HemorrhoidsHemorrhoids are no fun. They can cause severe pain, bleeding and discharge. And what’s worse, they are not uncommon. By the age of 50, half of all adults have had hemorrhoids, and an estimated 10 million people in the U.S. suffer from hemorrhoids every year. Many people live with hemorrhoid discomfort for long periods before seeking treatment for the condition.

Recognizable by swelling of the veins in and around the anal canal, hemorrhoids can develop for a variety of reasons, from being pregnant to straining with bowel movements. The silver lining in all this? Advances in hemorrhoid treatment mean some forms of the condition can be treated with much less painful measures than before.

What Are Hemorrhoids?

Often called the “varicose veins of the anus,” hemorrhoids are large, swollen blood vessels in and around the anus and lower rectum. Hemorrhoids are normal tissues that line the anal canal, located about an inch inside the anus. They don’t cause trouble until they become enlarged; sometimes they grow over time with aging, straining, and with bowel movements. But as they become enlarged, the tissues supporting the vessels stretch, the walls weaken, and hemorrhoids become symptomatic. Common symptoms include:

  • Bleeding
  • Pain and irritation
  • Protrusion of the skin during bowel movements
  • Itching in the anal area
  • Sensitive lumps

The exact causes of hemorrhoids are unknown. Regular upright posture puts considerable pressure on the blood vessels in the rectum and leads to bulging. Other contributing factors include:

  • Aging
  • Chronic constipation or diarrhea
  • Pregnancy
  • Heredity
  • Straining during bowel movements
  • Inadequate bowel function due to overuse of laxatives or enemas
  • Spending more protracted periods of time on the toilet

Treatment for Hemorrhoids

If the hemorrhoids are identified at the time of a patient’s examination in a colorectal surgeon’s office, the size and level of hemorrhoid irritation will be assessed. If the hemorrhoids are not too large, they can be treated with conservative measures including:

  • Dietary changes (high in fiber) to soften bowel movements (making it more comfortable on the hemorrhoids)
  • Hemorrhoid creams
  • Use of heat

If those measures fail to improve the symptoms, a colorectal specialist can inject chemicals into the hemorrhoids or place rubber bands around them to shrink them and reduce the symptoms. When hemorrhoids are too large or do not respond to those treatments, patients may require surgery.

Surgery may be recommended when:

  • Hemorrhoids attain a significant size
  • Symptoms are severe
  • Hemorrhoids become disabling

Surgery is performed in an ambulatory surgery center with sedation and local anesthesia. The hemorrhoid tissues are removed and the incisions to remove them closed with absorbable stitches. Typically, patients can return home immediately after surgery.

Recovery After Hemorrhoid Surgery

Although its success rate is high, patients can expect significant rectal and anal pain after hemorrhoid surgery that can last for up to two weeks. A colorectal surgeon may prescribe pain medication to ease the discomfort. It’s important for patients to understand the post-surgical implications of hemorrhoid surgery and ensure (along with their physician) that their adverse symptoms justify the operation.

When severe symptoms are present, hemorrhoid surgery is very effective in relieving them, and patient satisfaction is high. Patients can help themselves during the recovery process by:

  • Eating a high-fiber diet
  • Drinking abundant water throughout the day (8 to 10 glasses)
  • Using a stool softener to avoid straining during bowel movements
  • Avoiding heavy lifting or pulling motions
  • Having sitz baths (soaking the anal area in a few inches of warm salt water)

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