Many people have "hemorrhoid “ problems, but of those who have frequent symptoms, there are other causes for these symptoms other than hemorrhoids, even no rectal bleeding pain, itching lumps, and bumps can all be caused by other issues.
Hemorrhoids are only varicose veins of the anus caused by constipation, pregnancy, heavy lifting, sedentary lifestyle, and prolonged sitting vocations such his truck driving. Over 50% of all people have some hemorrhoid symptoms during their lifetime. They don't cause cancer but they do cause a lot of symptoms such as bleeding pain itching rectal seepage and prolapse.
The biggest problem is to exclude other more serious problems that may cause the same symptoms. Bleeding from the rectum can be caused by hemorrhoids but also by cancer anal warts fissures and rectal infection and inflammation such as Crohn's disease and ulcerative colitis. It is important for everyone fifty years of age, and some over 40 who have a family history, to have a colonoscopy at least every 10 years and anorectal exam by a trained general or colorectal surgeon will be able to make a proper diagnosis.
So, if it is hemorrhoids, what do we do about them? There are suppositories Tucks and Preparation H pads that contained witch hazel, compounding ointments, suppositories, surgery and rubber band ligation. We currently recommend CRH O' Reagan ligation with rubber bands. This is not a new procedure but a new technique that is more precise and less painful. We are able to ligate hemorrhoids well up in the rectum without pain or anesthesia the office. No preparation is required; no time off work is needed. There are usually three large groups of hemorrhoids which are banded one at a time every 2-3 weeks. This allows the lower external hemorrhoids to dry up. Most insurance companies reimburse this very well because there is no hospital charge.
Open surgical hemorrhoidectomy requires general anesthesia and usually an overnight stay in the hospital with 2-3 weeks off work. There are times when this is the only option.
Anal fissures are common problems and cause an awful lot of pain. They are caused by severe constipation with very hard stools. Initial treatment is to first fix the constipation with bulking agents and lots of water. Use of special compounded ointments and suppositories will relieve the pain and the rectal muscle spasm that is associated with the fissure and is the primary cause of the pain. Rarely these processes do not work and surgery to partially cut the rectal sphincter is required to relieve the pain
Anal Cancer is not recognized by the patient and sometimes but not well by a primary care physician. The only symptom is that of pain and bleeding the same as hemorrhoids and fissures. It usually begins as a sore in anal canal. It is associated with anal and perinea! condyloma (warts). Treatment is primarily nonsurgical with chemotherapy and radiation simultaneously. Any anal sore that will not heal, requires evaluation by a surgeon to exclude this problem.
These are fairly common and are caused by a virus called HPV, the same virus that causes cervix cancer and other cancers as well as usually anal cancer. They need to be aggressively treated. Most require laser or cautery therapy in the operating room to remove .
These are fairly common after previous episode of thrombosed hemorrhoids and tend to cause itching and seepage and can be removed easily in the office under local
These fairly common. They result from infection in glands that surround the rectum and also by skin oil glands. They cause a good bit of pain, sometimes fever and swelling. They require prompt surgical drainage. They will not get well with antibiotics without surgery. These are especially problematic in diabetics.