As a Gastroenterologist one of the most common reasons I see patients in the office is for symptoms related to hemorrhoids. In the past this was always a bit frustrating as the options for treatment were either ineffective or relatively invasive with a difficult recovery. Thankfully my partners and I at Peninsula Gastroenterology Medical Group have found a new device that makes the treatment of hemorrhoids much easier and virtually painless. This has really changed the way we approach the treatment of hemorrhoids. Before discussing the treatment in detail let's review some basics about hemorrhoids.

What Are Hemorrhoids?

Hemorrhoids are swollen veins in the lower rectum or anus. With onset commonly occurring after the age of 30, hemorrhoids will affect more than half the population at some point in their lives. Common causes include constipation, pregnancy, childbirth, obesity, heavy lifting, sitting for long periods and diarrhea. There are two types of hemorrhoids based on location. Internal hemorrhoids occur inside the lower rectum and often can’t be seen or felt. As this form is typically painless, the only symptoms you may notice are small amounts of bright red blood (on your toilet paper or inside the toilet bowl) or a feeling of fullness following a bowel movement. Occasionally, internal hemorrhoids can push through the anal opening. This is known as a prolapsed, or protruding, hemorrhoid. Sometimes these swollen veins remain prolapsed temporarily; in other cases, they become permanent. If the hemorrhoid remains outside the anus, it can cause pain, itching, bleeding and the formation of excess skin (skin tags). External hemorrhoids occur as bulges or lumps around the anus. Because of the sensitive nerve fibers in this area, these enlarged veins are often painful, especially when sitting. They also may bleed and itch. Should blood pool in an external hemorrhoid, a blood clot referred to as a thrombosed hemorrhoid may develop and cause severe pain. The less common of the two forms, external hemorrhoids are often incorrectly self-diagnosed because many people mistake internal hemorrhoids—or the skin tags they can produce—for external hemorrhoids. Always consult a physician to determine whether you have the internal or external type. Home remedies such as creams, suppositories and warm baths may offer temporary relief from the symptoms of hemorrhoids. But for many people, hemorrhoids don’t go away. Instead, they can get progressively worse over time, growing in both size and number. Some chronic sufferers develop hemorrhoids in as many as three locations.

Treatment Options
Conservative Treatment

If the above measures fail we typically recommend a procedure for definitive hemorrhoid treatment.

Hemorrhoid Procedures

At the Peninsula Gastroenterology Medical Group we use the patented and proprietary CRH O’Regan System (TM) , considered the “gold standard” treatment. This highly effective (99.1%), minimally invasive procedure is performed in our offices or endoscopy center in less than a minute. If there are multiple hemorrhoids, we treat them one at a time in separate visits. During the brief and painless procedure, we place a small rubber band around the tissue just above the internal hemorrhoid where there are few pain-sensitive nerve endings. Unlike traditional banding techniques that use a metal-toothed clamp to grasp the tissue, we use a gentle suction device, reducing the risk of pain and bleeding. Advanced cases where the diagnosis is both internal and external hemorrhoids may require additional therapy as rubber banding alone may not be suitable. Our banding procedure works by cutting off the blood supply to the hemorrhoid. This causes the hemorrhoid to shrink and fall off, typically within a day or so. You probably won’t even notice when this happens or be able to spot the rubber band in the toilet. Once the hemorrhoid is gone, the wound usually heals in a week or two. During the first 24 hours, some patients may experience a feeling of fullness or a dull ache in the rectum. This can typically be relieved with an over-the-counter pain medication. However, a remarkable 99.8% of patients treated with our method have no post-procedure pain. In fact, thanks to design improvements, the CRH banding procedure has a ten-fold reduction in complications compared to traditional banding. For more information in regards to this treatment please visit our practice website at Peninsula Gastroenterology Medical Group or the CRH O’Regan System (TM) website. Hopefully this information will clear up some questions about hemorrhoids but please see your physician to make sure your symptoms are due to hemorrhoids and not other forms of colorectal disease.

Some recent articles reviewing banding treatment for hemorrhoids:

Related Articles

• - Bacteria and Your Gut (May 11, 2010)