Hemorrhoids are swollen veins in the rectum. They can cause itching, bleeding and pain. An estimated 10 million people in the United States, 4.5% of the US population, complain of hemorrhoid symptoms. In some cases you can see or feel hemorrhoids around the outside of the rectum, in other cases they are hidden inside.
The development of symptomatic hemorrhoids has been associated with advancing age, diarrhea, pregnancy, pelvic tumors, prolonged sitting, straining, chronic constipation, and patients on anticoagulation therapy. The actual process by which hemorrhoids develop is not well understood. Most hemorrhoids, however, are the result of constipation, straining and sitting on the toilet for long periods of time.
The most important thing you can do is to avoid getting constipated or having hard stools. Some steps you can take:
If you have hemorrhoids, sitting in 2-3 inches of warm water for 10-15 minutes a few times a day can help. There are various over the counter medications you can try. Do not use any medication that has hydrocortisone for more than a week.
|Food||Serving||Grams of fiber|
|Apple (with skin)||1 medium apple||4.4|
|Banana||1 medium banana||3.1|
|Prunes||1 cup, pitted||12.4|
|Apple, unsweetened, with added ascorbic acid||1 cup||0.5|
|Grapefruit, white, canned, sweetened||1 cup||0.2|
|Grape, unsweetened, with added ascorbic acid||1 cup||0.5|
|1/2 cup sliced||2.3|
|1 medium potato||3.8|
|1 cup shredded||0.5|
|1 medium tomato||0.5|
|Lentils, boiled||1 cup||15.6|
|Breads, pastas, flours|
|1 medium muffin||5.2|
|Pasta and rice, cooked|
To learn how much fiber and other nutrients are in different foods, visit the United States Department of Agriculture (USDA) FoodData Central website. Data from: USDA FoodData Central. Available at: https://fdc.nal.usda.gov/ (Accessed on October 11, 2019).
Patients with symptoms of hemorrhoids should see their primary physician. An internal medicine or family practitioner can treat patients with hemorrhoids successfully with conservative treatments. When patients do not respond to conservative treatment they should be referred to a specialist. The following patients with bright red blood passage should be referred:
For patients who do not respond to conservative treatments such as creams, soaking and laxatives/fiber supplementation, there are several options for treatment. First, in office treatments are used, most commonly rubber band ligation (RBL) in which a rubber band is placed around hemorrhoid. Other treatments can involve sclerotherapy or infrared coagulation. These procedures involve direct manipulation of the hemorrhoids through the anus with an endoscope. Some patients, for instance, patients taking anticoagulation, may not be good candidates for these procedures. In addition, 10-15% of patients end up needing more invasive surgery, which requires long recovery and painful post-operative courses.
One of the newest treatment options is embolization of the superior rectal artery and may be a good alternative to invasive surgery, or in patients who are not candidates for other procedures.
SRA embolization is a minimally invasive procedure that uses a tiny catheter inserted into the femoral artery at the top of the leg which is guided into the arteries supplying the hemorrhoids. Tiny particles are injected through the catheter, which blocks the arteries, causing the hemorrhoids to stop bleeding and shrink.
The advantage of SRAE is that it is easily tolerated and performed as an in-office procedure with minimal sedation. Patients experience little to no discomfort and go home a few hours after the procedure. Multiple studies have shown improvement in patient symptoms in over 75% of patients with no major or minor complications, comparing favorably to 7-15% rates of complications with surgical procedures.
With a focus on patient comfort and safety, Vivid Vascular’s low-volume, the boutique-style medical facility caters to the diagnosis and treatment of medical and cosmetic vascular disorders. Founded by Dr. Adam Gropper, Vivid Vascular takes a comprehensive approach to the treatment of a broad range of vascular conditions — including the latest diagnostic and therapeutic technology — in a calm, soothing atmosphere. Unlike the hectic hospital environment, each patient at Vivid Vascular receives individualized attention from our professional, knowledgeable, and compassionate staff. Our patient-centric attitude ensures that our patients receive the best care available.
For your convenience, we now make it even easier for you to schedule your visit to Vivid Vascular by booking your appointment online. Simply select a date and time that is convenient for you and provide us with the requested information. One of our friendly patient care coordinators will reach out to you via your preferred contact method to confirm your appointment.