The term “hemorrhoid” has been used to refer to both normal anatomic tissue and pathologic structure. Hemorrhoid diseases are swollen and varicose blood vessels in the lower rectum. They are among the most common causes of anal complaints in the office visits.
Hemorrhoids diseases include internal hemorrhoids, external hemorrhoids, anal tags, thrombosis of hemorrhoids and mixed hemorrhoids. Internal hemorrhoids are graded from I to IV based on the degree of prolapse. Besides causing anal itching, pain, bleeding and prolapse, hemorrhoids could cause other complications, such as thrombosis, anemia, and infection. Moreover, many hemorrhoid patients have a comorbidity of anal fissure, fistula, or anal warts. Because no single treatment modality can fix all hemorrhoids, a true hemorrhoid clinic will offer multiple treatment modalities and options to meet a patient’s specific needs and provide complete care.
If you are treated with single modality for your hemorrhoids, regardless of the severity, type of hemorrhoids, and associated anorectal conditions, it leads to poor results because of poor quality care.
Internal hemorrhoid Grade 1
Very early hemorrhoids can often be effectively dealt with by dietary and lifestyle changes. The lifestyle changes should also be part of the treatment plan for more advanced hemorrhoids.
1. Eating plenty of high-fiber foods
2. Drinking plenty of fluids
3. Keeping stool soft
4. Good toilet habits
5. Doing exercise regularly, but avoid heavy lifting
6. Reducing weight
Internal hemorrhoid Grade 1-2
Infrared coagulation (IRC) is a non-surgical treatment that is fast, well tolerated, and remarkably complication-free. The infrared light quickly coagulates the vessels that provide the hemorrhoid with blood, causing the hemorrhoids to shrink and recede.
Internal hemorrhoid Grade 3
The third grade internal hemorrhoids can be treated with the combination of infrared coagulation and rubber band ligation (banding). Rubber band ligation is widely used for the treatment of more advanced (more prolapsed) internal hemorrhoids where the prolapsed hemorrhoidal tissue is pulled into a double-sleeved cylinder to allow the placement of rubber bands around the tissue. Over time, the ligated tissue dies off. Rubber band ligation downgrades the hemorrhoids to grade 1 or 2, so some patients may need to do Infra-Red Coagulation (IRC) treatments after rubber band ligation.
Internal hemorrhoid Grade 4
A hemorrhoidectomy surgically removes the tissue that causes bleeding or protrusion. It is done in a doctor’s office, surgical center, or hospital under anesthesia and may require a period of inactivity.
External hemorrhoidal tags (anal tags)
Small and asymptomatic tags don’t need any treatment. If symptomatic, anal tags can easily be removed in the office using a local anesthetic and a radiofrequency device.
Thrombosed external hemorrhoids
These hemorrhoids are typically treated with either incision to remove the clot or with external hemorrhoidectomy. Simply draining the clot usually relieves the pain immediately, but it may not work well if multiple thromboses exist as it can also lead to recurrence, so it is better for patients with multiple thromboses to completely excise the thrombosed hemorrhoids.
Small and asymptomatic external hemorrhoids don’t need any treatment, however most patients will have an intermittent flare up. Eventually patients may need surgery (external hemorrhoidectomy) if you have large external hemorrhoids and/or persistent symptomatic external hemorrhoids.