Hemorrhoids – A General Overview

Medically reviewed by: Gary H. Hoffman, MD

Hemorrhoids are the bane of human existence. Since the earliest known medical writings, hemorrhoids have played a prominent role in medical diagnoses and treatment.  Hemorrhoids have spawned an entire over the counter industry devoted to the treatment and care of this sometimes painful condition.

Hemorrhoids line the anal canal and facilitate the passage of stool through the anal canal.  They act as cushions, or “bumpers”.  But when they become inflamed, they produce a variety of disabling symptoms.

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Hemorrhoids are nothing more than a collection of arteries, veins, nerves and connective tissue, all held together in a small hemorrhoidal bundle.  They are a normal part of our anatomy.  They are also the specialty of the colon and rectal surgeon, also known as a proctologist.  When the hemorrhoids enlarge and become swollen, medical treatment is needed.  However, when medications fail, a hemorrhoidectomy may be required.

 Hemorrhoid Causes

  • Hereditary.
  • Childbirth.
  • Aging.
  • Hard Stools or straining at stool.
  • Prolonged heavy lifting.
  • Genetics.
  • Sitting for prolonged periods of time.
  • Obesity.
  • Low fiber diet.
  • Chronic diarrhea.

Hemorrhoids are often asymptomatic.  Most adults have them and most adults coexist peacefully with their hemorrhoids.  For reasons unknown however, the hemorrhoids may act up, causing a plethora of symptoms.

Hemorrhoid Symptoms

Both internal (inside) and external (outside) hemorrhoids may cause symptoms.  Some of these symptoms are:

  • Bleeding.
  • Pain.
  • Protrusion, also known as prolapse.
  • Itching.
  • A discharge.
  • A lump (painful or painless).

Medical measures

Initially, medical measures may handle your symptoms.  Commonly, stool softeners are started, topical creams and ointments (prescription and over the counter) are used and may provide some relief.  A warm water bath will be helpful.  Bedrest may also be used.  Your proctologist may recommend other treatments such as hemorrhoidal injections (sclerotherapy) to shrink your hemorrhoids, rubber band ligation to “choke” the hemorrhoids or infra red coagulation (IRC) to burn the hemorrhoids.  Each of these is more or less effective.

Hemorrhoidal Sclerotherapy

With injections, known as hemorrhoidal sclerotherapy, a dilute solution of phenol (in olive oil) is injected next to the hemorrhoid.  A minor inflammatory reaction ensues, and this heals with minor scaring.  The scaring helps to shrink the hemorrhoid.  Several injections may be necessary to resolve the problem,  This treatment may be permanent or temporary.  Hemorrhoidal sclerotherapy should be performed by a specialist.

Rubber Band Ligation

Conceptually, rubber band ligation is nothing more than placing a small rubber band around the hemorrhoid.  The band tightens, thus depriving the hemorrhoid of its blood supply.  No blood supply…no hemorrhoid.  The office treatment is relatively painless and more than one treatment may be needed.  The bands may fail by falling off too early or by failing to be tight enough around the hemorrhoid.  Banding should be performed by a specialist.

Infrared Coagulation (IRC)

Performed by a specialist, infrared coagulation applies heat to the hemorrhoidal tissue, coagulating and shrinking the hemorrhoid.  IRC is less commonly performed because of its mixed results and its ability to produce pain or chronic problems if performed incorrectly.

When all else fails, your physician may recommend a hemorrhoidectomy.

Los Angeles Colon And Rectal Surgical Associates

It is important that you see a specialist to be sure that your symptoms are hemorrhoidal in nature and not something more serious.  Do not take you symptoms for granted.  Do not assume that you have nothing else wrong.  Seek help from one of the board certified surgeons of Los Angeles Colon And Rectal Surgical Associates.  By calling (310) 273-2310, you can schedule a confidential visit to better understand and diagnose your problem and begin treatment.

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