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Rubber band ligation is probably the most widely used of the many treatments for internal hemorrhoids (and the least costly for the patient). This procedure is performed in the office of a family doctor or specialist, or in a hospital on an outpatient basis. An applicator is used to place one or two small rubber bands around the base of the hemorrhoid, cutting off its blood supply. After three to 10 days in the bands, the hemorrhoid falls off, leaving a sore that heals in a week or two. Because internal hemorrhoids are located in a part of the anus that does not sense pain, anesthetic is unnecessary and the procedure is painless in most cases. Although there can be minor discomfort and bleeding for a few days after the bands are applied, complications are rare and most people are soon able to return to work and other activities. If more than one hemorrhoid exists or if banding is not entirely effective the first time (as occasionally happens), the procedure may need to be repeated a few weeks later. After five years, 15-20% of patients experience a recurrence of
Respond to bowel urges. If you are prone to hemorrhoids, it’s important that you use the restroom immediately when you feel the need. Putting off a bowel movement or waiting for a “more convenient” time can cause constipation and painful bowel movements, which can cause hemorrhoids or aggravate existing ones.
Rectal pain occurs mainly with external hemorrhoids. Blood may pool under the skin, forming a hard, painful lump. This is called a thrombosed, or clotted, hemorrhoid. You might also notice streaks of blood on the toilet paper after straining to pass a stool.
If your doctor believes that you do have enlarged hemorrhoids, she will most likely perform a proctoscopy next. This involves inserting a short tube with a light and lens on it (the proctoscope) that exams the membranes lining the rectum. The doctor is looking to see if there are enlarged hemorrhoids and how big they are. People tend to fear the pain and discomfort that come with these procedures, but they usually don’t hurt and do help your doctor make suggestions about how to get rid of hemorrhoids.
A doctor can evaluate symptoms of hemorrhoids to rule out other, more serious problems. A number of conditions that affect the anus and colon (large intestine) can cause bleeding, mucus drainage, itching, and discomfort. Most people who have these symptoms think they have hemorrhoids, but often they do not.
Sometimes, increased pressure on external hemorrhoids causes them to get irritated and to clot. This causes a lump (thrombosed, or clotted, hemorrhoid) to form. You may suffer from severe pain at the site of a clotted hemorrhoid.
When the released salts reach the large intestine, they cause profuse stools or diarrhea because of their strong laxative effect. People may often confuse this condition with “travelers” diarrhea, since it isn’t described in medial literature [back].
John Geibel, MD, DSc, MSc, AGAF is a member of the following medical societies: American Gastroenterological Association, American Physiological Society, American Society of Nephrology, Association for Academic Surgery, International Society of Nephrology, New York Academy of Sciences, Society for Surgery of the Alimentary Tract
Celsus (25 BC – AD 14) described ligation and excision procedures, and discussed the possible complications. Galen advocated severing the connection of the arteries to veins, claiming it reduced both pain and the spread of gangrene. The Susruta Samhita (4th–5th century AD) is similar to the words of Hippocrates, but emphasizes wound cleanliness. In the 13th century, European surgeons such as Lanfranc of Milan, Guy de Chauliac, Henri de Mondeville, and John of Ardene made great progress and development of the surgical techniques.
Hemorrhoid or haemorrhoid (also commonly called piles) are vascular structures (similar to veins) in the anal canal which help with stool evacuation. We only speak of hemorrhoids (or piles) when they become swollen or inflamed. But Hemorrhoids are a normal part of the anatomy and everyone has these structures. They act as a cushion that is made of complex tissue. Their job is to aid the passage of stool. Hemorrhoids are very common. Nearly three out of four adults will have hemorrhoids from time to time.
Injection (sclerotherapy). In this procedure, your doctor injects a chemical solution into the hemorrhoid tissue to shrink it. While the injection causes little or no pain, it may be less effective than rubber band ligation.
It can also be done with a spinal anesthetic block while you are awake (similar to an epidural injection given during childbirth), or with a combination of relaxing and sedating drugs given intravenously (IV) and a local anesthetic injected around the anus.
Whatever you happen to have, all of these conditions are addressed in depth in the Restoring Normal Bowel Movements and Restoring Anorectal Sensitivity guides. If you are affected by IBS, please also study the Irritable Bowel Syndrome guide.
Remember, most hemorrhoids can be avoided by maintaining a healthy lifestyle with lots of fiber-rich fruits and vegetables, along with plenty of water. If you maintain a healthy weight, exercise regularly, watch your salt intake, and avoid straining on the toilet, can prevent the occurrence of hemorrhoids naturally.