Extreme strain in the rectal region can put so much pressure on the area’s veins that a hemorrhoid forms. They can be painful, itchy, and cause bleeding. Less severe cases can often be treated at home with warm baths, over-the-counter creams like Preparation H, decreasing the amount of time spent sitting, and adding more fiber to your diet. An anti-inflammatory can help manage the pain, and hydrocortisone cream may relieve the itching. However, these options don’t always provide a “cure”. While they may deal with symptoms, and even send hemorrhoids into a sort of remission, in some cases, it’s necessary to go to the doctor for more extreme measures.
Minimally Invasive Procedures
A thrombus forms when an external hemorrhoid creates a pool of blood which then clots. With a small incision, a doctor can remove the clot and relieve the associated pressure. The most effective treatment for stubborn internal hemorrhoids is also, unfortunately, one of the more painful. Rubber band ligation involves cutting off the blood supply to the hemorrhoid by putting a rubber band around it. It usually takes about a week for the hemorrhoid to shrivel sufficiently that it simply falls off. There may be bleeding and pain for a few days, but most patients do not find the procedure unmanageable.
Sclerotherapy is a less painful (but often less effective) option. An injection of chemicals like quinine or zinc chloride is placed directly into the hemorrhoid, which subsequently shrinks. Coagulation uses different kinds of lasers or lights to make hemorrhoids harden and grow smaller. This option of laser, infrared or bipolar light, or heat is good for hemorrhoids that won’t quit bleeding. While there’s little pain or discomfort associated with it, there’s also a much higher chance the hemorrhoids will come back than with other techniques.
A stapled hemorrhoidectomy stops hemorrhoidal tissue from receiving blood. While it has a faster healing time and patients report less pain, there’s also a chance of rectal prolapse (the rectum falls out) and hemorrhoids come back more often than when a complete hemorrhoidectomy is performed.
A hemorrhoidectomy surgically removes all of the hemorrhoidal tissue causing bleeding. There are various ways this may be performed, depending on patient needs and hemorrhoid severity. The patient may be completely anesthetized, or the doctor may opt for a local or spinal anesthetic and sedation. While it is the best, most complete way to get rid of problematic hemorrhoids, it is also quite painful. Some problems have also been reported with urinating and urinary tract infections. However, many patients find the one-time pain of a hemorrhoidectomy preferable to the recurrent pain of recurring hemorrhoids.