What Are Hemorrhoids

Hemorrhoids are swollen veins in the lower rectum and anus. They are extremely common and often result from increased pressure related to constipation, straining, pregnancy, or prolonged sitting. Hemorrhoids may be internal (inside the rectum) or external (under the skin around the anus). Symptoms can include itching, pain, discomfort, swelling, and bright red bleeding with bowel movements.

If you are experiencing pain or bleeding due to hemorrhoids, our team at Salem Gastroenterology offers compassionate care and a range of treatments to restore your comfort.

Conservative Management

Many hemorrhoids can be effectively managed without surgery. Conservative care focuses on relieving symptoms and reducing straining during bowel movements.

• Increase fiber and fluid intake to soften stools.
• Use stool softeners or fiber supplements as needed.
• Avoid straining and prolonged time on the toilet.
• Take warm sitz baths to soothe irritation and swelling.
• Apply topical creams or suppositories to reduce discomfort.

Office Procedures

If symptoms persist despite conservative care, hemorrhoid banding is an effective, minimally invasive, non-surgical office procedure performed without sedation. A small tube called an anoscope is used to visualize the internal hemorrhoids. The physician places a small rubber band around the internal hemorrhoid, cutting off its blood supply. The hemorrhoid typically falls off within one to two weeks. One or more hemorrhoids can be banded during a single session, and multiple sessions may be required.

Hemorrhoid banding is considered a low-risk procedure, but complications can occur:

• Pain: Mild discomfort or pressure is common and usually resolves within a few hours. Contact the office if you experience severe pain.
• Bleeding: Light bleeding may occur after the first bowel movement or when hemorrhoids fall off (around one week post-procedure). If bleeding continues or is heavy, apply local pressure and contact the office.
• Infection: Although rare, infection may occur at the banding site. Symptoms can include fever or pain —seek medical attention promptly.
• Urinary retention: a rare complication related to nerve reflexes
• Narrowing of the rectal opening: Scar tissue may occasionally form, causing a smaller opening that can make bowel movements difficult.
• Recurrence: Hemorrhoids can return over time especially with uncontrolled constipation or straining, and the procedure may need to be repeated.
• Other Risks: Reactions related to other medical conditions or instrument malfunction are extremely rare but possible.

Important: Inform your physician of all allergies, medications, and medical problems before the procedure.

Surgical Options

Very large, recurrent, or external hemorrhoids may require surgical removal. Hemorrhoidectomy by a surgeon is effective but recovery is significantly more difficult than with hemorrhoid banding, taking up to 6 weeks.

Your specialist will discuss the best treatment option for your specific condition and comfort.