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 and treatment plan and to exclude a serious illness or condition such as colon or anal cancer. Hemorrhoids are just one of the many causes for 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 can be cured if detected early.
Hemorrhoids are extremely common. By age 50, approximately half of the population has experienced signs of this health condition . 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. If blood pools in an external hemorrhoid, it may form a clot, called a thrombus. This condition can result in severe pain and inflammation. Our doctors can assist in the diagnosis and formulate an effective treatment plan.
Our trained 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?
What are the symptoms of hemorrhoids?
The signs and symptoms 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 serious underlying condition including cancer. Other symptoms of hemorrhoidal disease include: itching around the anus, blood on your tissue after having a bowel movement, 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 symptoms.
Hemorrhoids can be very painful. Visit our NYC hemorrhoids doctors, leading hemorrhoids specialists, for the best hemorrhoid treatment options. Emergency appointments are available at the NYC doctor’s office.
What are the causes of hemorrhoids?
When people need to sit on the toilet for a prolonged length of time, it can interfere with the blood flow to and from the area. Sitting on the toilet for an extended length of 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 do you diagnose and classify 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 and which has a light, is gently inserted into the anus, allowing your physician to visualize the tissues in your anorectal area more clearly.
Our GI 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. Hemorrhoids are divided into three categories: internal (above the dentate line), external (below the dentate line), or mixed (above and below the dentate line).
Colonoscopy may be suggested 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, and this can result 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 hemorrhoids that prolapse on straining, but which reduce naturally.
- Grade III: These are prolapsing hemorrhoids which require manual reduction.
- Grade IV: These are prolapsing, non-reducible hemorrhoids and which includes incarcerated hemorrhoids and acutely thrombosed hemorrhoids (incarcerated hemorrhoids are prolapsed hemorrhoids that are unable to be reduced 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 serious illness or condition such as colon or anal cancer.
These are hemorrhoids 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, conservative therapies are suggested. 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 push the lump back through the anus gently, but this merely changes the location of the hemorrhoid. 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 hemorrhoid 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 it 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 it’s estimated up to 40% of pregnant women have hemorrhoids which without treatment can become prolapsed. Obesity is another risk as the weight puts more strain on the rectal veins, increasing the likelihood of hemorrhoids 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 hemorrhoids and prolapsed hemorrhoids.
A prolapsed hemorrhoid can be especially painful if a blood clot or thrombus has formed within it and this is known as a thrombosed hemorrhoid. A thrombosed hemorrhoid can become acute and will 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 to 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 NYC gastroenterologists as well as hemorrhoid specialists and 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, IRC (Infrared Coagulation), hemorrhoid banding, or rarely, surgery can be performed to remove the hemorrhoids. A complete evaluation and early diagnosis by your hemorrhoid doctor is very important for an accurate diagnosis and treatment plan.
Our renowned NYC gastroenterologists are amongst the best-in-class doctors and specialize in treatment and prevention of 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” specialists 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 hemorrhoid treatment option for you 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 has been shown to be 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. Infrared coagulation is conducted on an outpatient basis in the doctor’s office. Mild sedation can be administered as necessary for the laser hemorrhoid surgery procedure, which usually only takes a few minutes.
Laser for hemorrhoids has been shown to demonstrate effectiveness in improving bleeding and pain symptoms in patients with both internal and external hemorrhoids.
It has been proven that the hemorrhoid laser 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, 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 treatment 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 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 might be the answer.
What Happens During the IRC Procedure?
During the infrared coagulation procedure, our doctors use a handheld device that creates an intense beam of infrared light. 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 the hemorrhoid. This causes the hemorrhoid to shrink and die. A scar forms on the wall of your anal canal where the hemorrhoid was located. As an added benefit, the scar tissue acts to hold 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?
Infrared coagulation treatment is usually covered by most insurances, and you won’t need an overnight stay in a hospital. IRC is more effective than sclerotherapy and may be better tolerated 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 to 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 doctor.
Treatment with IRC (infrared coagulation) is usually very well tolerated with minimal side effects
What Are the Complications of Infrared Coagulation?
There usually are no or few side effects or complications from infrared coagulation, the best hemorrhoid treatment, although infection or bleeding can occur. Although it’s a fairly new technique, it’s been used across the country to treat hemorrhoids successfully.
To keep hemorrhoids from returning, our hemorrhoids doctors recommend the following lifestyle changes. Add more fiber to your diet. Get some exercise. Drink more water. 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 one or two tiny rubber bands are placed around the base of an internal hemorrhoid with a specialized instrument called a syringe ligator. This procedure can also be performed 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 causes hemorrhoids 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 hemorrhoids have dried and withered, the bands are usually passed with bowel movements. You should discuss any concerning symptoms after your procedure with your doctor.
Surgical Options for Hemorrhoid Treatment. Do I need Surgery?
Hemorrhoid surgery is only needed by a small percentage of people and will most likely only be recommended after other less invasive procedures have been unsuccessful. In these cases, a referral to a colorectal surgeon that we work closely with is made. We can discuss the case with the surgeon as well to come up with an effective treatment plan for your case.
Questions regarding further surgical options and recovery should be discussed with your surgeon directly. Surgery is usually recommended after less invasive procedures have been unsuccessful or if they are thought to be unlikely to be successful. Some of the surgical treatments that may be suggested are listed below.
Hemorrhoid surgery is only needed by a small percentage of people and will most likely only be recommended 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 hemorrhoidal disease, though it is associated with the greatest rate of 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 bleeding, 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 prevents blood flow to the haemorrhoidal tissue and is usually any used for prolapsed hemorrhoids.
Treatment is given 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, special tools are used to staple the base of the hemorrhoid to the wall of the rectum using circular titanium staples. During healing, fibrous tissue develops around the staples, which help to anchor the hemorrhoid in place. This prevents blood flow to the hemorrhoid and decreases swelling. Eventually, the staples are passed 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
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 hemorrhoidal disease includes eating more fiber and making sure you remain well hydrated. However, putting this advice into practice is not always so straight forward. Usually, you will need to aim for between 25 and 30 g of fiber each day. This is more than twice the amount found in the average American diet. You should ideally 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. Your treatment should be discussed with your gastroenterologist to make sure 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 useful, it is still essential to see a gastroenterologist for an accurate diagnosis and treatment plan for your condition. We look forward to meeting you.