What are Hemorrhoids?
Hemorrhoids are swollen veins in your lower rectum and anus, much like varicose veins. Hemorrhoids may be internal—located inside the rectum or external—where they develop under the skin around the anus. Hemorrhoids are more likely to occur with aging because the tissues that support the veins in your rectum and anus can weaken and stretch. There are many ways to treat hemorrhoids, from topical to surgical.
What Causes Hemorrhoids?
Hemorrhoids can develop for several reasons, including:
- Excessive straining during bowel movements
- A lower fiber diet
- Increased pressure as a result of pregnancy
- Sitting for long periods of time on the toilet
- Chronic diarrhea or constipation
- Regularly lifting heavy objects
Once a hemorrhoid is enlarged, it won’t function correctly and can result in mild to more severe symptoms, including bleeding, pain, leakage and odor.
Treating your hemorrhoid(s) at home
When hemorrhoids first appear, there are several options for treating them at home:
- Apply topical cream or suppositories, available over-the-counter.
- Ensure your cream contains hydrocortisone, which can soothe pain and itch with minimal side effects.
- Don’t use hydrocortisone cream for over a week unless your doctor approves it.
- Soak the anal area in plain water from 10 to 15 minutes two to three times daily or use a sitz bath that fits over the toilet.
- Soap is not necessary and can, in fact, aggravate the area.
- Do not use scented or alcohol-based wipes.
- Use moist towelettes or wet toilet paper after a bowel movement.
- Make sure they do not contain perfume or alcohol.
- Apply a cold pack on the trouble spot several times a day to help dull pain and bring down swelling temporarily.
- Take over-the-counter pain relievers like Tylenol, aspirin or ibuprofen.
With these treatments, hemorrhoid symptoms often go away within a week. If they don’t or you have severe pain or bleeding that occurs, call your doctor immediately. Once a hemorrhoid reaches a certain size, prescription medication, a procedure or surgery may be necessary.
Rubber Band Ligation of Hemorrhoids
One common office procedure that is used for persistent bleeding or pain with hemorrhoids is rubber band ligation. With this procedure, a rubber band is inserted around the base of the hemorrhoid, cutting off the blood supply so that it shrivels and dies. This treatment does not usually call for anesthesia and typically takes one to two days to recover from.
Surgical Procedures for Hemorrhoids
If the rubber band ligation or other treatments were not successful, your doctor may recommend a surgical procedure to remove hemorrhoids called a hemorrhoidectomy.
In this procedure, the surgeon removes hemorrhoidal tissue, internal and external, that causes bleeding or is more severe—such as an internal hemorrhoid that has prolapsed.
Hemorrhoidectomy is the most effective and complete way to treat severe or recurring hemorrhoids. Most people experience some pain after the procedure but medications or soaking in a warm bath can help to alleviate it. Recovery from a hemorrhoidectomy takes approximately two weeks but it can take as long as six weeks to feel normal again.
How to find a doctor for hemorrhoid surgery and treatment
To seek treatment for hemorrhoids, please visit your primary care doctor or an urgent care location for temporary relief and a referral to a specialist, such as a proctologist. Some proctologists, like Dr. Paul Broderick, will see new patients without a referral.
There are other doctors who perform hemorrhoid surgery, including colorectal surgeons and some general surgeons.