What are Hemorrhoids, symptoms and how are they treated?
Hemorrhoids are one of the most common gastrointestinal conditions and affect 40-60% of all adults over the age of 40. Hemorrhoids are simply swollen blood vessels inside the anal area or skin around the anus. Hemorrhoids do not usually produce symptoms (i.e. stools soft) unless they progress down into the anal canal (known as a prolapsed hemorrhoid) which can can cause rectal bleeding (bright red blood), swelling, irritation, itching and leakage or soiling. Prolapse often occurs because of aging, pregnancy, which greatly increases venous pressure, chronic constipation and physical straining sometimes seen with weight lifting. Hemorrhoids are not always a sign of digestive diseases.
It is of the utmost importance that the symptoms of hemorrhoids, in particular bleeding, to not be confused with other more serious conditions such as early rectal cancer, anal cancer or pre-malignant polyps. If you have any of these symptoms, a colonoscopy or sigmoidoscopy (shorter version of a colonoscopy) is extremely important to examine the lower bowel and exclude these conditions before a diagnosis of hemorrhoids is assumed. This is a surprisingly common and sometimes devastating mistake.
Hemorrhoidal symptoms are never life-threatening and most likely do not require surgical treatment, but can be very bothersome and even debilitating. Most hemorrhoid symptoms can be treated with what is called ‘conservative medical management’ which includes fiber supplements, treatment of constipation, hot baths with Epsom salts (“Sitz Baths”) and avoidance of straining with bowel movement or prolonged sitting on the toilet bowl. Surgery to remove hemorrhoids is now rarely required because of newer non-surgical techniques (banding, rubber band ligation, etc.) which have been shown to be just as effective. One of the newest techniques is the CRH O’Regan minimally invasive band ligation, which is as effective as surgery yet has none of the pain, prolonged recovery period or risks of surgery. The CRH O’Regan method takes only a minute to perform, requires no anesthesia or preparation and is generally painless. We have found this technique to be moderately to highly successful in 90% of patients with hemorrhoids.