Also referred to as piles, hemorrhoids are abnormally large veins that develop in the rectum or anal area.
Hemorrhoids are sometimes related to chronic constipation, excess weight, hard bowel movements, and pregnancy. Other times, they develop without a clear reason. Symptoms and level of pain experience will depend on whether hemorrhoids are internal, external, or affected by a blood clot (thrombosed hemorrhoids).
If you are referred to a hemorrhoid doctor in Orange County after seeing your regular physician, the following steps may be taken to resolve your discomfort.
Making a Detailed Diagnosis
External hemorrhoids are often diagnosed by a hemorrhoid doctor in Orange County with a visual examination. It's internal hemorrhoids that typically require a more extensive evaluation. A digital rectal exam (DRE) may be done to detect internal swollen veins. It's performed by inserting a gloved finger into the rectum. When internal hemorrhoids can't be felt with a DRE, a visual examination may be done with a specialized instrument, such as an anoscope or flexible sigmoidoscope. If the doctor suspects another digestive problem may be contributing to symptoms, a colonoscopy may be performed to rule out or confirm the presence of a digestive system disease.
Recommending Non-Surgical Treatments
More than a million people seek outpatient care for hemorrhoids each year in the United States, according to stats reported by National Institute of Diabetes and Digestive and Kidney Diseases. Unless symptoms are severe or ongoing bleeding is being experienced, a hemorrhoid doctor in Orange County is likely to recommend non-surgical treatments first. Some patients benefit from the use of over-the-counter hemorrhoid creams, ointments, suppositories, specially treated pads, or taking warm baths. If OTC medications aren't effective, a hemorrhoid doctor may prescribe stronger topical creams for external hemorrhoids.
Performing Minimally Invasive Procedures
Medication and lifestyle changes sometimes provide meaningful relief for patients with hemorrhoids. But for many people with this type of irritation, symptoms simply don't go away with initial non-surgical treatment efforts. Instead, these swollen anal veins progressively worsen or they grow in size and number. If this is the case, a hemorrhoid doctor may discuss minimally invasive procedures with a patient. Should a blood clot form inside of an external hemorrhoid, an external hemorrhoid thrombectomy may be performed. During the procedure, a small cut is made to drain the affected part of the swollen anal vein. Minimally invasive procedures recommended to address problems with hemorrhoids may also include:
- Rubber band ligation: Two rubber bands are placed around the bottom of an internal hemorrhoid to cut off its circulation.
- Sclerotherapy/injection: A specially prepared solution is injected into the enlarged tissues to cause the hemorrhoid to shrink.
- Coagulation: Infrared heat or lasers are used to cause internal hemorrhoids to shrink.
Performing a Hemorrhoidectomy or Stapled Hemorrhoidectomy
If painful hemorrhoids can't be effectively treated with the minimally invasive procedures already discussed, the next option may be surgical removal, referred to as a hemorrhoidectomy. During the procedure, the tissues causing the bleeding and extreme discomfort are removed. After the application of local, general, or spinal anesthesia, small incisions are made around the anus to slice away the affected tissues.
Hemorrhoid surgery is generally considered to be the most effective treatment methods for painful, excessively large, bleeding, or recurring hemorrhoids. Having surgery doesn't automatically mean hemorrhoids won't be a problem again in the future, although the odds of recurrence may be reduced if proper precautions are taken. Following removal surgery, discomfort may continue for 2 to 4 weeks as the surgical site heals.
Hemorrhoid stapling is another surgical option. It's often recommended for patients with third-degree hemorrhoids, which are abnormally enlarged veins that protrude with straining. During the procedure, a circular, hollow tube is placed into the anal canal. A long thread is woven above the internal hemorrhoid. A disposable instrument is used to manipulate the thread and block the flow of blood to the hemorrhoid tissue. The lower and upper edges of abnormal tissues are also cut. Risks associated with hemorrhoid surgery are typically mild. Some patients may develop a temporary urinary tract infection.
In rare cases, untreated hemorrhoids that are regularly bleeding may contribute to anemia, a condition characterized by a lack of healthy red blood cells. Most of the time, however, piles are mainly uncomfortable or painful. A hemorrhoid doctor in Orange County may also suggest ways to minimize recurrence after treatment, such as maintaining a healthy weight, eating more high-fiber foods, and drinking 6-8 glasses of water each day. Getting regular exercise and staying active may also ease pressure on anal veins enough to reduce the odds of developing hemorrhoids.