I see so many patients in the office who think they have hemorrhoids. Hemorrhoids are one of the most common problems that I, as a colon and rectal surgeon, see. However, many of the patients whom I see who think they have hemorrhoids actually have other problems, such as an anal fissure or anal fistula. So the question you are probably wondering is, “Do I have hemorrhoids?”
Hemorrhoids can be divided into two main categories: Internal and external. Internal hemorrhoids cause bleeding (one of the more common causes of bright red rectal bleeding, but not the only one!) and they may protrude. Typically, patients with internal hemorrhoids that prolapse or protrude may even need to reduce the hemorrhoids (or push them back in). Some patients with hemorrhoids that protrude find that the hemorrhoids go back in on their own and some patients may have internal hemorrhoids that are always out.
The good thing about internal hemorrhoids is that they often can be treated in the office. The most common way that we treat them in the office is with a procedure called rubber band ligation. This is a short procedure in which a rubber band is placed at the base of the hemorrhoid. The hemorrhoid will fall off, along with the rubber band. Patients have some pain that is typically minor. The obvious advantage of rubber banding is not only that it can be done in the office, but also that it is not as painful as hemorrhoid surgery. However, some patients do still need hemorrhoid surgery.
External hemorrhoids usually become a problem when they get a blood clot in them; this is called a thrombosed external hemorrhoid. Common symptoms include the rather acute onset of anal (or butt) pain that is associated with a lump. These also can most commonly be treated in the office with the offending hemorrhoid being excised.
Those are the mains type of problems that hemorrhoids cause. You will note that I didn’t list itching as a common symptom. While hemorrhoids can cause itching, the most common cause of itching is, well, we really don’t know what it is. It is called pruritus ani and doesn’t require surgery. Also, while bleeding is common with hemorrhoids, I often will want to make sure my patient has had something (such as a colonoscopy) done to make sure there isn’t another cause of their bleeding.
Thanks for joining. We will present more topics soon!