Screening, Diagnosis and Treatment of Hemorrhoids
As a general rule, make an
appointment with our office if your hemorrhoids are painful or
bleed frequently or excessively. With earlier treatments, many times the
"cure" was as bad, or worse, than the disease. For this reason many
hemorrhoid sufferers put off treatment until only surgery could correct the problem.
Now with Infrared Coagulation, there is no reason to put off treatment - it is
safe, effective and well tolerated by patients. The earlier treatment occurs with
onset of hemorrhoids, generally, the easier it is to treat.
The most common sign of hemorrhoids is rectal bleeding, but because rectal bleeding can occur for other reasons, make an
appointment so that a physician can
evaluate for more serious conditions or diseases. Other
causes of bleeding in the lower gastrointestinal tract include:
- Proctitis, an inflammation of the inner lining of the rectum
- Colon or rectal growths (polyps)
- Anal fissure, a tear in the lining of your anus
- Anal fistula, an abnormal channel that develops between the
anal canal and the skin around the opening to the anus
- Rectal prolapse, in which a portion of the rectal lining
protrudes through the anus
- Diverticular disease, in which small sacs or pouches
(diverticula) commonly form from the lining of the large intestine
If the onset of your hemorrhoids occurs along with a marked
change in bowel habits or if you're passing black, tarry or maroon stools, consult our
office or your primary care physician without delay. These types
of stools can signal more extensive bleeding elsewhere in your digestive tract.
Seek emergency care if you notice large amounts of rectal
bleeding, lightheadedness, weakness or a rapid heart rate of more than 100 beats a minute.
A doctor can determine if you have external hemorrhoids
simply by looking. For internal hemorrhoids, a physician
may want to conduct an examination with a rubber-gloved finger. But even this technique
may be inconclusive because hemorrhoids are often too soft to detect and anoscopy
is usually the only clear way to definitely diagnose them.
In this case your doctor may want to examine the lower
portion of your colon and rectum with an anoscope, proctoscope or sigmoidoscope. A more
extensive examination could include a barium enema, which results in a better display of
your colon and rectum on an X-ray, or colonoscopy — an examination of the entire
colon using a flexible fiber-optic colonoscope. These tests can determine that the
bleeding is not from higher in the colon, which typically indicates other conditions. |
For some patients steps that can be
taken on their own can lead to the prevention of hemorrhoids however, having exhausted
these remedies medical treatment is likely necessary to return to a normal life without
hemorrhoids.
For painful or persistent hemorrhoids,
there are several medical procedures:
Infrared Coagulation. A one-second
burst of infrared light also can seal off circulation to an internal hemorrhoid. You
may experience some warmth during the procedure — called infrared photocoagulation
— and about one in three patients experience a little bleeding within a few days. According to an article published by John F. Johanson, M.D., and Alfred Rimm, Ph.D. (Department of Medicine,
University of Illinois College of Medicine, Rockford, Illinois, and Department of
Epidemiology and Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin).: Optimal
Nonsurgical Treatment of Hemorrhoids: A Comparative Analysis of Infrared Coagulation,
Rubber Band Ligation, and Injection Sclerotherapy, in an
evaluation of 863 patients who received Rubberband
Ligation, Schlerotherapy and Infrared Coagulation, when given consideration to safety,
effectiveness and patient comfort, Infrared coagulation was considered the preferred
treatment.
Tying off a hemorrhoid/Rubberband
Ligation/Banding. A doctor ties one or two tiny rubber bands around the base of an
internal hemorrhoid to cut off its circulation. Within 7 to 10 days, the hemorrhoid falls
off. This fairly simple procedure — called rubber band ligation — is done in a
doctor's office and is effective for many people.
Sclerotherapy. A chemical solution
is injected around the blood vessel to shrink the hemorrhoid. Schlerotherapy has a 3-fold
occurrence of requiring further treatment by other methods over Infrared coagulation.
It is simply not as effective according to statistical reviews of hemorrhoid
treatment procedures.
Laser therapy. In this procedure
— called laser coagulation — a laser beam vaporizes hemorrhoidal tissue.
Freezing. This technique,
cryosurgery, freezes the affected tissue, cutting off circulation and destroying the
hemorrhoidal tissue.
Bicap/Galvanic. Bursts of electric
current shrink a hemorrhoid.
Surgery. If other procedures
haven't been successful or if you have a large hemorrhoid, your doctor can remove tissue
in a procedure called hemorrhoidectomy. The more extensive the removal of tissue, the
lesser the chance of recurrence but the greater the discomfort. Surgery may require up to
a 1- or 2-day hospital stay — a significantly longer and more painful recovery period
than other methods of hemorrhoid removal. Other procedures. If a blood clot has
formed within an external hemorrhoid, our physician can easily remove the clot with a
simple incision, which provides prompt relief.
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