Hemorrhoid treatment

People are often embarrassed about talking to their doctor about anything to do with colorectal health. At Aurora Health Care, you can let go of any nervousness or embarrassment about topics like hemorrhoids. We’ll give you clear, accurate information about what they are and what to do about them.

What are hemorrhoids?

A hemorrhoid is simply an inflamed or swollen vein around the anus (the opening that lets feces exit the body) or inside the rectum. Hemorrhoids around the anus are called external hemorrhoids. Those that form inside the rectum are called internal hemorrhoids.

What does a hemorrhoid look like?

An external hemorrhoid looks skin-colored or reddish. It makes a hard, tender bump and it may itch or be covered in mucus. An internal hemorrhoid is mostly colored red because it forms on the mucous membrane that lines the inside of the anus.

If either an internal or external hemorrhoid develops a blood clot inside it, it may take on a blue, purple, grey, black or dark brown color (depending on your skin color). A hemorrhoid with a blood clot inside it is called a thrombosed hemorrhoid and can cause severe pain.

You usually won’t see an internal hemorrhoid and you may not even know you have it unless a doctor tells you about it after an exam or a procedure like a colonoscopy. Sometimes you’ll see an internal hemorrhoid if it is enlarged and gets pushed outside the body during a bowel movement. Then it’s called a prolapsed hemorrhoid. You may be able to gently push it back inside.

No matter what kind of hemorrhoid you have, they’re often annoying and uncomfortable, and sometimes extremely painful.

Hemorrhoid symptoms

Symptoms of hemorrhoids may include:

• Soreness or burning pain
• Itchiness or irritation
• Bulging of a vein
• One or more hard, tender lumps near the anus
• Bleeding

If you notice blood on feces (stool), on toilet paper or in the toilet, contact your doctor. Your doctor will want to check for causes of the bleeding such as anal fissures, ulcerative colitis, Crohn’s disease or some types of cancer. Note that hemorrhoids don’t cause any of these other conditions, and the treatments for each condition are different from each other.

Complications from hemorrhoids

Complications from hemorrhoids are rare, but can include:

• Infection
• Anemia: From chronic blood loss.
• Strangulated hemorrhoid: When part of an internal hemorrhoid prolapses (part of it comes out through the anus) and its blood supply is cut off by the muscles of the anus. This can be very painful.
• Thrombosed hemorrhoid: When a blood clot forms inside an internal or external hemorrhoid. Sometimes causes extreme pain.
• Skin tags: Skin that remains after a blood clot inside a hemorrhoid is reabsorbed.

Hemorrhoid risk factors

We don’t know exactly why hemorrhoids form. But we do know some things that seem to contribute to them.

• Straining during bowel movements
• Lifting heavy things (particularly when it’s frequent)
• Obesity
• A diet low in fiber
• Chronic constipation or diarrhea
• Smoking
• Aging
• Genetics (some people inherit a tendency to develop hemorrhoids)
• Anal sex
• Standing or sitting for long periods of time
• Pregnancy

Hemorrhoid treatments at home

You can prevent or treat minor hemorrhoids by drinking enough water, eating a high fiber diet, avoiding straining or sitting too long on the toilet, and going as soon as you feel the urge (rather than waiting).

In addition to these lifestyle changes, here are some home hemorrhoid treatments that should ease your symptoms:

• Sitting in warm water for 15 minutes two to three times a day
• Applying ice packs or cold compresses
• Taking painkillers such as aspirin, ibuprofen or acetaminophen
• Taking fiber supplements or using stool softeners

There are several over-the-counter hemorrhoid creams, ointments or suppositories that you might try for hemorrhoid treatment. They may contain zinc oxide, witch hazel, steroids or lidocaine.

If any of these hemorrhoid treatments don’t improve your symptoms within a week or if you have severe pain or bleeding, you should contact your doctor. They’ll be able to verify whether you have hemorrhoids or another condition, and can offer a variety of treatments depending on the severity of your condition. There are other causes for rectal bleeding or pain. The treatments for each condition are different.

Hemorrhoid diagnosis

Your doctor will start with a thorough physical, including asking about your general health history and your symptoms. They’ll ask if you’ve been doing anything to treat the pain and whether or not those things have helped.

They’ll do a physical exam and check the appearance of any external hemorrhoids. They may do a digital rectal exam by putting on gloves, applying lubrication and inserting a finger into your rectum to feel for tenderness or lumps and check muscle tone.

Depending on what they find, they may also use an anoscope (short plastic tube) or a sigmoidoscope (flexible lighted tube) to look at the colon.

Hemorrhoid treatments

Your doctor can prescribe medications that are more effective than the remedies available over the counter. Or they may counsel you to use some of the home hemorrhoid treatments mentioned previously. In some cases, surgical options might be the best option.

Nonsurgical hemorrhoid treatment

More complex conditions may require other treatments. Bleeding and persistent hemorrhoids can be treated with minimally invasive procedures such as:

• Rubber band ligation: Your doctor puts one or two small medical-grade rubber bands around the base of a hemorrhoid to cut off its blood flow. You may need more than one banding hemorrhoid treatment to get the hemorrhoid to shrink and fall off.
• Sclerotherapy: Injection of a chemical solution into the hemorrhoid that cuts off blood supply, causing the hemorrhoid to shrink. Any pain is minimal.

• Cryotherapy: Applying a cooled gas or liquid to freeze the external hemorrhoid, which then shrinks and falls off.

Surgical hemorrhoid treatment

Surgery is usually recommended for large hemorrhoids, bleeding or prolapsed internal hemorrhoids, or those that haven’t responded to other hemorrhoid treatments. These hemorrhoid treatments are usually outpatient procedures but sometimes require an overnight hospital stay. Procedures include:

• Excisional hemorrhoidectomy: This hemorrhoid treatment includes surgical removal, where your doctor makes incisions around the hemorrhoid and removes it while you’re under general anesthesia. You may have pain after the procedure and may need to take it easy for as long as two weeks, but the surgery has a high rate of lasting success.

• Stapled hemorrhoidopexy: This method of hemorrhoid treatment doesn’t require an incision. Instead, using a device inserted through a tube into your anus, your doctor removes tissue around the hemorrhoid. The hemorrhoid is lifted and the tissue is stapled back into place. Blood flow to the hemorrhoid is cut off, and it shrinks within four to six weeks. Stapled hemorrhoidopexy takes about 30 minutes under general anesthesia. This hemorrhoid treatment is usually less painful than hemorrhoidectomy and lets you get back to your regular activities faster.