What Are Hemorrhoids

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

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, office-based procedures can effectively treat internal hemorrhoids.

• Rubber-band ligation: A small rubber band is placed around the base of an internal hemorrhoid to cut off its blood supply, causing it to shrink and fall off within a few days.
• Sclerotherapy: A chemical solution is injected to shrink the hemorrhoid.
• Infrared coagulation or laser therapy: Heat or laser energy is used to reduce the hemorrhoid.

Surgical Options

Large or recurrent hemorrhoids may require surgical removal. Minimally invasive surgical techniques include:

• Hemorrhoidectomy: Removal of the hemorrhoidal tissue.
• Stapled hemorrhoidopexy: A technique that repositions and secures prolapsed hemorrhoidal tissue.

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

Hemorrhoid Banding

Hemorrhoid banding is a 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 each 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.

Reasons for Hemorrhoid Banding

• Presence of internal hemorrhoids requiring removal
• Pain or bleeding caused by internal hemorrhoids

Risks and Possible Complications

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, pain, or difficulty urinating—seek medical attention promptly.
• 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, 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.

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.