Good News About Hemorrhoids

If you have a problem with hemorrhoids, you are certainly not alone. Did you know that three out of four people will develop hemorrhoids at some time in their lives? In fact, millions of Americans visit their doctor in the U.S. each year with symptoms of hemorrhoids. While many people associate hemorrhoids with painful surgery, only a small percentage of patients actually require surgery. Most can be treated with a high fiber and topical preparations to soothe the area.

When simple measures fail, however, more aggressive treatment may be needed. In the past, this usually meant painful surgery. The good news is that new comfortable office treatments have taken the fear out of hemorrhoids. This article has been prepared to help you understand one new technique that can eliminate some hemorrhoids without the need for surgery - Infrared Coagulation (IRC).

(For other physicians, the source of this device is the REDFIELD corporation in Montvale New Jersey. They can be reached for more information at 1-800-678-4472)

What Are Hemorrhoids And Who Gets Them?

Hemorrhoids are simply enlarged veins - much like varicose veins of the lower leg - that may protrude through the anus on straining. Hemorrhoids never turn to cancer, but can cause troublesome symptoms such as bleeding, pain, itching, swelling, and obstruction. Both men and women get hemorrhoids. They affects all ages but are more common after age 50.

What Causes Hemorrhoids?

We don't know for sure, but hemorrhoids are often found in people who either sit or stand a lot or who have low fiber diets or poor bowel habits. Pregnancy is often the culprit. Once hemorrhoids form, they are often permanent. However, they may seem to "come and go" as they swell intermittently and cause symptoms.

Are Hemorrhoids Preventable?

No one knows for sure. Avoid straining or extensive sitting on the toilet. A diet rich in fluids, fruits, vegetables and fiber is desirable. If symptoms develop, it is important to see your doctor without delay to be sure that any symptoms you may have are really due to hemorrhoids and not due to another more serious condition such as cancer.

Are There Different Kinds Of Hemorrhoids?

Yes- the come in two varieties. Internal hemorrhoids develop inside the anus. The most common symptoms are bleeding during bowel movements or protrusion through the anus upon straining. External hemorrhoids develop around the anus and can be very painful, especially if a blood clot develops within them. They can be felt as a firm lump or lumps around the anus.

How Are Hemorrhoids Treated?

When treated early, hemorrhoids usually disappear within a week or two. By increasing fiber and fluids in your diet, your stool will soften thereby promoting more regular bowel movements. It also helps to eliminate excessive straining and to take warm baths.

Most painful external hemorrhoids will respond to rest and warm sitz baths. Within a week the pain should subside. The firm lump should completely recede within 4-6 weeks. If pain is severe, the physician may decide to make a small incision under anesthesia and remove the clot to provide immediate relief.

When symptoms of bleeding, pain, obstruction do not respond to simple measures, more aggressive treatment is often needed. In the past this meant surgery. Now your doctor has new techniques available to treat many cases of hemorrhoids without painful surgery - one of which is Infrared Coagulation.

What Is Infrared Coagulation?

Infrared Coagulation (IRC) has quickly become the most widely used office treatment for hemorrhoids and is preferred over other methods because it is fast, well-tolerated by patients, and virtually problem-free. A small probe contacts the area above the hemorrhoid, exposing the tissue to a burst of infrared light for about one second. This coagulates the veins above the hemorrhoid causing it to shrink and recede.

You can think of a hemorrhoid like a venous lake that is fed by many small streams, or veins. Blood flowing from these veins keeps the hemorrhoid full of blood and swollen. This often leads to symptoms of bleeding and painful swelling. Since the hemorrhoids are located in an area that is full of sensitive nerve endings, it is too painful to coagulate the hemorrhoids directly.

Fortunately, there is a simple, painless, and effective alternative. For some reason, the small veins that feed the hemorrhoids lie in an area that has very few nerve endings and very little feeling. With IRC, your doctor can take advantage of this fact by going above the hemorrhoids and destroying these small veins. In this way, the pain sensitive area is avoided. Destroying these small veins stops the flow of blood to the hemorrhoids just like blocking a river will dry up a lake.

How is IRC done?

This technique could not be simpler. There is no laxative preparation or need for fasting before this procedure. You don't need a driver to accompany you. After changing into a patient gown and signing a permission form, you will be asked to lie on your left side on the padded exam table. After examining the rectum with a lubricated glove, the doctor will insert a short plastic scope called an anoscope. This is not painful but will cause a feeling of fullness in the anal area. The doctor can now view the hemorrhoids directly. Once the "target" is identified, he will pass a small infrared probe above the hemorrhoids. He will then apply 5 - 10 short bursts of Infrared light. Much like a laser, this generates heat which destroys these "feeder" veins.

Is IRC painful?

The patient may feel a sensation of heat very briefly, but since the treatment is done in an area which lacks pain fibers, it is generally not painful. Therefore anesthetic is usually not required.

What is the success rate of IRC?

The success of this technique depends upon many factors such as the size and duration of the hemorrhoid. In general, about 85% of individual report a satisfactory response to treatment. That "cure" rate is somewhat diminished when a large hemorrhoid has been neglected for many years. It is best to treat them when they are small are more readily curable.

Are There Any After Effects?

Generally not. Most patients return to a normal lifestyle the same day. There may be slight spot bleeding a few days later. Heavy straining or lifting should be avoided and aspirin should not be taken for a few days. We ask our patients to stay on a high fiber diet and to use a fiber supplement such as Citrucel daily for the duration of treatment.

How Many Visits Are Required?

Each treatment takes about 2 minutes and most patient require several trips a few weeks apart to destroy all of the "feeder" veins. Over time, this causes the hemorrhoids to shrink and, in many cases, disappear completely. Even if the hemorrhoid is not totally eliminated, the shrinkage usually stops troublesome symptoms such as bleeding, pain, and protrusion.

Will The Hemorrhoids Come Back?

Millions of patients have been treated with IRC. Experience tells us that hemorrhoids treated with IRC generally do not recur. A sensible diet, moderate exercise and proper bowel habits will also help.