Hemorrhoids are blood vessels located in the lower rectum and anus that may become engorged, swollen, and inflamed, causing irritation, discomfort, or bleeding. Hemorrhoids can present with and without pain. Hemorrhoids often become symptomatic with straining with bowel movements, as well as with obesity and pregnancy. There are two kinds of hemorrhoids: internal hemorrhoids and external hemorrhoids.
External hemorrhoids are hemorrhoids which develop under the skin of the anus and are visible on the outside of the anus. External hemorrhoids may swell or become engorged with straining. If the blood vessels in the external hemorrhoid rupture or become clotted, a painful thrombosed external hemorrhoid may occur. External hemorrhoids are often accompanied by overlying anal skin tags, or excess skin, that may become irritated or itchy.
Patients are often surprised to learn that we are typically born with three internal hemorrhoids, one on the left side of the anal canal and two on the right side of the anal canal. These internal hemorrhoids are a normal part of the human anatomy and function to preserve fecal continence. However, if they become engorged, swollen or prolapse to the outside of the anus, they may become symptomatic and cause discomfort and painless rectal bleeding. Sometimes, the prolapse does not automatically reduce or go back inside of the anal canal resulting in a thrombosed internal hemorrhoid which is a blood clot inside the internal hemorrhoid which can be very painful. If the prolapsing internal hemorrhoid is not reducible or able to be manually placed back into the anal canal, it may require immediate surgery.
Hemorrhoids get swollen, inflamed, or engorged for many reasons, with common risk factors including:
Diets lacking fiber-rich foods or high in certain types of foods, such as spicy foods, can also increase your chances of developing internal hemorrhoidal problems.
The hemorrhoid treatment that’s best for you depends on your treatment goals as well as both the severity of the condition and the type of hemorrhoids being treated. To evaluate your internal hemorrhoids, an anoscopic examination is performed using a small scope (anoscope) to visualize the inside of the anal canal. After Dr. Maziar Ghodsian completes a comprehensive assessment and examination, the best custom-tailored approach to treat your hemorrhoids will be discussed with you taking into account different factors including lifestyle and personal health goals.
Internal hemorrhoids are typically located above the dentate line in the anal canal. The dentate line is an anatomical landmark that separates the outer skin from the internal mucosa. Above the dentate line, pain receptors are largely absent allowing for painless treatment. Therefore, targeting and treating internal hemorrhoids that are above the dentate line can be done in a non-invasive and painless manner.
Infrared coagulation uses laser (light) energy to treat non-protruding, bleeding hemorrhoids. It’s a painless nonsurgical non-invasive in-office hemorrhoid treatment that does not require anesthesia. The infrared energy shrinks the internal hemorrhoid tissue by clotting the blood vessels delivering blood to the internal hemorrhoids with a few short bursts of energy. The hemorrhoids then shrink and reduce in size.
Sclerotherapy is a non-surgical, non-invasive, painless procedure that uses a liquid sclerosing solution. The sclerosing solution is injected into the internal hemorrhoids to scar and shrink down the blood vessels.
Rubber band ligation is an in-office, non-surgical, non-invasive, painless procedure that involves tying rubber bands around the base of the internal hemorrhoid to cut off the blood supply. After several days, the rubber band and hemorrhoid fall off, leaving a small wound that heals within a few weeks.
Call Dr. Maziar Ghodsian to arrange a hemorrhoid treatment evaluation, or use the online booking feature to schedule a photo consult, telehealth consultation, or in-person consultation today.