What Are Hemorrhoids?
Hemorrhoids are swollen and inflamed veins in the rectum and anus that can cause discomfort and bleeding. If you suspect hemorrhoidal disease, you should always be evaluated with a thorough consultation and examination by a physician for an accurate diagnosis, treatment plan and to exclude a serious illness or condition such as colon or anal cancer. Hemorrhoidal disease is just one of the many causes of rectal bleeding and lesions around the anus that need evaluation. Rectal bleeding can be a symptom of any type of colorectal or anal cancer, a type of cancer that is curable if detected early.
A complete evaluation and early diagnosis by your local hemorrhoid doctor are critical. Rectal bleeding can be a symptom of any type of colorectal or anal cancer, a type of cancer that is curable if detected early.
Piles are extremely common. By age 50, approximately half of the population has experienced signs of this health condition . You can get piles inside your anal canal, where they’re called internal hemorrhoids, or under the skin around your anus, where they’re called external hemorrhoids. If blood pools in external hemorrhoid, it may form a clot called a thrombus. This condition can result in severe pain and inflammation.
This health condition can be very painful. Visit our NYC hemorrhoids doctors for the best hemorrhoid treatment options, including laser hemorrhoid treatments. Emergency appointments are available at the NYC doctor’s office.
Our trained, best-rated hemorrhoid doctors offer several minimally invasive and effective treatment options, including infrared coagulation and hemorrhoid banding.
What Are the Treatments We Offer at Manhattan Gastroenterology?
At Manhattan Gastroenterology, our doctors are not only top-rated NYC gastroenterologists. They are also best-in-class hemorrhoid specialists. They offer varying hemorrhoidal disease treatments, including minimally invasive laser hemorrhoid treatments and other effective treatment options.
In mild cases, topical medications and conservative treatment such as sitz baths and laxatives can help to alleviate symptoms.
In other cases, we can perform IRC (Infrared Coagulation), hemorrhoid banding, or rarely surgery to remove the piles. A complete evaluation and diagnosis by your hemorrhoid doctor are very important for an accurate diagnosis and treatment plan.
When Should I See My Hemorrhoid Doctor?
You should see a hemorrhoid specialist if you feel discomfort and pain in the rectum, especially when you sit or notice blood when wiping. Don’t put off seeing a doctor if you notice your hemorrhoids bleeding, symptoms get drastically worse or if they start interfering with your daily activities. Seek emergency medical care immediately if you experience a large amount of rectal bleeding (including painless bleeding) accompanied by dizziness.
What Are the Symptoms of Hemorrhoids?
The symptoms and signs of hemorrhoids depend on the type, but the most common sign is rectal bleeding when you pass feces. Usually, the blood is not mixed in with the stool but instead will coat the outer surface or is visible on toilet paper. The blood tends to be bright red and is also sometimes visible in the toilet.
Rectal bleeding, however, should always be evaluated by a physician or your local hemorrhoids treatment doctor, as it can be a symptom of a severe underlying condition, including cancer.
Other hemorrhoid symptoms include:
- Itching around the anus
- Blood on your tissue after having a bowel movement
- An itchy or painful lump or swelling near your anus
- Painful bowel movements, irritation, and pain around the anus
- Rectum pain while sitting and many other signs
What Are the Causes of Hemorrhoids?
Several factors can cause the condition, but often, the exact reason for hemorrhoids is unknown. Traditionally, this health issue is associated with straining during bowel movements or with chronic constipation.
When people need to sit on the toilet for a prolonged time, it can interfere with the blood flow to and from the area. Sitting on the toilet for an extended time can cause the blood to pool, enlarging the blood vessels.
You can get hemorrhoids inside your anal canal, where they’re called internal hemorrhoids, or under the skin around your anus, where they’re called external hemorrhoids.
How To Classify and Diagnose Hemorrhoids?
Our gastroenterologists are hemorrhoids specialists and will perform a complete physical examination, including a rectal exam and anoscopy, at our NYC offices as part of your evaluation. An anoscopy is a procedure where a device called an anoscope with light is gently inserted into the anus, allowing your physician to visualize the tissues in your anorectal area more clearly.
Our GI hemorrhoids doctors may also suggest a colonoscopy for full visualization of your colon and to rule out other more serious causes of your symptoms. Colonoscopy is the gold standard for visualization of the entirety of the colon for a proper diagnosis.
There are three types of hemorrhoids:
- internal hemorrhoids (above the dentate line)
- external hemorrhoids (below the dentate line)
- mixed hemorrhoids (above and below the dentate line)
The specialist may suggest colonoscopy for full visualization of your colon and to rule out other more serious causes of your symptoms.
Internal hemorrhoids are inside the rectum and usually cannot be felt or seen. Symptoms of internal hemorrhoidal disease may include bleeding when passing a stool or seeing bright red blood on toilet paper or in the toilet. Straining can cause hemorrhoids to push through the anal opening, where it becomes prolapsed or protrudes, resulting in irritation and pain. If the veins in your lower rectum or anus swell and create an outward bulge, it’s called a prolapsed hemorrhoid.
Internal hemorrhoids are further categorized — and treated — according to their degree of prolapse:
- Grade I: These are non-prolapsing hemorrhoids.
- Grade II: These are piles that prolapse on straining but which reduce naturally.
- Grade III: These are prolapsing hemorrhoids that require manual reduction.
- Grade IV: These are prolapsing, non-reducible hemorrhoids, including incarcerated hemorrhoids and acutely thrombosed hemorrhoids (incarcerated hemorrhoids are prolapsed hemorrhoids that we cannot reduce into the anal canal).
However, if an internal hemorrhoid bleeding is causing you pain and discomfort, you should see the best hemorrhoid doctors in NYC right away. Your symptoms should always be evaluated by a physician for an accurate diagnosis and treatment plan and to exclude a severe illness or condition such as colon or anal cancer.
These are piles that develop under the skin around the anus and which can become thrombosed. You may notice signs and symptoms that include pain and bleeding. The area around your anus may be swollen. You could have irritation or itching in the anal region. If external hemorrhoids become acutely thrombosed, we recommend conservative therapies. In certain cases, these patients are referred for excision by a colorectal surgeon.
If the vein in your lower rectum or anus swells and causes hemorrhoids, creating an outward bulge, it’s called a prolapsed hemorrhoid. A prolapsed hemorrhoid can be quite painful. The main symptom of a prolapsed hemorrhoid is feeling one or more lumps around the anus, but usually, this symptom only occurs if you have a significant prolapse.
Sometimes it may be possible to gently push the lump back through the anus, but this merely changes the location of the piles. Although it may help to ease some symptoms, it will not cure the problem. Prolapsed hemorrhoids tend to be quite painful when sitting and can hurt during bowel movements.
Protrusive hemorrhoids can collect small amounts of tiny stool particles and mucus, potentially causing an irritation called pruritus ani. Unfortunately, continually wiping the area to relieve the itching can worsen the irritation.
What Causes a Prolapsed Hemorrhoid?
Hemorrhoids can become prolapsed when the connective tissues holding them in place begin to weaken. One possible cause is straining during bowel movements and especially if you suffer from diarrhea or constipation.
Pregnancy also increases the risk, and up to 40% of pregnant women have hemorrhoids that can become prolapsed without treatment. Obesity is another risk as the weight puts more strain on the rectal veins, increasing the likelihood of piles and prolapsed internal and external hemorrhoids. If you smoke, it can harm your blood vessels, including those in your anus and rectum, which in turn increases your risk of hemorrhoidal disease and prolapsed hemorrhoids.
A prolapsed hemorrhoid can be especially painful if a blood clot or thrombus has formed within it. This condition is known as a thrombosed hemorrhoid. A thrombosed hemorrhoid can become acute and frequently develop in people with severe constipation or who have a history of straining for prolonged periods when they go to the toilet.
Usually, the pain is worst during the first 24 to 48 hours. After this time has elapsed, the thrombosis is gradually absorbed, lessening the pain. A thrombosed hemorrhoid can look like a blue-colored lump.
Although a thrombosed hemorrhoid isn’t as dangerous as developing blood clots in other areas of the body, you may need professional treatment to drain and relieve severe pain. Prolapsed hemorrhoids can also cause significant pain if they become strangulated, where the blood supply to the hemorrhoid is cut off.
Symptoms of a thrombosed hemorrhoid include:
- A hard lump near the anus
- Pain which may be severe
An excisional haemorrhoidectomy is a surgical technique to remove excess tissue that is causing the bleeding. The surgery can be performed under general anesthesia or using spinal anesthesia or sedation. It is a highly effective way to treat severe and recurring hemorrhoids, and the procedure cures 95% of cases. The risk of complications is low. During surgery, one or more incisions are made near the hemorrhoid to remove it. The incisions are then closed or may be left open.
Hemorrhoid Treatment Options
At Manhattan Gastroenterology, our doctors are top-rated New York City gastroenterologists and hemorrhoid specialists who offer varying hemorrhoidal disease treatments according to their severity. In mild cases, conservative therapy is offered, which may include sitz baths, laxatives, OTC, or prescription medications. In other cases, we can perform IRC (Infrared Coagulation), hemorrhoid banding, or rarely surgery to remove the piles. Your top hemorrhoid doctor specialist’s complete evaluation and early diagnosis are essential for an accurate diagnosis and treatment plan.
Our renowned Manhattan gastroenterologists are among the best-in-class doctors and specialize in treating and preventing conditions related to swollen and inflamed veins in the rectum, referred to as hemorrhoids. You can finally stop your search for a “hemorrhoid specialist near me” and call the best-rated team of gastroenterologists, leading hemorrhoidal disease treatment doctors in NYC for an appointment. A board-certified “hemorrhoid doctor near me” specialist who will not only help you with your pain but also employs the latest cutting-edge hemorrhoidal disease treatments.
Our gastroenterologists in New York might recommend one of the minimally invasive procedures, including hemorrhoid banding and IRC (Infrared Coagulation).
For more information about the best bleeding hemorrhoid NYC treatment or to schedule a consultation with one of our hemorrhoids specialist GI doctors, please contact our office.
Laser Treatment for Hemorrhoids
While there are many techniques for treating hemorrhoids, laser hemorrhoid removal is an effective, fast-acting, and the best hemorrhoid treatment course of action. Our doctors, best-in-class Upper East Side NYC gastroenterologists, have completed special training in applying IRC and have treated many patients successfully.
Laser hemorrhoids treatment uses infrared light, a laser, or an electrical current with the same efficiency. We conduct infrared coagulation on an outpatient basis in the doctor’s office. We may administer mild sedation as necessary for the hemorrhoid laser surgery procedure, which usually only takes a few minutes.
Laser for hemorrhoids demonstrates effectiveness in improving bleeding and pain symptoms in patients with internal and external hemorrhoids.
It has been proven that the laser hemorrhoid treatment procedure is more effective than rubber band ligation in reducing postoperative pain, resolving symptoms, and improving quality of life in patients with grade II or III hemorrhoids with incomplete mucosal prolapse.
What Is Infrared Coagulation?
Infrared coagulation is a minimally invasive, state-of-the-art office-based option that uses infrared light or heat to treat your hemorrhoidal disease. Infrared Coagulation (IRC) has quickly become one of the most widely used office laser treatments for hemorrhoids.
The IRC or Infrared coagulator has a light source at its tip, which applies heat to the base of the hemorrhoid column. This procedure causes scar tissue to form at the site and can lead to the shrinking or disappearance of the hemorrhoid column. This procedure is usually very well tolerated with minimal side effects. Each treatment will only take a few minutes, and you may need several separate treatments to ensure all areas are covered. Patients can often return to work and their regular activities soon after treatment.
Why You May Need Infrared Coagulation?
Infrared coagulation is effective in treating hemorrhoids of both small- and medium-size. If you’re suffering from irritating internal hemorrhoids that continue to cause pain, bleeding and other symptoms not responding to conservative management, IRC treatment for hemorrhoids in NYC might be the answer.
What Happens During the IRC Procedure?
Our hemorrhoid doctors use a handheld device that creates an intense beam of infrared light during the infrared coagulation procedure. A small probe makes contact with the skin above the hemorrhoid, exposing the tissue to a quick pulse of infrared light. The heat from the infrared light burns the tightly targeted area, coagulating the vein above the hemorrhoid.
The resulting scar tissue cuts off the blood supply to hemorrhoid, causing it to shrink and die. A scar forms on the wall of your anal canal where a hemorrhoid has formed. As an added benefit, the scar tissue holds nearby veins in place so they don’t bulge into the anal canal and become hemorrhoids.
How Is IRC Hemorrhoid Treatment Performed? Is It Painful?
Most insurances usually cover infrared coagulation treatment, and you won’t need an overnight stay in a hospital. IRC is more effective than sclerotherapy, and you may tolerate it better than rubber band ligation in some cases.
What Does Infrared Coagulation Preparation Involve?
In most cases, there is no preparation necessary. Our hemorrhoid doctor, the best gastroenterologist in NYC, will need to examine you to decide on the ideal hemorrhoids treatment plan in your case.
What is Recovery like after IRC (infrared coagulation)?
After each treatment, it is normal to feel the urge to have a bowel movement and experience slight rectal bleeding. It is usually well-tolerated, but it can be helpful to use a stool softener to ease bowel movements during healing. Warm shallow baths such as a sitz bath can help to aid the healing process. You should discuss any concerning symptoms after your procedure with your proctologist in NYC.
Laser treatment of hemorrhoid with IRC (infrared coagulation) is usually very well tolerated with minimal side effects
What Are the Complications of Infrared Coagulation?
There are usually few side effects or complications from infrared coagulation, the best hemorrhoid treatment in NYC, although infection or bleeding can occur. Although it’s a relatively new technique, doctors have used it to treat hemorrhoids successfully across the country.
To keep the hemorrhoidal disease from returning, our doctors recommend the following lifestyle changes. Add more fiber to your diet. Eating foods high in fiber can make stools softer and easier to pass and help treat and prevent hemorrhoids. Get some exercise, drink more water, and lose weight, if necessary. A sensible diet, moderate exercise, and proper bowel habits will help you remain free of this uncomfortable medical condition.
Hemorrhoid banding or rubber band ligation is where the specialist places one or two tiny rubber bands around the base of internal hemorrhoid with a specialized instrument called a syringe ligator. This procedure with a banding kit accessory on the tip of a standard colonoscope which is our practice.
The rubber bands are applied proximal to the hemorrhoidal column, thus, decreasing their blood supply and causing piles to shrink. Usually, treatment will only take a few minutes, but the process may be longer if you have multiple hemorrhoids. Rubber band ligation is widely used and is effective for removing medium-sized internal hemorrhoids.
What is the recovery after hemorrhoid banding?
Sometimes treatment may feel uncomfortable and can cause bleeding, but side effects are usually minor. Your physician may recommend laxatives to help prevent constipation or that you use a stool softener. Once the piles have dried and withered, the bands usually pass with bowel movements. You should discuss any concerning symptoms after your procedure with your doctor.
Surgical Options for Hemorrhoid Treatment. Do I need Surgery?
Only a small percentage of people require hemorrhoid surgery, and we will most likely recommend it after other less invasive procedures have been unsuccessful. In these cases, we make a referral to a colorectal surgeon that we work closely with. We can discuss the case with the surgeon to develop an effective treatment plan for your case.
You should discuss questions regarding further surgical options and recovery with your surgeon directly. We usually recommend surgery after less invasive procedures have been unsuccessful or are unlikely to be successful. Some of the surgical treatments that we may suggest are listed below.
Only a small percentage of people require hemorrhoid surgery, and we will most likely recommend it after other less invasive procedures have been unsuccessful.
What is Hemorrhoidectomy?
Hemorrhoidectomy is a type of surgery to remove internal or external hemorrhoids that are extensive or severe. Surgical hemorrhoidectomy is an effective treatment for a hemorrhoidal disease, though it is associated with the most complications. An excisional haemorrhoidectomy is a surgical technique to remove excess tissue that is causing the bleeding. The surgery can be performed under general anesthesia or using spinal anesthesia or sedation. It is a highly effective way to treat severe and recurring hemorrhoids, and the procedure cures 95% of cases. The risk of complications is low. During surgery, one or more incisions are made near the hemorrhoid to remove it. The incisions are then closed or may be left open.
What Is Recovery After Hemorrhoidectomy Surgery?
After the surgery, you might be able to go home the same day, or more likely, you will need to spend one night or longer in hospital. During the first few days, the incision may cause pain and bleed, and you may have bleeding with bowel movements for several weeks after. Usually, it’s necessary to take 7 to 10 days off work.
What Is Stapled Hemorrhoidopexy?
Stapling hemorrhoids prevent blood flow to the haemorrhoidal tissue, and we usually use them for prolapsed hemorrhoids.
Your doctor performs the treatment using general anesthesia or local or spinal anesthesia. If you choose local or spinal anesthesia, you may feel some pressure during surgery, but you shouldn’t feel any pain. During surgery, the specialist uses special tools to staple the base of hemorrhoid to the rectum wall using circular titanium staples. During healing, fibrous tissue develops around the staples, which help to anchor hemorrhoids in place, preventing blood flow to hemorrhoids and decreasing swelling. Eventually, the staples pass out with bowel movements.
What is Recovery After a Stapled Hemorrhoidopexy?
After surgery, you may need to spend a night in hospital, and you may feel a sensation of pressure in your rectum for the first one or two days after. During the first few days, you may have a small amount of bleeding from your rectum. Bowel movements could cause some bleeding and discomfort for several weeks.
Frequently Asked Questions
How To Prevent Hemorrhoids?
One of the ways to prevent hemorrhoids is to keep your stool soft. If you are wondering how to avoid hemorrhoids, we have prepared a list of tips that you can make use of:
- Drink a lot of water. To help keep your stool soft, we recommend drinking six to eight glasses of water a day.
- Eat high-fiber foods. Specialists recommend consuming more fruits, whole grains, and vegetables. These products soften the stool.
- Consider fiber supplements. The recommended amount of fiber is around 20-30 grams a day. But most people do not consume the recommended amount. Numerous studies have proven that over-the-counter fiber supplements improve the overall signs of hemorrhoidal disease.
- Exercise. You should stay active to help prevent constipation and reduce pressure on your veins, which occurs when you stand for a long time. Physical activity can also help you lose excess weight, which can be a trigger for your hemorrhoids.
- Do not sit for a long time. Sitting too long, especially on the toilet, can increase the pressure on the veins in the anus.
- Avoid straining. Holding your breath and straining when trying to pass a stool causes greater pressure in the veins in the lower rectum.
How Long Do Hemorrhoids Last?
It is not possible to state the exact time frame. Everything depends on the severity of the condition. Your symptoms might disappear in a few days without treatment if your hemorrhoids are small. It might also be needed to make minor modifications to your diet and lifestyle. Prolapsed hemorrhoids that stick out of the anus might require treatment from a specialist and will take longer to heal.
Some women develop this condition during pregnancy because of the increased pressure in the abdomen. In this case, signs of this health condition will disappear after giving birth. Your best bet would be to contact a leading proctologist in NYC for an accurate hemorrhoids diagnosis and effective treatment.
Are There Any Home Remedies for Hemorrhoids?
You can sometimes manage moderate pain, swelling, and inflammation of hemorrhoids with home treatments, such as:
- Aloe vera. Historically, people widely used aloe vera to treat hemorrhoidal disease and certain skin conditions. People believe it has anti-inflammatory properties that assist in reducing irritation.
- Witch hazel. This product can reduce pain, itching, and swelling. You can purchase it in liquid form and apply it directly to hemorrhoids.
- A warm bath with Epsom salt. A warm bath can manage the irritation from hemorrhoids. We recommend taking a warm bath for 20 minutes after every bowel movement. You can achieve greater relief by adding Epsom salts to the bath.
Why Do Hemorrhoids Bleed?
Are Hemorrhoids Bad?
How Do Hemorrhoids Look and Feel?
Is It an Anal Fissure or a Hemorrhoid?
Are Hemorrhoids Contagious?
Can You Pop Hemorrhoid?
What About Diarrhea and Hemorrhoids?
How Can I Tell If It Is Hemorrhoids or Cancer?
Can Anal Sex Cause Hemorrhoids?
Can You Push a Hemorrhoid Back In?
Can Alcohol Cause Hemorrhoids?
What Are Alternative Names for Hemorrhoids?
Are There Any Specific Diets or Alternative Therapies for Hemorrhoids?
The most common advice for the hemorrhoidal disease includes eating more fiber and making sure you remain well hydrated. However, putting this advice into practice is not always so straightforward. Usually, you will need to aim for between 25 and 30 g of fiber each day. This amount is more than twice the amount found in the average American diet. Ideally, you should aim to drink between six and eight glasses of water and other liquids each day, not including alcohol and coffee, which are diuretics. Many alternative hemorrhoid treatments include lifestyle remedies. Listed below are a few tips to help reduce the symptoms of this health issue. You should discuss your treatment with your gastroenterologist to ensure it is the right next step for you.
- Avoid straining when trying to pass a stool, as this creates greater pressure on the veins in your lower rectum.
- If you feel the urge to pass a bowel movement, try to go as soon as you can.
- Exercise helps to prevent constipation.
Although these lifestyle remedies can be helpful, it is still essential to see a gastroenterologist for an accurate diagnosis and treatment plan for your condition. We look forward to meeting you.
As the best-in-class gastroenterologists, our hemorrhoid doctors provide highly personalized and comprehensive care. Their philosophies regarding the doctor/patient relationship are based on trust and have earned them some of the most respected reputations in New York.
For more information about hemorrhoid treatment options or to schedule a consultation with one of our hemorrhoid specialists, please contact our NYC gastroenterology office.