the anal canal made up of smooth muscle, blood supply, and tissue that facilitate the control of bowel movements. We are all born with hemorrhoids. We become more aware of hemorrhoids when the anal cushions slide downward and become enlarged due to gravity, straining, irregular bowel habits, or pregnancy resulting in hemorrhoid symptoms. Many people suffer in silence before seeking medical care due to embarrassment or fear of the procedure. Today’s treatments for hemorrhoids make some types of hemorrhoid removal much less painful.
External verses Internal Hemorrhoids
External hemorrhoids developed near the outside of the anus and are covered by highly sensitive skin. Enlargement of external hemorrhoids causes annoying symptoms of itching and burning. External hemorrhoids are usually painless, however if a blood clot develops in the external hemorrhoid (thrombosed hemorrhoid), patients can experience significant pain.
Internal hemorrhoids develop inside the anal tissue. Symptoms of internal hemorrhoids
include mild discomfort, mucus production, and bleeding with bowel movements which can be small or heavy in amount. Internal hemorrhoids can prolapse outside the anal canal with bowel movements and often can be pushed back inside. If an internal hemorrhoid is completely prolapsed and cannot be pushed back inside the anus, they can become quite painful.
Hemorrhoid Treatment
Mild symptoms of hemorrhoids can be relieved by simple measures at home such as increasing fiber, bran, and water in your diet. Topical application of over-the-counter hemorrhoid creams can help improve itching and burning. Additionally, soaking in warm baths (sitz baths) can also provide relief of hemorrhoid symptoms.
Persistent hemorrhoids that fail to improve with home remedies may benefit from Rubber Band Ligation. Rubber Band Ligation (RBL) is only performed on internal hemorrhoids and is done as an office procedure. It is important to note that RBL is a painless procedure; patients may report mild pressure within the rectum or perhaps a dull ache. With RBL a small rubber band is placed over the hemorrhoid, cutting off its blood supply. The hemorrhoid tissue will fall off in a couple of days with a bowel movement.
Hemorrhoids that fail to improve with RBL or are too numerous or large may require a Formal Hemorrhoidectomy in the operating room. A hemorrhoidectomy is surgery to remove the hemorrhoids and is the most complete method for removal of internal and external hemorrhoids. Hemorrhoidectomies are performed under anesthesia as an outpatient procedure. The postoperative recovery after hemorrhoidectomy is typically 2-4 weeks.