Category Archives: Anorectal Diseases

This Was Minnesota’s Most Googled Health Condition of 2018 | Minnesota

When you think of medical conditions or illnesses related to Minnesotans, you may assume something along the lines of frostbite, pneumonia, dry skin, or just anything related to the state’s extremely cold winters. However, a study of the most frequently Googled health condition in every US state in the past year revealed that the Land of 10,000 Lakes is most concerned about…hemorrhoids.

Credit: Medicare Health Plans

According to Patch, Medicare Health Plans first tapped Google Trends to identify the most-searched medical terms overall, then added conditions for a second search to find out which states had the highest search volume for each medical condition.

Despite hemorrhoids coming in number one for Minnesota, it doesn’t necessarily indicate a high prevalence of hemorrhoids amongst Minnesotans. A higher search rate for a specific condition may simply show “what people in a specific area are most concerned about regarding their health or the health of a loved one.” For example, attention deficit hyperactivity disorder (ADHD) was the most Googled condition in nine states, but this doesn’t signify that ADHD is vastly prevalent in all nine states.

But it’s clear that Minnesotans ARE concerned about hemorrhoid care and hemorrhoid prevention. At One Stop Medical Center, we offer a range of treatment options tailored to each patient’s needs. For more information on hemorrhoid care, please contact us at (952) 922-2151, or visit our Edina office at 6545 France Avenue South, Suite 290.

 

How Botox Can Help Treat Your Chronic Anal Fissure | Minnesota

While Botox is often associated with battling wrinkles and fine lines on the face, the medication can actually be used in your…anal region. But not for cosmetic purposes, of course.

The muscle-relaxing effects of botulinum toxin can do wonders for patients suffering from painful anal fissures, an anorectal condition that produces sharp rectal pain during bowel movements due to a tear in the anal canal. Typically caused by hard bowel movements or a lack of dietary fiber, fissures usually resolve on their own after responding positively to increased fiber intake, stool softeners, ointments and sitz baths. However, when a fissure fails to heal within six weeks (thereby becoming a chronic fissure), a Botox injection is most likely the preferred plan of attack.

Because Botox blocks the release of acetylcholine, a chemical that causes muscles to contract, injecting it into the muscle surrounding the anus will relax those muscles and reduce tension. Not only does this decrease pain and discomfort, but it also improves blood flow to the fissure, helping it heal more quickly and naturally.

Requiring no anesthetic and only a few minutes on the exam table, the Botox procedure involves 6-8 consecutive injections into the sphincter muscle using a hair-thin needle. And then, you’re done! Patients can simply head home and wait for the Botox to start working after 2-3 days. There usually aren’t any side effects, although slight bleeding/pain and gas incontinence can occur.

Effects should last for at least three months—plenty of time for the fissure to fully heal on its own. With a roughly 70 percent success rate, Botox is a highly preferred method for treating chronic, painful anal fissures.

For more details on what happens before, during and after a Botox injection procedure, click here. If you find yourself dealing with a chronic anal fissure, please contact our clinic for treatment options.

 

Try These 8 Tips to Relieve Constipation | Minnesota

Constipation is one of the most common bowel disorders affecting American adults, with roughly 20 percent of the population suffering from hard, painful stools. Defined as having fewer than three bowel movements per week for several weeks, constipation occurs when the colon absorbs too much water from the food passing through it, creating dry stool that’s extremely difficult to pass.

While constipation is never pleasant, there are a few ways to manage and improve symptoms so that other complications—like hemorrhoids—don’t set in. Below are a few tips for boosting your bowel movements:
 
1. Eat more apples – This juicy fruit is packed with pectin fibre, which has been found to help relieve constipation and slow down the absorption of excess dietary fats, making you feel fuller for longer. The sorbitol in apple juice also has a laxative effect.

2. Eat more raisins and figs – If apples aren’t your thing, perhaps these two dried fruits can be added to your diet. High in fiber, raisins and figs are even more beneficial to your digestive system when soaked in water.

3. Exercise more – Being more active is always beneficial to your health! Hitting the gym or simply going for a jog outside helps aid food breakdown and reduce the time it takes food to move through the large intestine. The less time food sits in your colon, the more water it retains to help ease stool passage later.
 
 
4. Hydrate – Retaining water in your stool is the key takeaway here, so drinking more fluids is critical. When you don’t drink enough water, your body absorbs more water from the food you eat in order to make up for the imbalance.

5. Try over-the-counter medications – For a quicker fix, laxatives (used in moderation) can help with constipation. These substances work to loosen your stools and increase bowel movements pretty quickly.

6. Don’t hold your poop – If you feel even the slightest urge, go to the bathroom! Holding your bowel movements causes stools to sit longer in the colon, increasing the amount of water absorbed. Definitely not what we want!

7. Drink some coffee – Despite being a diuretic that can dehydrate you if consumed in large quantities, coffee has been shown to stimulate the muscles in your digestive system. Small amounts of soluble fiber in coffee can also boost the balance of your gut bacteria.

8. Try probiotics – Studies have shown that Bifidobacterium, a bacteria of the gastrointestinal tract, can aid in digestion and reducing constipation. Yogurt, fermented vegetables (kimchi, miso, sauerkraut), cured meats, vinegar and sourdough bread are good options for increasing your probiotics intake.

 

The Many Causes of Anal Skin Tags | Minnesota

While anal skin tags are extremely common, they’re very rarely cause for alarm. These non-cancerous, benign small bumps or raised areas around the anus are essentially excess skin growths that develop for various reasons. They’re usually sensitive to the touch and can be quite itchy, but aren’t usually painful. While some individuals seem to be genetically prone to developing skin tags, a variety of causes ranging from skin friction to hemorrhoids may be linked to skin tag formation.
 

Who gets anal skin tags?

Anal skin tags can affect anyone, but they’re much more prevalent in obese individuals and individuals who suffer from chronic bowel problems, especially Crohn’s disease. Additionally, pregnant women tend to develop skin tags more easily due to hormone fluctuations and increased skin friction around the anal region. Those who suffer from hemorrhoids or inflamed lesions and anal injury are also at a higher risk of having anal skin tags.
 

How do anal skin tags develop?

Although the exact causes of skin tags are unclear, they usually result from one or more of the following:

  • Hemorrhoids – When swollen hemorrhoids begin to shrink and eventually heal, excess skin may remain and form into a skin tag.
  • Diarrhea – Also related to friction, having recurrent bowel movements can irritate the skin around the anus, especially if combined with excess wiping.
  • Constipation – Too many bowel movements can lead to skin tags, as can too few bowel movements. When you overstrain, the anal blood vessels can swell and bulge; skin near the anus must also stretch to accommodate large or hard stools. Skin tags form when the skin fails to snap back to its original position.
  • Friction/irritation – Increased friction between surfaces of the skin, such as from exercising or prolonged sitting, can lead to anal skin tags.
  • Crohn’s disease – Sufferers of this chronic bowel disorder experience inflamed intestines and bouts of diarrhea and constipation, all of which contribute to a higher risk of skin tags.
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    How can I prevent anal skin tags from forming?

  • Decrease the chances of constipation and diarrhea by eating plenty of fiber and keeping your bowel movements regular.
  • Do not excessively wipe after a bowel movement to avoid excess friction and irritation.
  • Do not wear overly tight underwear, which can cause skin irritation and unnecessary friction while moving or sitting.
  • Aim for a healthy body weight and avoid a sedentary lifestyle. Overweight and obese individuals are more prone to developing skin tags, so eating a balanced diet and regularly exercising can significantly lower your risk.
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    Excessive Smartphone Usage May Be Giving You Hemorrhoids | Minnesota

    The average American spends over five hours per day scrolling through Instagram feeds, checking Twitter, answering emails and texts, and watching Netflix—all via smartphone devices and, more often than not, while sitting. Add in the extra layer of using these mobile devices during bathroom trips, and most of us have significantly increased our risk of developing hemorrhoids.

    A 2015 survey found that 9 out of 10 people bring their mobile device with them to the bathroom, a habit that leads to unnecessary extra time on the toilet. While doctors recommend that you spend no more than 10 minutes at a time sitting on a toilet, being absorbed in the contents of your phone can easily extend that window to 15-20 minutes or longer.

    This prolonged sitting time can then cause excess pressure on your rectal veins and increase your hemorrhoid risk. Additional straining may also cause existing hemorrhoids to engorge, swell and bleed. In general, your bowel movements should last somewhere between 3-10 minutes, as anything longer may indicate constipation.

    Furthermore, another major concern of using mobile devices in the bathroom is the risk of fecal contamination. A 2017 study of high school students’ smartphone usage showed that these devices can cling to E.coli and other bacteria, potentially making mobile devices even dirtier than toilet seats. Gross.
     

    Tips for Better Bathroom Habits

  • Only sit on the toilet for as long as you need to. If there isn’t an actual urge for a bowel movement, don’t force it.
  • Do NOT sit and strain for long periods of time. The more you strain, the more irritated those rectal veins will become!
  • Set a timer if you get distracted easily so that you’re aware of how long you’ve been sitting.
  • Always wash your hands before leaving the bathroom, and try to wipe down your smartphone!
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    Here’s What You Need to Know About an Anoscopy | Minnesota

    If you’re undergoing an anoscopy soon and unsure of what to expect, don’t fret—this simple procedure is pretty straightforward and extremely effective in helping your doctor diagnosis whatever anal/colorectal condition you may have.
     

    What is an anoscopy?

    An anoscopy is a quick and painless examination used to identify and diagnose any problems in the gastrointestinal tract, specifically inside the anus and rectum. The procedure helps your doctor identify various potential anorectal conditions, including hemorrhoids, anal fissures, anal polyps, anal abscesses and, more rarely, anal cancer. An anoscopy is often performed in conjunction with other diagnostic tests such as a digital rectal exam (DRE) or a biopsy.
     

    How is an anoscopy performed?

    You’ll first be asked to remove your clothing and undergarments and lie down either sideways or bending forward on the exam table.

    Your doctor will then insert a light-equipped device called an anoscope into your lower gastrointestinal tract via the anus. An anoscope is a small, hollow, rigid tube roughly 3-5 inches long and 2 inches wide and is usually coated with a jelly-like substance to help ease insertion. While the device is being inserted, your doctor may also ask you to clamp and relax your internal muscles to help with the placement of the anoscope.

    During the procedure, you may feel pressure or an urge to have a bowel movement. If you have hemorrhoids, there may be a small amount of bleeding.

    Once the exam is completed, your doctor will gently withdraw the anoscope.
     

    How do you prepare for an anoscopy?

    There isn’t any special preparation required for an anoscopy. However, you’ll be advised to empty your bladder and bowels prior to the procedure to make the exam more comfortable. To help with this, your doctor may give you a laxative or enema.

    Most patients are able to drive themselves home following the procedure, so you won’t need to arrange for someone to pick you up unless you wish to.
     
     
    Once your doctor confirms the results of your anoscopy, you can move forward with determining the best treatment plan for your condition. Click here to learn more about the anorectal anatomy and potential anorectal conditions.

     

    The Potential Health Benefits of Elephant Foot Yam | Minnesota

    Alternative MedicineYes, you read that correctly—elephant foot yam is loaded with potential medicinal benefits and may even improve hemorrhoidal symptoms. This alternative medicine has long been used in Ayurveda, a traditional system of medicine rooted in the Indian subcontinent whose practices have recently been globalized. Used to treat numerous conditions such as sperm quality, liver and spleen disorders, and hemorrhages, elephant foot yam just may be the next big home remedy for treating hemorrhoids as well.

    The thickened, underground part of the yam’s stem, known as tubers, is often prescribed as medicine in Ayurveda to treat hemorrhoids, dysentery, asthma, vomiting and abdominal pain. While it is typically used as a blood purifier, tubers can also be made into a paste to externally treat arthritis pain.

    In treating hemorrhoid symptoms, elephant foot yam can be prepared as a medicine called “suran vataka,” recommended to be taken in small capsules (1-2 grams each) both morning and evening on an empty stomach. While the exact treatment results are unclear due to the yam’s alternative nature, this has long been a prescribed treatment method for patients in India suffering from hemorrhoid/bowel discomfort.
     

    Other Potential Health Benefits of Elephant Foot Yam

  • The cooling effect of the yam can be a cure for hypertension.
  • The yam may help reduce cholesterol levels.
  • It can serve as an anticoagulant (blood thinner) to improve blood flow.
  • Elephant foot yam may even help maintain hormonal balance in women by increasing estrogen levels and relieving them of pre-menstrual syndrome.
  • The presence of Vitamin C can help delay aging.
  • Elephant foot yam may also benefit patients who suffer from acute rheumatism.
  • Irregular bowel movements and constipation may be cured through consuming elephant foot yam.
  • It may help reduce muscle spasms.
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    Please note that while elephant foot yam may help with hemorrhoid symptoms, anyone who suffers from hemorrhoid discomfort should see a doctor for a full evaluation. Home remedies certainly help with symptoms, but it’s always best to see a doctor for a complete, thorough treatment method.

     

    5 Potential Side Effects of Taking Stool Softeners | Minnesota

    When considering temporary hemorrhoid treatment options and lifestyle changes to help battle hemorrhoid flare-ups, stool softeners are almost always recommended. Because hemorrhoids often develop as a result of constipation and overstraining during bowel movements, taking stool softeners is an efficient short-term option for easing stool passage.

    However, every drug has its side effects. While stool softeners are generally well-tolerated by hemorrhoid patients, there are a few potential side effects that can cause discomfort.
     
     
    Stomach Cramps

    Because the ingredients in stool softeners aim to soften your stool for easier bowel movements, there’s a chance that you’ll experience stomach/intestinal cramps. Your digestive tract, which was previously constipated, is now suddenly being affected by changing stool habits. Make sure to drink plenty of water while taking stool softeners to help prevent cramping.
     
    Diarrhea

    If you exceed the recommended dosage for your stool softener, your stool may become overly runny and loose, potentially leading to over-passage of stool. If diarrhea does occur, drink plenty of fluids to avoid dehydration
     
    Nausea & Vomiting

    Whenever your digestive tract is affected, there’s always the risk of nausea and vomiting. If vomiting occurs, stop taking the stool softener immediately, as severe vomiting can lead to dehydration and more extreme digestive issues.
     
    Allergic Reaction

    While allergic reactions to stool softeners are fairly rare, they can occur. Hives, difficulty breathing, rashes, and swelling in the lips, hands and tongue can all potentially develop. In these cases, immediately stop taking the stool softener; call 911 if a severe allergic reaction occurs.
     
    Rectal Bleeding

    This side effect is more uncommon, but if rectal bleeding or irritation occurs, call your doctor immediately.
     

    If you experience any of the above side effects, stop using the stool softener and call your doctor to discuss alternative treatment methods.
     

    Is a Hemorrhoidectomy During Pregnancy Safe? | Minnesota


     
    Hemorrhoids during pregnancy is, without a doubt, one of the most irritating and uncomfortable parts of the pregnancy process. While developing pregnancy hemorrhoids is extremely common, treatment methods differ depending on the size and severity of a patient’s hemorrhoids. While some women are able to effectively utilize home remedies or less invasive procedures like infrared coagulation (IRC) and rubber band ligation (RBL), there’s the unfortunate chance that your hemorrhoids will require a hemorrhoidectomy.

    Typically used to treat more extreme, grade 4 internal hemorrhoids or severe cases of external hemorrhoids and thrombosed external hemorrhoids, a hemorrhoidectomy is a more invasive hemorrhoid removal procedure. It’s generally used on patients whose external hemorrhoids clot repeatedly, who don’t respond to rubber band ligation, whose protruding hemorrhoid does not respond to treatment, or who experience ongoing bleeding.
     

    Are Hemorrhoidectomies Safe for Pregnant Patients?

    Because a hemorrhoidectomy is more intensive, it’s admittedly not the preferred treatment method for pregnant patients. However, it is perfectly safe to perform either during pregnancy or shortly afterward. In the case that your hemorrhoids fail to respond to less invasive treatments, your doctor will most likely suggest surgery in the form of a hemorrhoidectomy. Here at One Stop Medical Center, Dr. Shu opts for a less invasive version of a traditional hemorrhoidectomy, combining it with rubber banding and IRC. This approach typically produces great results while allowing patients a quicker recovery.

    During the hemorrhoidectomy, the bleeding tissue is surgically removed with a radio frequency device under local anesthesia. Both ends of the hemorrhoid must be tied to prevent bleeding while the hemorrhoid is being removed. After excision is completed, the incision site is sewn or cauterized shut. Medicated gauze is then placed over the remaining wound. Healing time is generally four to six weeks, during which patients must increase fiber intake, drink plenty of fluids, and take stool softeners to ease bowel movements.
     
    Click here to learn more about our hemorrhoid treatment options, or call us at (952) 922-2151 to schedule a consultation.

     

    Here’s Why Your Anus May Be Itching at Night | Minnesota

    If you’ve ever experienced an itchy bum in the middle of the night, it’s quite an unpleasant sensation. Scratching the area may provide temporary relief, but the harshness of your nails ends up causing further irritation and damage to the already sensitive anal region.

    Known as pruritis ani, this condition literally translates to “itchy anus” and occurs on an intense, cyclical basis where an unpleasant burning sensation around the anus produces the urge to scratch. This feeling typically intensifies at night or after a bowel movement, when even minimal stimulation of the anal skin can cause extreme itching.

    So what causes anal itching? The exact reason for pruritis ani is unclear, but it is often linked to anorectal diseases, lifestyle habits and skin conditions. Below are a few of the more common reasons your bum may be keeping you up at night:
     

    Hemorrhoids

    Anal itching is both a symptom and complication of hemorrhoids that can escalate into pruritis ani. When a patient experiences hemorrhoid flare-ups, blood vessels in the walls of their anus and lower rectum swell and bulge, often causing inflammation and bleeding. This irritation around the anus causes sporadic itching, and continuous scratching of the area can further harm the sensitive tissues and worsen symptoms.

    More specifically, itching can occur when overstraining during bowel movements pushes an internal hemorrhoid outside the anus, otherwise known as a prolapsed internal hemorrhoid. Internal mucus then comes into contact with the anal tissues and prolongs the itching.
     

    Pinworms

    Pinworms are tiny parasites that infect the colon and rectum via ingestion of their eggs through contamination. Once the eggs hatch in your intestines, the pinworms wiggle out from the anus (especially at night) and lay eggs on the surrounding anal skin. The primary symptom is intense anal itching that causes restless sleep. However, treating pinworms is usually a simple and straightforward process of oral medication and topical creams.
     

    Skin Conditions

    Chronic skin disorders around the anal region, such as eczema and idiopathic dermatitis, can cause itching and dry, flaky skin for no apparent reason. Allergic dermatitis, however, results from the skin coming into contact with an allergen via creams, lotions, soap, powders, etc. and having a negative reaction. At times, excessive cleaning using one of the aforementioned products ends up worsening one’s anal itching. While chronic skin conditions are untreatable, allergen-based conditions can be managed by avoiding the triggering products.
     

    Hygiene Habits

    Both excessive cleaning and lack of cleaning of the anal region can irritate the skin. Over-wiping after bowel movements, especially with rough toilet paper or soap/topical products, can lead to dryness and itching.
     
    For more information on pruritis ani and its causes and treatment methods, check out our earlier blog post here.

     

    Ways to Manage Proctalgia Fugax Pain | Minnesota

    While the term “proctalgia fugax” (pronounced proh-TAL-ja few-gacks) may sound completely obscure, the rectal condition actually affects up to 18 percent of Americans. The Latin term literally translates to “fleeting rectal pain” and is characterized by intensely painful, sporadic rectal or anal spasms that last anywhere from a few seconds to a few minutes. Sometimes described as feeling like a severe muscle cramp or like a knife is shoved up one’s rear end, proctalgia fugax is extremely unpleasant to experience. However, home remedies can help alleviate some of the pain and discomfort.

    One of two primary functional anorectal pain syndromes, proctalgia fugax occurs as a result of cramping of the levator ani muscle. Attacks are more common in the middle of the night, but they can occur during the daytime as well. The pain is usually so intense that patients must stop what they were doing and attempt to alleviate the discomfort or wait until the spasm subsides. While these episodes typically only occur a few times per year, some patients have reported feeling pain almost everyday. While attacks are technically spontaneous and unpredictable, certain lifestyle factors such as stress, anxiety, excessive sitting and defecation may trigger episodes.

    Roughly 80 percent of patients suffering from proctalgia fugax do not seek medical attention due to the infrequency of their attacks, and the condition, thankfully, does not cause lasting damage. However, it’s helpful to know some effective pain reliever options, as well as lifestyle changes to potentially prevent future attacks.

    Medications: Topical glyceryl nitrate (pain-relieving drug), nerve blockers, muscle relaxers, hemorrhoid creams

    Warm baths: To relax the anal muscles and potentially reduce the chance of spasms

    More potassium: Food like bananas, cantaloupe, spinach, potatoes and oranges are rich in potassium and can aid in preventing spasms

    More vegetables: More vegetables and whole grains mean more fiber and less chance of constipation, which in turn reduces straining of the anal muscles. Natural vegetable powder can also help produce softer stool

    Relaxation techniques: Reduce stress and anxiety via meditation, deep-breathing exercises and yoga

    Pelvic muscle retraining: Pelvic muscle exercises, such as kegel exercises, can help strengthen and relax muscles in that area.

     

    Comparing Anal Abscesses and Anal Fistulas | Minnesota

    Hemorrhoids, abscesses, fistulas, fissures, anal itching, rectal prolapse—with so many anorectal disorders out there, it’s hard to keep track of which is which. Two of these conditions, anal abscesses and anal fistulas, are closely linked to one another but can be easily distinguished via the guidelines below.
     

    Defining Each Disorder

    Anal Abscess – This is a pus-filled, infected cavity near the opening of the anus or deep in the rectum. Most abscesses result from infection of anal glands in the lining of the anal canal near the anus opening. When bacteria from the gut passes the anal sphincter barrier and into the surrounding tissue of the rectum, an abscess of varying severity and depth forms. When an abscess fails to fully heal, an anal fistula may form.

    Anal Fistula – As mentioned above, fistulas usually occur due to a previous anal abscess. A fistula is an inflamed tunnel under the skin, connecting the anal canal and the surface of the surrounding skin. The majority result from an anorectal infection, wherein the anal crypts are infected and cause pus-filled cysts to form near the anal canal.
     

    Symptoms

    Anal Abscess – The most common symptoms are pain around the anal area, swelling, redness, and fever. Rectal bleeding and urinary complications (difficult or painful urination) may also occur.

    Anal Fistula – In addition to most likely having a history of anal abscesses, patients may also experience skin irritation around the anus, a throbbing pain when sitting, anal discharge, swelling and redness, and fever.

     

    Causes

    Anal Abscess – This usually occurs from infection of anal glands in the lining of the anal canal near the anus opening. Other causes include an anal fissure and sexually transmitted infections (STIs).

    Anal Fistula – As previously mentioned, fistulas typically result from an abscess that did not fully heal. They may also, though less frequently, be caused by Crohn’s disease, STDs, trauma, tuberculosis, cancer or diverticulitis.
     

    Treatments

    Anal Abscess – Surgical incision and drainage should be performed ASAP, as antibiotics are ineffective at this stage of the infection. Delaying surgery can result in tissue destruction, fibrosis (scar tissue formation), and impaired anal continence. Drainage involves making a small incision above the abscess as close to the anus as possible, then removing the gauze after 24 hours. Sitz baths and stool softeners can help with post-surgery discomfort.

    Anal Fistula – Surgery is generally needed to treat fistulas and involves cutting a small part of the anal sphincter muscle away. By doing so, the tunnel/fistula is opened up to form a trench that heals from the bottom outwards. After a few weeks, the trench ideally fills up with scar tissue and heals. Post-surgery discomfort is mild and can usually be addressed with painkillers.
     

    Recurrence Rates

    Anal Abscess – Nearly half of abscesses may recur, either in the form of a new abscess or as a frank fistula.

    Anal Fistula – Fistulas can also potentially recur, with recurrence rates dependent upon the particular surgical technique utilized.

     

    10 Reasons For Rectal Bleeding That Aren’t Hemorrhoids | Minnesota

    Bleeding from your rectum or anus is never a pleasant experience, and it can understandably cause immediate panic. Generally, bright red blood indicates bleeding in the lower rectum, while dark red blood indicates bleeding from deeper and further up in the body. While passing dark red blood is usually a sign of digestive bleeding and requires immediate attention, any amount of rectal bleeding should be taken seriously.

    While rectal bleeding can be caused by pesky hemorrhoids, there are a number of other potential causes ranging from fistulas and fissures to more serious cases of colon/bowel cancer.
     
    1. Anal Fistula
    An anal fistula is an inflammatory tunnel under the skin connecting the anal canal and the surface of the surrounding skin. Most fistulas occur from an anorectal infection, where the anal crypts are infected and cysts containing pus form near the anal canal. Fistulas are often misdiagnosed as hemorrhoids, as symptoms can be similar, including drainage from the anus, itchiness and pain during bowel movements. They can be treated with antibiotics, pain meds and a fistulotomy.

    2. Anal Fissure
    An anal fissure is a small rip or tear in the lining of the anal cana typically caused by trauma to the inner lining of the anus via a bowel movement or stretching of the anal canal. They can be painful, but fissures often heal within a few weeks through increasing fiber/fluid intake to keep stool soft and help ease bowel movements.

    3. Colon Cancer
    As scary as it may sound, rectal bleeding is a dangerous sign of colon cancer and must be taken very seriously. Symptoms of colorectal cancer include abdominal pain, a change in bowel habits, an anal or rectal lump, and bleeding during bowel movements. Click here to read our post on the differences between rectal cancer and hemorrhoids.

    4. Gastroenteritis
    Gastroenteritis, otherwise known as the stomach flu, is a common bacterial infection that causes diarrhea, fever and vomiting. Due to inflammation in the stomach and colon, the bowel becomes more sensitive during the illness and may cause bloody stools. While the process is uncomfortable, gastroenteritis normally clears up after a few days of rest and hydration.

    5. Diverticulosis
    Diverticulosis is a chronic bowel condition that causes small bulges or pockets to develop in the lining of the intestine/digestive tract. If these bulges become inflamed or infected, abdominal pain, bloating, constipation, diarrhea, and bloody stools can occur. More common in people over 40, diverticulosis can be treated using diet modifications, antibiotics and, if needed, surgery.

    6. Rectal Prolapse
    Believe it or not, a bit of your intestine can actually slip outside of your body. A rectal prolapse occurs when part of the large intestine slips outside the anus, which can happen during a bowel movement. This in turn causes pain and bright red blood in the stool, as well as difficulty in controlling your bowel movements. A prolapse usually requires surgical treatment, so call your doctor right away.

    7. Polyps
    Polyps are non-cancerous growths that can develop along the lining of your bowel. They’re pretty common and don’t usually manifest symptoms. In more severe cases, they can cause diarrhea, constipation, mucus in the stool and bloody stools. While most polyps do not escalate into cancer, there is still risk of cancer development. Be sure to call your doctor for a full examination.

    8. Internal Bleeding
    As mentioned earlier, darker colored blood can be a sign of internal bleeding in your digestive system. It can also be a sign of cancer, stomach ulcers or severe gastrointestinal disease. If you see dark red blood in your stool call your doctor ASAP.

    9. Colitis
    Colitis is a chronic inflammation of the innermost lining of the large intestine and rectum. Small ulcers develop in the lining of the bowel, which then bleed and produce pus. This causes recurring diarrhea, abdominal pain, rectal bleeding, and the frequent urge to pass stools. Management of colitis conditions can include antibiotics, medications and surgery.

    10. Sexually Transmitted Infection (STI)
    Sexually transmitted infections (STI) can result from unprotected anal sex and cause inflammation of the lining of the anus, which can lead to bleeding and pus. Treatment includes antibiotics and antiviral/antifungal medications.

     

    Hemorrhoids vs. Rectal Cancer: How to Tell the Difference | Minnesota

    Because the symptoms of hemorrhoids and early-stage rectal/colon cancer are very similar, people often confuse and, at times, misdiagnose the two conditions. Since the treatment method for each condition is vastly different, it’s important to know how to differentiate hemorrhoids from rectal cancer and proceed with the appropriate treatment options.

    Rectal Cancer

    The most obvious and noticeable symptom of rectal cancer is a malignant tumor (cancerous tumor that spreads) that forms in the tissues of the rectum. Additional rectal cancer symptoms can include:

  • Stools that are not round in shape
  • Bloody stools
  • A change in bowel habits (diarrhea, constipation)
  • Anal tenesmus (the feeling of urgently and constantly needing to pass stools due to rectal inflammation)
  • Unexplained weight loss (typically later symptom)
  • Unexplained fatigue (typically later symptom)
  • Pelvic or lower abdominal pain (typically later symptom)
  • The risk of rectal cancer increases as you age, so the condition is more common in individuals over 50, although it can also manifest in younger people. Those with either a personal or family history of colorectal polyps, colorectal cancer or inflammatory bowel disease (IBD) are at a higher risk.

    If you have any of above symptoms, you’ll need to still see a doctor for a digital rectal exam, colonoscopy and full work-up.
     

    Hemorrhoids

    Hemorrhoids are swollen, bulging blood vessels in the walls of the anus and lower rectum. When the tissues supporting the vessels become inflamed and stretch, the vessels expand and cause its walls to thin. This often leads to bleeding. If the intense stretching and internal pressure continue, these already weakened vessels ultimately protrude from the anus. Patients with hemorrhoids can suffer from internal hemorrhoids, external hemorrhoids, or both.

    Internal hemorrhoids are small or large hemorrhoids that develop inside the rectum and do not protrude outside the anus. They may bleed but are normally painless.

    External hemorrhoids are small or large hemorrhoids that protrude from the anus and bleed. Some external hemorrhoids retract back into the anal sphincter after a period of time, while larger, more severe ones require manual pushing to force them back into the interior of the anus. Hemorrhoids can exit the body via coughing, sneezing, laughing or standing for long periods of time. Prolapsed hemorrhoids can produce external anal mucus and itching around the anus.

    Symptoms of hemorrhoids include:

  • Discomfort, itching or pain around your anus
  • Bloody stools or seeing blood on the toilet paper when wiping
  • Moist, pink bumps around the edge of the anus, or bulging out from the anus
  • Severe or abnormal pain (advanced hemorrhoids)
  • Discomfort when sitting and laying down (advanced hemorrhoids)
  • Unlike rectal cancer, hemorrhoids are typically caused by changeable lifestyle habits such as lack of movement and exercise (lack of blood circulation), sedentary work, and straining from constipation, as well as pregnancy.

    If you experience any of the above rectal cancer or hemorrhoid symptoms, see a doctor immediately. For more on rectal examinations, check out our blog post about what to expect from a standard rectal exam.

     

    Rectal Examination Process in Hemorrhoid Care | Minnesota

    Anorectal assessments include visual inspection, palpation, digital rectal examination and anoscopic examination. The patient typically lies sideway on his or her left side with the patient’s knees flexed toward the chest (left lateral decubitus position), which is allows comfort for the patient as well as good visualization and access for the examiner.

    The doctor usually inspects the entire perianal area first. It is common that patient apprehension is great before any anal examination, and you may slowly take deep breath and try to relax. The doctor gently spread your buttocks to allow easy visualization of anus.

    The doctor often the following signs by simple inpection.
    1. Redundant tissue
    2. Skin tags, anal polyps, and anal cancer
    3. External hemorrhoids
    4. Anal warts
    5. Fissures and fistulas
    6. Signs of infection or abscess formation
    7. Rectal or internal hemorrhoidal prolapse.

    The digital exam is to palpate any suspicious mass lesion in the anorectal canal. Because internal hemorrhoids are soft vascular structures, they are usually not palpable unless thrombosed. The prostate in men is palpated during the rectal exam.

    anoscopeAnoscopy is a simple medical procedure that can help your doctor identify an abnormality in your anus and distal rectum.

    To perform an anoscopy, your doctor will insert a device called an anoscope into your anus. This scope is typically 3-4 inches long, made of plastic or stainless steel . An anoscope allows your doctor to get a detailed look at the tissue within your anorectal areas.

    Anoscopy is to confirm the diagnosis of hemorrhoids, severity of hemorrhoids, anal fissure and other anorectal diseases.

    Injections of Botulinum toxin for Anal Pain and Anal Fissure

    Introduction
    Botulinum toxin A, is a toxin protein produced by bacteria called clostridium botulinum. When injected into a muscle, it will temporarily blocking neural signals for muscle contractions, causing the muscle fibers at the injection area to relax. Botulinum toxin A has been successfully used for the treatment of a variety of medical conditions involving unwanted muscle spasms such as strabismus and cervical dystonia. It is also commonly used for removing unwanted wrinkles in cosmetic care.

    The internal anal sphincter that controls the anus is always under tension. If this tension (also called resting pressure) is too high, it causes rectal pain. The common diseases associated with anal sphincter spasms are anal fissure and functional anal rectal pain. Spasm can make an anal fissure worse or prevent an existing one from healing.

    Botulinum toxin A has also been used to treat anal fissure for several years. Injecting Botulinum toxin A into muscle around the anus will temporarily relax the internal anal sphincter. This reduces the spasm and pain and allows the fissure to heal.

    Most patients have at least some pain relief in their pain after treatment with Botulinum toxin A. The success rate for an anal fissure healing after the injection is 70 out of 100 treatments. Sometimes the injection might need to be repeated, especially in the patients with functional anorectal pain.

    What Happens During the Procedure?
    There is no special preparation needed before the injection procedure. You don’t need to do any preparation, but you are encouraged to have bowel movement and please do carry out your usual hygiene routine (shower or bath) before you come in.

    Dr. Shu will perform the injection procedure in the exam room or procedure room, and it takes a few minutes to perform. You will be awake throughout the procedure.

    You will be asked to lie on your left side on the exam table. The area around your anus will be cleaned with an alcohol spray. Dr. Shu will then give 6-8 injections of Botulinum toxin A into your sphincter muscle with a hair thin needle. This will be uncomfortable during the injection, but it is an extremely quick procedure.

    After the Procedure
    You can drive home or return to work afterwards. Very occasionally, the patient develops vasovagal reaction (fainting) to the procedure, the you lie on the table for a few minutes to recover.

    The Botulinum toxin A will start to work in a few days. The effects of Botulinum toxin A peaks in 1-2 weeks and usually lasts 3-6 months. During this time, anal fissures are allowed to heal.

    Most people do not have any side effects. The potential side effects of botulinum injections may include the inability to control the passage of gas (gas incontinence), pain from the injections, bleeding, infection at the injection site, and rarely, fecal incontinence (we don’t have any case of fecal incontinence). If symptoms of incontinence occur following Botox® injection, they typically disappear completely after several months.

    It is important to make sure that you continue to keep your stool soft following the treatment, to avoid straining. Continue anal care measures including Sitz bath, fibre in your diet, and drinking enough water.

    One Stop Medical Center Receives the Renewal of Three Accreditation from IMQ 2nd Time a roll | Minnesota

    One Stop Medical Center (OSMC) recently received an updated renewal accreditation by the Institute for Medical Quality (IMQ) that assures their patients are receiving the highest level of care. Three year accreditation is the longest term that an ambulatory surgical facility can get from IMQ. This is the second time in a roll that OSMC received three year accreditation.

    It’s an honor to be recognized as a top-quality ambulatory surgical facility. We are extremely pleased to have received the renewal of three year accreditation 2nd time in a roll. We work extremely hard to uphold the highest standards of patient care. For our patients, this serves as validation for out rigorous standards of safety, professionalism and quality care by our clinic.

    The Institute for Medical Quality certification is a complicated, lengthy process that serves to ensure all accredited surgery centers and operating rooms are providing high quality, safe surgical care. The IMQ Ambulatory Care Review Program includes a rigorous review of the facility’s clinical staff credentials, patient medical record-keeping practices, calibration, and maintenance of medical equipment and other safety measures. Facilities are also evaluated on-site by physician peers before a final decision is rendered by the IMQ Ambulatory Care Review Committee.

    Dr. Shu and his staff all strive to make sure our medical and cosmetic patients are receiving the best care possible in our clinic. From a warm, welcoming environment to our bedside manner to the innovative surgical procedures we provide.

    Need to be a high suspicion of anal cancer if patients have rectal symptoms | Minneapolis & St Paul

    Patients with anal cancer often mistakenly think that the rectal symptoms are caused by hemorrhoids, which lead to a significantly delayed diagnosis. Even when patients seek medical attention, anal cancer is often misdiagnosed as hemorrhoids. It is important to have a high suspicion of anal cancer if patients have rectal symptoms.

    Anal cancer is account for 2% of cancer in the gastrointestinal tract. It usually refers to anal squamous cell carcinoma. Anal squamous cell carcinoma is a disease associated with human papillomavirus (HPV). The anal cancer develops from the inflammation of squamous cells in the anal canal, which is the space that connects the rectum to the outside of the body. This is inflammation is often believed to be caused by HPV. Squamous cell cancer makes up the majority of cases of anal cancer- about 80%. Cancer types other than squamous cell carcinoma are varied and rare, accounting for only a minority of anal cancer.

    Symptoms
    Anal or rectal cancer generally do not produce any pain; an external or internal mass may be palpable. Some lesions are so soft that they are missed on palpation. Common symptoms include anal/pelvic pain and anal bleeding (seen in about half of patients), sensation of a mass in the rectum (seen in about a third of patients), local sensations of wetness/irritation, prolaps, rectal incontinence, and severe constipation.

    About 19% of patients wait 6 months to see a doctor after initial symptoms. To further complicate things, about 27% of patients end up initially receiving treatment for misdiagnosed anorectal diseases with similar symptoms like hemorrhoids. Anal cancer has a very long lag time between symptoms and diagnosis due to reluctance or denial, often out of shame/embarrassment, or fear.

    Risk factors for anal cancer include active HPV infection, smoking, receiving anal sex, immunosuppression, HIV infection, and organ transplant. Risk is particularly high if one has two or more of these factors.

    Treatment
    Surgery plays a limited role in the treatment for anal cancer. Surgery is indicated in anal cancer with very early stage, such as T1, N0, well-differentiated lesions in the anal margin.

    For the majority of patients diagnosed with anal squamous cell carcinoma, treatment will consist of radiation therapy combined with radiosensitizing chemotherapeutic agents. These treatments can caused the complications that affect the anal cancer patient, including the short-term adverse effects of chemotherapy and long-term risks of radiation exposure.

    Conservative management of symptoms include lifestyle changes and bulking agents and anti-diarrheal agents.

    Vaccination against HPV serotypes 16 and 18, which are believed to cause the majority of cases, is the best way to prevent the development of anal cancer.

    How to Differentiate Anal Fissure from Hemorrhoids | Minneapolis & St Paul

    The patients in Minnesota often couldn’t tell the differences between anal fissure and hemorrhoids. Although both hemorrhoids and anal fissure are associated with rectal pain and rectal bleeding, they are two very different diseases that are important to distinguish.

    Hemorrhoids could be as painful as anal fissure when thrombosis develops. In the most time, the pain caused by hemorrhoids is mild, persistant, dull aching pain, not always related to bowel movement. Anal fissure usually has sharp rectal pain during bowel movements.

    Anal Fissure
    An anal fissure is a tear in the anal canal in the lower rectum. Anal fissures are typically thought to be caused by trauma from a hard or painful bowel movement, and are often associated with a lack of fiber in the diet. Symptoms include severe rectal pain during bowel movements, which can last from minutes to hours after. The pain is worse with constipation, which may occur if the patient has been avoiding bowel movements due to pain. Many patients report bright red blood on the toilet paper or the stool, though bleeding is usually not significant. If a fissure persists over time it may become a chronic fissure.

    Anal fissure require anoscopy as it cannot be directly observed visually. However, anoscopy is quite painful for those with an anal fissure so a doctor may treat it based on symptoms alone. About 80% of fissures resolve themselves without the need for surgery. Initial treatment is generally conservative in nature, with the goal of relieving constipation and breaking the cycle of hard bowel movements. Patients may take stool-bulking agents like fiber supplements and stool softeners, as well as laxatives to encourage regular bowel movements. Mineral oil can serve this purpose as well, but it is not advisable to be used indefinitely. Sitz baths after bowel movements are effective in relieving symptoms.

    If these first-line treatments do not work, the patient may be directed to use 0.4% nitroglycerine (NTG) ointment in conjunction the treatments listed above; however, this is generally not preferred as NTG ointment can cause adverse side effects like headache and dizziness. Alternatively, Nifedipine gel is a better option to treat anal fissure.

    Botox has also shown to be a promising treatment, its relaxation effect on sphincters lasts for three months that is long enough for anal fissure to heal. If the anal fissure does not resolve following treatments, then a partial anal sphincterotomy may be needed, where a cut will be made on the anal sphincter in a different location in the anus, and both the fissure and new cut will heal together.

    Differences Between Hemorrhoids and Anal Abscesses | Minnesota

    Although both hemorrhoids and anal abscesses appear to be tissue lumps protruding from the rectum, they are two very different issues that are important to distinguish.

    Hemorrhoids could be as painful as anal abscesses when thrombosis develops. Anal abscesses are an infection around the opening of the anus or deep in the rectum, where there is pus. An anal abscess is commonly mistaken for a hemorrhoid upon first notice; however it eventually becomes more painful and leads to a fever.

    Hemorrhoids are usually a chronic condition, while anal abscess is an acute disease, which can cause serious complications that could result in death if left untreated. If you are experiencing any of these symptoms, medical attention should be found as soon as possible.

    ANORECTAL ABSCESS?
    Anorectal abscesses are the result of infection of anal glands in the lining of the anal canal near the opening of the anus. The anal glands secrete fluid into the anal canal, passing through a crevice known as the anal crypt. Most perirectal abscesses form from obstruction of the anal crypts (approx. 90% of cases). Normally the internal anal sphincter acts as a barrier between bacteria in the gut and the tissue surrounding the rectum, but it is possible for bacteria to pass this barrier through the anal crypt. Once bacteria passes through the crypt, it can easily move to the surrounding tissue. This results in the formation of an abscess of varying severity and depth depending on how deep the infection is and where it spreads.

    Anal abscesses most commonly occur in the third and fourth decade of life, and are more common in men. Deaths due to anorectal abscesses are very rare.

    Most abscess can be easily identified via physical examination and digital rectal examination. Deep rectal abscesses are more difficult to find and may require a CT scan, MRI scan, or ultrasonography to confirm.

    Most of the time a perirectal abscess can be detected upon initial examination. Digital rectal examination involves the doctor putting the finger of their gloved hand into the rectum in order to feel out the presence of an abscess. Sometimes anesthetic is used in cases where pain from the abscess would limit the effectiveness of the examination.

    Sometimes the formation of a fistula can accompany this infection (approx. 30-60%% of cases). 10% of patients suffer from recurring and chronic anal fistula. An anal fistula is an abnormal passage between the anal canal and the skin near the anus.

    TREATMENT
    The presence of an abscess warrants surgical incision and drainage as soon as possible. Just antibiotics would be ineffective at this stage in the infection. Delaying surgical intervention can result in tissue destruction, fibrosis (scar tissue formation), and impaired anal continence.

    Drainage of perianal abscesses involve a small incision above the abscess made as close to the anus as possible. After 24 hours the gauze is removed. Postoperative care involves sitz baths three times a day and after bowel movements. Painkillers and stool softeners may be prescribed for pain and constipation. The patient will follow up with the doctor 2-3 weeks later. After the procedure, antibiotics are generally not necessary in healthy adults.

    Laser Hemorrhoids Treatment Doctor Minnesota | MN Procedure Clinic

    No longer will you have to fear hemorrhoid treatment — Infrared coagulation (IRC) of hemorrhoids is a fast and effective non-surgical solution.

    A hemorrhoid is a common illness that numerous Minnesotans suffer from. It is estimated that more than 10 million people in the United States suffer from hemorrhoids. Approximately three out of four people will develop hemorrhoids at some time in their lives. Dr. Steven Shu, an office proceduralist, commonly treats hemorrhoids and can quickly alleviate your pain.

    While many people associate hemorrhoids with painful surgery, only a small percentage of patients actually require surgery. A fast and simple office procedure has taken the fear out of hemorrhoid treatment. The majority of hemorrhoids patients are good candidates for non-surgical treatment, or Infrared coagulation (IRC).

    What is Infrared Coagulation (IRC) of Hemorrhoids?
    Infrared Coagulation (IRC) is a safe, fast, and effective solution for hemorrhoids. It is approved by the FDA for the treatment of hemorrhoids. This office-based procedure takes just a few minutes and uses infrared light to treat symptomatic internal hemorrhoids. Therefore, IRC has quickly become the most widely used office procedure for hemorrhoids and is preferred over other methods because it is fast, effective, well-tolerated by patients, and rarely has complications.

    A small light probe contacts the area above the hemorrhoid complex under direct view, exposing the tissue to a burst of infrared light for about one second. This coagulates the veins above the hemorrhoid, causing it to shrink.

    Since the hemorrhoids are located in an area that is full of sensitive somatic nerve endings (same as the nerves in skin), it is too painful to coagulate the hemorrhoids directly because they are too close to the opening of the anus. Fortunately, many small veins that feed the hemorrhoids lie in an area that is supplied with sympathetic nerve endings, which is not as sensitive as the somatic nerves in skin.

    With IRC, your doctor can effectively coagulate the insensitive area right above the hemorrhoids and destroy these small veins. In this way, the sensitive and painful area is avoided, and IRC becomes a very tolerable treatment.

    By destroying these small veins with IRC, it stops the flow of blood to the varicose veins of hemorrhoids, just like blocking many small rivers will dry up a large lake.

    IRC offers major advantages to patients over previous hemorrhoid treatment methods:
    • Fast, simple, and safe solution
    • No anesthesia required
    • No special preparation needed
    • No recovery time after treatment
    • Clinically proven results
    • Covered by all major insurance companies

    Who are the Best Candidates for Infrared Coagulation (IRC)?
    Infrared coagulation can be used to treat the early stages of hemorrhoids, and it is most effective in grade 1-2 hemorrhoids. If you’re suffering from irritating internal hemorrhoids that continue to cause itching, discomfort, pain, bleeding and other symptoms, and it does not respond to conservative self-management, IRC treatments might be a good solution.

    How is Infrared Coagulation Procedure Performed?
    Before IRC procedure is performed, Dr. Shu gently inserts the anoscope (a very short, 3-4 inch rigid metal tube), then uses a handheld device that creates an intense beam of infrared light to touch the mucosa above the hemorrhoids, exposing the hemorrhoid tissue to a quick pulse of infrared light. The heat from the infrared light burns 4-5 spots in the targeted area, coagulating the vein above the hemorrhoids.
    The resulting scar tissue cuts off the blood supply to the hemorrhoid venous complex. This causes the hemorrhoid complex to shrink and die. It may take a few weeks for all the hemorrhoids to shrink completely. Moreover, the scar tissue acts to hold nearby hemorrhoid veins in place so they don’t bulge into the anal canal easily and become hemorrhoids as you age.

    Each IRC treatment only takes a couple of minutes. You may need as many as four separate treatment sessions every two weeks to cover all the areas where hemorrhoids appear, but this depends on each individual case and how extensive your hemorrhoids are.

    What is the Recovery Time of Infrared Coagulation Procedure?
    After the IRC procedure, you may feel mild discomfort in the anus and the urge to have a bowel movement sometimes. You are able to resume normal everyday activities immediately afterward. Typically, there are no post-treatment effects. However, there may be slight spot bleeding a few days later, but heavy rectal bleeding is extremely rare. Avoid heavy straining, lifting, and aspirin. If you notice significant rectal bleeding, you should call your doctor’s office.

    You may use Tylenol as needed and take a warm sitz bath daily to relieve discomfort. A stool softener, fiber, and water will help ease your bowel movement while you heal.

    Dr. Shu has had extensive experience in treating hemorrhoids with non-surgical IRC treatments in the past two decades, and he has successfully treated about two thousand hemorrhoids patients with almost ten thousand IRC treatments. Please call 952-922-2151 if you need help to treat your symptomatic hemorrhoids.

    Daily Activities Risk Factors for Causing Your Hemorrhoids | Minnesota

    A hemorrhoid is a common disease that numerous Minnesotans suffer from. Many patients know treatment options such as infrared coagulation (IRC), banding, and surgeries, however far fewer people understand the causes of hemorrhoids and the risk factors contributing to it.

    The normal hemorrhoids structure is clusters of vascular tissue, smooth muscle, and connective tissue lined by the normal epithelium of the anal canal. Most symptoms arise from enlarged internal hemorrhoids. The engorged anal hemorrhoidal mucosa is easily traumatized, leading to rectal bleeding. The prolapse of hemorrhoid tissue leads to soiling, mucus discharge, and trigger pruritus.

    Many people in Minnesota don’t realize that they’re exposing themselves to the causes of hemorrhoids every day. Those activities actually become the risk factors of hemorrhoids. Whether you are currently suffering from hemorrhoids or are looking to avoid them, knowing the hemorrhoid risk factors related to your everyday activities is important. Therefore, you can work to prevent them from developing, worsening, and recurring.

    Some of the most common hemorrhoid risk factors related to your everyday activities are:

    Compromised Bowel Movements
    You should have good bowel habits and maintain smooth stool. Constipation with hard stool and straining can increase abdominal pressure rapidly, as well as expansion of venous plexus, often causing rupture of hemorrhoidal vessels and even anal skin tearing. If you develop chronic constipation, you should treat it aggressively by having a high fiber diet, increasing water intake, walking daily, and taking bulking agents and laxatives. However, frequent diarrhea does not help, either. Straining related to diarrhea also can rapidly increase the pressure in the abdomen and hemorrhoid vessel complex, too. The toilet time should not be too long, and you should avoid the bad habit of reading newspapers or surfing the Internet on the toilet.

    Sitting and Standing
    Most people’s jobs in Minnesota involve either extended hours sitting or standing. But doing either for too long can result in increased pressure in the lower rectum, leading to develop hemorrhoids. Individuals who are prone to developing hemorrhoids should avoid sitting and standing for extended periods of time.

    Heavy lifting
    Heavy lifting can put pressure on the abdomen and lower rectum rapidly, increasing venous engorgement of the internal hemorrhoids which causes them to swell and enlarge, and also causes the rupture of hemorrhoidal vessels and even thrombosed external hemorrhoids, a common complication of hemorrhoids.

    Weight and Pregnancy
    Being overweight can also put pressure on the abdomen and lower rectum due to carrying too much weight for what body organs can normally withstand. The same goes for pregnancy, as the uterus increases venous pressure.
    .
    Genetics
    Unfortunately, hemorrhoids do run in some families. Although hemorrhoids are a very common disease, it is not a disease that everyone develops. Those who inherit certain genes are more likely to suffer from the condition.

    Solution to Your Hemorrhoids
    You may find that you are exposed to several of these common risk factors after reading this blog, but by knowing what these risk factors are, you can work to minimize their impact on your body.

    Functional Anorectal Pain

    Functional anorectal pain is a relatively common symptom that occurs in the absence of any clinical abnormality although some patients may also have other anorectal diseases, such as hemorrhoids. It is not sure if the local inflammation caused by hemorrhoids contributes to the development of anorectal pain syndromes in those patients. Despite their benign nature of functional anorectal pain, they can cause debilitating to the sufferer.

    There are two functional anorectal pain syndromes.
    • Proctalgia fugax (PF) (fugax = fugitive/fleeting in Latin)
    • Levator ani syndrome (LAS)

    Proctalgia Fugax is an anorectal pain syndrome that occurs as a result of cramping of the levator ani muscle. It occurs in episodes lasting seconds or minutes, typically in the middle of the night, though it is very possible to experience it during the day as well. Patients may feel spasm-like, sharp pain in the anus that is often mistaken for a sign that they must defecate. This may also be accompanied by an involuntary erection in men. Attacks, and typically start at the age of 45. An estimated 8-18% of people in the developed world are affected by proctalgia fugax, but true figures are not clear because many people do not seek professional diagnosis. It is estimated that only 20-30% of people with this condition seek out professional diagnosis.

    The condition is recurrent, and while not curable, treatments are available.

    Traditional ways to manage pain include warm baths, warn/hot enemas, relaxation techniques. Applying ice or some similar cold pack to the afflicted area can help pain as well. Severe attacks can be mitigated a bit using salbutamol. For most cases, reassurance, and topical calcium-channel blockers, salbutamol inhalers, and sublingual nitroglycerine are used for treatment. Botulinum toxin A injection is a new way to effectively reduce the tone of anal sphincters and reduce anorectal pain. Co-existent psychological issues should be addressed with behavioral and/or pharmacological therapies. Increased fiber intake and withdrawing gut-affecting medication can also help with pain. High-voltage pulsed galvanic stimulation has been shown to reduce short-term frequency of the attacks.

    Levator ani syndrome presents the symptoms with vague, aching or pressure feeling high in the rectum. It could be worsened by sitting and relieved by walking. The pain tends to be constant and lasts from hours to days. It recurs regularly.

    The diagnostic criteria of levator ani syndrome is that the symptoms must be present for three months with symptom onset at least six months prior to diagnosis, and other causes of similar anorectal pain must have been excluded.

    Management of levator ani syndrome is similar to that of proctalgia fugax, including biofeedback treatment, Inhaled salbutamol, Botulinum toxin A, electrogalvanic stimulation and nerve stimulation.

    Self Management in Relieving the Symptoms of Hemorrhoids | Minneapolis & St Paul

    Studies suggest that an estimated more than 50% of Americans will develop a hemorrhoid condition by the age of 50- yet, only a small percentage of people seek treatment until it is impossible to ignore. While not a replacement for professional treatment, conservative treatments are available that can manage the symptoms and prevent recurrence.

    For grade I internal and nonthrombosed external hemorrhoids, warm baths, a high-fiber diet, high fluid intake, stool softeners, topical analgesics, topical steroids, and proper hygiene can improve hemorrhoids. Warm baths increases blood flow and relaxes the sphincter, easing perianal pain caused by a hemorrhoid. Ice can be used in cases of acute thrombosis. The key to conservative management of hemorrhoids is reducing constipation and hard stool. This, in turn, reduces pressure in the lower rectum. Increasing dietary fiber increases fluid retained in the stool, which, combined with increased water intake, can greatly relieve pressure on hemorrhoids. Good sources of fiber include beans, fruit, veggies, and whole grains. Fiber supplements, such as psyllium husk powder, are effective and can make fiber intake more convenient. Another important consideration is time spent on the toilet- with so many ways to distractions available it is easy to linger in the bathroom, but one should only stay on the toilet long enough to evacuate the bowels.

    Topical agents are available, but only a few are marginally effective. Topical hydrocortisone can relieve the rectal irritation and itching and decrease internal hemorrhoidal bleeding. However, it should not be used longer than two weeks due to mucosal atrophy.

    Hemorrhoids can be a hassle, but luckily there are ways to manage it independently. Conservative treatment aims to reduce constipation and stool hardness, by adjusting diet or through supplements, reduce strain by changing toilet habits, and medicate in some circumstances with topical medication. However, if bleeding is persistent or if pain is present or if the irritation with itching affects your quality of life, it is best to see a medical professional.

    How Accurate does a Physician Make a Diagnosis of Hemorrhoids? | Minneapolis & St Paul

    Hemorrhoids are a condition in which swollen varicose veins are found in the lower rectum and anus. It is estimated that three out of four people will develop hemorrhoids at some time in their lives. Because of rich vascular and nerve supply, as well as tendency to prolapse in the anorectal area, hemorrhoids are among the most common reasons for anorectal complaints in office visits.

    Although not all rectal symptoms are caused by hemorrhoids, hemorrhoids subsequently are blamed for almost all rectal complaints by patients and doctors alike. How accurate does a physician make a diagnosis of Hemorrhoids? Actually, the accuracy of a diagnosis is not very high. Studies show that the correct rate of hemorrhoid diagnosis is lowest in seven common anorectal conditions. There was no correlation between diagnostic accuracy and years of physician experience. The investigators in the studies found the average diagnostic accuracy among the physicians to be 53.5%, with the accuracy for colorectal and general surgeons being 70.4% and that for the rest of the doctors being less than 50%.

    Hemorrhoids are a common and benign disease; many patients in Minnesota are too embarrassed to ever seek medical attention. It is important to rule out other rectal conditions, such as cancer and other causes of rectal bleeding, anal fissure and fistula, and anal warts. It is relatively common to see that the patients have two benign conditions at the same time. Occasionally, the patients have both hemorrhoids and rectal or colon cancers. Early medical consultation is important to confirm diagnosis and start early treatments, which not only improve the quality of life, but also save lives.

    What Kind of Hemorrhoid Patients in Minnesota Need the Banding Treatments?

    No single treatment modality can fix all hemorrhoids or get rid of anorectal symptoms. Early hemorrhoids can often be effectively treated with by Infra-red Coagulation (IRC) and dietary and lifestyle changes, but more advanced hemorrhoids may need Rubber band ligation (RBL) or hemorrhoidectomy.

    RBL is one of the common procedures to treat hemorrhoids in in Minnesota. RBL is an office procedure in which the prolapsed hemorrhoid tissue is tied off at its base with rubber bands. It works very well for prolapsed hemorrhoids, such as the advanced grade 2 and grade 3 hemorrhoids. It cannot be performed if there is not enough tissue to pull into the barrel in the banding device. This procedure is almost never appropriate for grade 1 or mild grade 2 hemorrhoids (treated with IRC), or most severe (grade 4) hemorrhoids (treated with surgery).

    The process involves a doctor inserting an anoscope into the anus and grasping the prolapsed hemorrhoid with a long clamp to place a rubber band around its base. Cutting off the blood flow to the hemorrhoid causing it to shrink and dies off within a week. The reduced volume of venous tissue with the scar formation prevents hemorrhoid tissue bulging into the anal canal. The procedure is done in a doctor’s office and only a couple of minutes. Treatment is usually limited to 1 hemorrhoid each office visit and additional areas may be treated at 2 week intervals. Most patients require two to four treatments. Rubber band ligation downgrades the hemorrhoids to grade 1 or 2, some patients may need to do IRC to treat the remaining hemorrhoids after Rubber band ligation.

    After the procedure, some patients may feel tightness, mild pain or have the feeling of bowel movement. Most patients are able to return to regular activities (but avoid heavy lifting) almost immediately. If you feel some pain after banding, you may use Tylenol or Ibuprofen as needed and do a lot of sitz bath for 15-30 minutes at a time to relieve discomfort. Some patients may have slight rectal bleeding in a week. If you notice significant rectal bleeding, then you should call your doctor’s office.

    Learn about Pruritis Ani | Minneapolis & St Paul

    What is pruritis ani?
    Pruritis ani is a Latin term meaning “itchy anus” and it is an unpleasant, intense, cyclic itching or burning sensation of the skin around the anus (rectal opening) that produces the urge to scratch. Minimal stimulation or irritation of the skin in the anal area may cause itching. The subsequent scratching may cause damage to the skin which leads to more itching and scratching, which is a vicious cycle.

    Pruritis ani is classified as either primary or secondary. The primary form is idiopathic, which may not have an identifiable cause, while the secondary form has an identifiable cause. It affects up to 5% of the population in Minnesota.

    The symptom of itching is common to many anorectal diseases, such as internal and external hemorrhoids, anal tags, anal fissures and fistulae, anal warts. But the difference is that itching in pruritis ani is more intense and cyclic, having an irresistible urge to scratch, and it happens more often at night or after a bowel movement.

    What causes pruritis ani?

    The exact mechanism of developing pruritis ani is not clear. There are many risk factors that contribute the disease.

  • Excessive Cleanliness
  • Prolonged exposure to moisture
  • Dietary factors
  • Skin Irritants
  • Infectious processes
  • Anal skin diseases.
  • How is pruritis ani diagnosed?
    The diagnosis of pruritis ani is clinically diagnosed by history, physical examination, and anoscopy. There is no test for it. In the initial office visit, your doctor may inspect the anus visually to look for skin changes or growth in the anus, followed by a digital rectal examination with a gloved, lubricated finger and then anoscopy to look for abnormalities in the lower rectum and anal canal. If indicated, your doctor may also perform a biopsy (a small piece of skin removed for microscopic examination).
    Anoscopy is a rectal exam with a very short (3 to 4 inch) rigid metal tube to examine the lower rectum and anal canal. It is very useful when your doctor suspects hemorrhoids, anal fissures and other anorectal diseases.

    How is pruritis ani treated?
    The goal of therapy is to reduce or eliminate the itching symptom and cure the disease by restoring clean, dry, and intact skin.

  • Avoid injury to the skin. This is one of the most important, but often most difficult, part treatment of pruritis ani. This means no scratching with hands or dry toilet paper, which is often very difficult to achieve, due to the intense desire to scratch. The patients should cut their nails and wear a pair of mittens at night so they are not able to scratch.
  • Thicken stool and create a formed bowel movement to minimize leakage. Most people can benefit from taking a fiber supplement. If stools still remain loose, additional medications, such as Imodium and Lomotil, may be helpful.
  • Make dietary changes. Avoiding overuse of several common foods and beverages may improve symptoms. These foods and include coffee, colas, tea, chocolate, tomatoes and beer.
  • Improve bowel hygiene or modify cleaning habits. It is important to clean the anus gently. Cleaning with plain water rinses is quite helpful. Anything containing deodorants, alcohol and witch hazel agents should be avoided. You may use diluted white vinegar.
  • Make sure the skin is dry. You may use a hair dryer on a low setting and place a wisp of rolled cotton between the buttocks and against the anus to absorb moisture.
  • Try skin barriers or short course of steroid cream in the initial stage of treatment.
  • Treat the underlying diseases such as hemorrhoids, anal tags, anal fissures, and anal warts.
  • The Common Causes of Minor Rectal Bleeding | Minneapolis & St Paul

    Minor rectal bleeding is one of the common symptoms that the Minnesotan patients seek for the medical care. It refers to the passage of small amount of bright red and fresh blood from the rectum and anus, which may appear on the surface of stool, on the toilet paper or in the toilet bowl.

    This blog mainly discusses on the conditions with minor rectal bleeding that occurs intermittently. Rectal bleeding can be caused by various conditions, but even the slightest amount of bleeding should be taken seriously. Common causes of minor bleeding are internal hemorrhoids, ruptured thrombosed external hemorrhoids, fissures, fistula, diverticulosis, colon cancer, colitis, and polyps. Patients of older age or with significant family history of bowel disease or cancer should consider further examination. In addition, patients who were previously treated for rectal bleeding but continued to experience bleeding must be further examined.

    The source of minor rectal bleeding is determined by history, physical examination and endoscopies. In the initial office visit, your doctor may inspect the anus visually to look for anal warts, anal fissures, cancer or external hemorrhoids, and followed by the digital examination with a gloved, lubricated finger and then anoscopy to look for abnormalities and sources of bleeding in the lower rectum and anal canal. If indicated, your doctor may also perform endoscopies, either sigmoidoscopy or colonoscopy.

    Anoscopy is a rectal exam with a very short (3 to 4 inch) rigid metal tube to examine the lower rectum and anal canal, it is very useful when your doctor suspects hemorrhoids, anal fissures and other anorectal diseases.

    A flexible sigmoidoscopy is to uses a short (24 inches) and flexible tube with a camera to examine the lower colon and rectum.

    Colonoscopy is a test that examines the lining of the entire colon for abnormal growths, such as polyps or cancer. A long tube is passed into your bowel, and a light on the end allows the examiner to see the inside of the bowel. If anything abnormal is found, a small biopsy will be done, and polyps or growths can be removed.

    The management of minor rectal bleeding mainly focuses on the treatments of the underlying diseases.

    Why can’t Single Treatment Modality Fix All Hemorrhoids? | Minnesota

    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 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.

    No single treatment modality can fix all hemorrhoids or get rid of anorectal symptoms. Specialized hemorrhoid clinics should be able to offer multiple treatment modalities with cutting edge technologies to cure hemorrhoids and associated diseases.

    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.

    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
    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.

    External 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.

    What Can I Expect After Hemorrhoidectomy? | Minnesota

    Most cases of hemorrhoids can be managed through non-surgical anal care measures or minimal invasive office procedures. Some cases with more advanced grade, though, cause more severe symptoms and must be dealt with in a more invasive manner.

    Banding and Infra-red coagulation are common office procedures that are used to treat mild or moderate internal hemorrhoids. These minimal invasive procedures require little or no aftercare.

    In most cases that require surgical intervention, however, a hemorrhoidectomy is necessary. This procedure is usually performed under local anesthesia with or without sedation in a surgical center. During this surgery, your doctor will remove the prolapsed hemorrhoids by cutting them out and coagulating the varicose veins with the radiofrequency (RF) device. You are able to go home after a short observation.

    How Will I Manage The Pain After Surgery?

    Most people report that they have more pain with bowel movements in the first few days, but they usually feel better with each passing day after a hemorrhoid surgery. They should expect to have some pain for at least one week and maybe as long as two weeks. We usually offer prescription pain medicine for most patients following an extensive surgery. In the most time, we prefers not to give you a narcotic prescription to avoid constipation, but you are encouraged to use Tylenol and/or Ibuprofen to manage the pain after surgery.

    Even after the initial pain fades, many people have mild pain, irritation or itching during or after bowel movements for a few weeks after surgery. Following the anal care instructions with sitz bath, stool softener, and OTC topical creams, may help relieve these symptoms.

    What Else Do I Need To Know About Aftercare?

    In addition to pain medication, you are required to do regular sitz bath that helps not only heal and prevent infection, but also relieve the pain and other symptoms associated with hemorrhoid surgery. This consists of sitting in warm water for up to thirty minutes three times a day. The warm water will help to clean the anal area, as well as relax the muscles to ease pain.

    One of the keys to quick healing is to avoid straining while having a bowel movement. We usually suggest stool softener and fiber supplement. You should also drink water throughout the day. If you have constipation before surgery or you develop constipation after surgery, then you may need a laxative.

    After a bowel movement, you may have light bleeding. You can lessen this by using wet wipes instead of toilet paper during this time.

    As with any surgery, there is a risk of infection after hemorrhoid removal. Infection after hemorrhoidectomy is rare. It is important to call your doctor if you have severe swelling, redness or increased pain, a fever or any unusual draining from the surgical sites.

    How to Prevent the Hemorrhoids in Minnesota

    Now that you feel much better after hemorrhoid care and you are very happy that your quality of life is back, you are ready to enjoy the beautiful spring season in Minnesota next month. However, you may raise the question, do hemorrhoids come back? If so, how do I prevent them? Hemorrhoids are a varicose vein disease. It is possible to relapse after hemorrhoid care, especially in the advanced hemorrhoids, but recurrence rate is much lower in the mild hemorrhoids.

    Hemorrhoids are one of the most persistent chronic medical conditions in the Minneapolis and St. Paul areas, leading to many people becoming frustrated at the recurrent symptoms. Luckily, there are numerous different measures available to prevent them to come back.

    One of the best things you can do to prevent hemorrhoids is to make important dietary changes. Follow a high fiber diet. Why is fiber so very important? People in Minneapolis who do not get enough fiber in their diet tend to have constipation with hard stool and strain when going to the bathroom. In turn, this pressure constitutes one of the greatest risk factors to those who are vulnerable to developing hemorrhoids. In order to prevent the onset or return of hemorrhoids, you should strive to eat a diet rich in fruits, vegetables, and fibers.

    For those who have a history of hemorrhoids in the Minneapolis and St. Paul areas, it is recommended that these patients should integrate bulking agents into their daily diets, such as Metamucil The use of bulking agents is an important step in preventing the onset of hemorrhoids. These bulking agents work better if you drink plenty of water every day (6-8 glasses of water daily).

    You should have good bowel habits and maintain smooth stool. Constipation with hard stool and straining can increase abdominal pressure rapidly, as well as expansion of venous plexus, often causing rupture of hemorrhoidal veins and anal skin tearing. If you develop chronic constipation, you should treat it aggressively by having a high fiber diet, increasing water intake, walking daily, and taking bulking agents and laxatives. However, frequent diarrhea does not help, either. Straining related to diarrhea also can rapidly increase the pressure in the abdomen and hemorrhoid venous complex, too. The toilet time should not be too long; you should avoid the bad habit of reading newspapers in the toilet.

    Individuals who are prone to developing hemorrhoids should also avoid standing for extended periods of time and constant heavy lifting.

    Obese patients in Minneapolis are 2-4 times more likely to develop hemorrhoids than the average patients, so weight loss may help to reduce the recurrence.

    People with other medical problems, such as liver cirrhosis with portal hypertension, cardiovascular diseases, and abdominal tumors are more likely to develop hemorrhoids. The treatment of these underlying medical diseases is important to prevent hemorrhoids.

    You may program your bowel movement in the way that you always try to have bowel movements right before your regular shower. For example, if you are a morning person, you go to toilet first before you take a shower, so the anus is always clean without residual feces. Residual feces are irritable to the skin around anus. If you starting having recurrent symptoms, then a daily Sitz bath helps a lot to relieve the symptoms.

    Finally, once the hemorrhoids come back, you should immediately request an experienced practitioner in Minnesota to treat it. One Stop Medical Center serves the entire Twin Cities and offers the comprehensive hemorrhoid treatment in both Edina and Shoreview offices.

    How to Manage the Hemorrhoids During Pregnancy in the Minnesotan Women

    Although the women in Minnesota are prone to develop hemorrhoids when pregnant, they’re not inevitable. There are several ways to avoid or improve hemorrhoids.

    Soak in warm water in the tub or sitz bath 2-3 times a day.
    Try witch hazel or ice packs to soothe the sting of hemorrhoids; a warm bath might reduce discomfort, too. If you’re really uncomfortable when sitting, use a doughnut-shaped pillow to make sitting on your bum a little less painful.
    Apply ice packs or cold compresses to your anus several times a day to help relieve swelling.
    Keep your anal area clean. Pre-moistened wipes may be more comfortable than dry toilet paper. Choose brands that don’t contain perfumes or alcohol — or use medicated wipes made specifically for people who have hemorrhoids.
    Try an over-the-counter hemorrhoid remedy. You may use Preparation cream for a few days or ask your health care provider to recommend a hemorrhoid cream that’s safe to use during pregnancy. Remember, hemorrhoid creams don’t cure the underlying condition — they simply soothe the pain of existing hemorrhoids. You should not use it continuously for a long term.
    Avoid constipation: Eat a high-fiber diet, drink plenty of water, and get regular exercise daily. When you’re constipated, you may take a fiber supplement or stool softener, drink 6-8 glasses of water. If your constipation doesn’t resolve, ask your practitioner about it. You may program your bowel movement, if you are morning person or evening person, you may train yourself to have the bowel movement regularly every morning before shower. Don’t wait when you have the urge to have a bowel movement, try not to strain when you’re moving your bowels, and don’t linger on the toilet, because it puts pressure on the area.
    Perform kegel exercises daily. Although no study shows Kegels decreases the chance of hemorrhoids, it increases the circulation which may help to avoid hemorrhoids. It also strengthens the muscles around the anus, the vagina and urethra, which can help your body recover after you give birth.
    Avoid sitting or standing for long stretches of time. Try lying on your side or standing up. If you must sit, get up and move around for a few minutes every hour or so. At home, lie on your left side when sleeping, reading, or watching TV to take the pressure off your rectal veins and help increase blood return from the lower half of your body.

    If these suggestions don’t help or your hemorrhoids get worse, consult with the hemorrhoid care expert Dr. Shu in Edina and Shoreview, MN. He provides one stop hemorrhoid care with multiple treatment modalities.

    Hemorrhoids During Pregnancy In the Minnesota Women

    Hemorrhoids are very common complaints during pregnancy. It afflicts 20 to 50 percent of all pregnant women in Minnesota. The hemorrhoids are actually varicose veins in the anorectal area, and although it is usually not dangerous, it can be very annoying. Four cardinal symptoms of hemorrhoids are itching, pain, bleeding and bulging out.

    Some women get them in the first pregnant, others get recurrent hemorrhoids. Hemorrhoids usually get worse in the third trimester, right after labor pushing or if you develop constipation. The good news is that hemorrhoids will begin to improve soon after giving birth.

    Why does pregnancy make women in Minneapolis and St Paul areas more prone to hemorrhoids? There are several reasons on it. First, hemorrhoids are a type of venous disease similar to varicose veins. Second, the enlarging uterus plus increased blood flow put pressure on the pelvic veins and other large veins that increases the pressure on the veins and causes them to become more dilated. Third, constipation is another common problem during pregnancy, which can also aggravate hemorrhoids due to the straining. Fourth, an increase in progesterone hormone during pregnancy causes the walls of hemorrhoidal veins to relax, allowing them to swell more easily. Moreover, progesterone slows down women’s digestive tract and contributes to constipation.

    Interesting Story about Hemorrhoids | Minneosta

    More than 10 million people in the United States suffer from hemorrhoids. Three out of four people in Minnesota will develop hemorrhoids at some time in their lives. In fact, the disease is so common that hemorrhoid sufferers have their own patron Saint, St. Fiacre.

    Patron Saint of Hemorrhoid Sufferers

    During the middle ages, an integral part of the therapy for certain ailments included prayer to “patron” saints for possible divine intervention. Through legends surrounding his life, St. Fiacre, a 7th century Irish monk, became the patron saint for hemorrhoid sufferers (and gardeners). During medieval times, hemorrhoids were known as St. Fiacre’s curse. St. Fiacre is also known as the patron saint of gardeners because he could farm all the land and manage to cultivate in a single day. As the legend goes, the saint was given a rather small shovel by his bishop and spent very long days spading his garden and developed a severe case of prolapsed hemorrhoids. Seeking a solution, he sat on a stone and prayed for help. The legend states he enjoyed a miraculous cure from the stone.

    Napoleon Bonaparte’s Hemorrhoids

    Napoleon Bonaparte had long suffered from hemorrhoids. On last day of the battle of Waterloo he was unable to mount his horse, and his doctors accidentally overdosed him with laudanum. Researchers believe that it’s possible that’s what caused the fatal delay starting the battle. It is pretty well known that if Napoleon had begun the battle earlier, the Duke of Wellington would not have been able to join forces with Blucher and the battle most likely would have been lost.

    Complications of Hemorrhoids in Minnesota

    Not everyone in Minnesota knows that hemorrhoids are actually part of the normal anatomy and that every human body has them, so hemorrhoids should not be embarrassing. When people in Minnesota complain about “hemorrhoids”, they are often referring to symptoms in the perianal and rectal areas. Hemorrhoid symptoms are the most common ailments affecting humans, almost everyone in Minneapolis and St Paul areas will develop symptoms at some time in their life, and significant percentage will develop chronic symptoms. Although hemorrhoids are usually not life threatening, they can certainly interfere with one’s quality of life.

    Complications of hemorrhoids in Minnesota include:

    Anal Itching

    Anal itching, or pruritis, is one of the most common symptoms related to hemorrhoid disease in Minnesota. Anal itching is instigated by the anal skin inflammation triggered by the hemorrhoids. Excessive wiping and scratching further damage the perianal skin and causes chronic dermatitis. Over use of OTC hemorrhoid cream containing steroid can cause the damage in the perianal skin. The patients may develop the true complication called Pruritic Ani with persistent cyclic anal itching.

    Thrombosed External hemorrhoid

    Thrombosed external hemorrhoid occurs when the enlarged hemorrhoidal venous complex ruptures, a blood clot can then form in the hemorrhoid. Thrombosed hemorrhoids are usually quite painful, and it requires immediate surgical intervention to remove the blood clot.

    Anemia

    Chronic blood loss from hemorrhoids may cause anemia, resulting in fatigue and weakness. We had a few cases in Minnesota in the past few years that developed severe iron deficiency anemia due to hemorrhoidal bleeding, and their Hemoglobin dropped to as low as 5 or 6.

    Strangulated hemorrhoid

    When the hemorrhoids are so severe that they prolapse, it leads to the anal sphincter spasm due to pain and irritation. Persistent sphincter spasm can cut off blood supply to an internal hemorrhoid which causes more swelling of hemorrhoid tissue, it turns into a vicious cycle. Eventually, the hemorrhoid may be “strangulated,” which can cause extreme pain and lead to tissue death.

    Infection

    The local inflammation triggered by the bulging hemorrhoids causes the swelling and erosion of anorectal mucosa, which may increase the chance of infection. Opportunistic bacteria and microorganisms established on feces and the surrounding might attack and flourish in the damaged tissue.

    The Common Causes of Rectal Lumps | Minnesota

    A rectal lump is one of the common symptoms in the anorectal diseases in Minneapolis and St Paul areas. A rectal lump is a growth in the anal canal or rectal area. Rectal lumps vary in size and the degree to which they produce symptoms. Depending on the underlying cause, a rectal lump may or may not cause any pain.

    Should you be worried about that bump you just discovered back there? A palpable mass in the anal area may or may not indicate cancer or hemorrhoids. Lumps can be caused by a variety of conditions including anal warts, hemorrhoids, polyps, fissures, or cancer.

    • Hemorrhoids are probably the most common reason for having a rectal lump in Minnesota. It can be caused by internal hemorrhoids, but more commonly by external hemorrhoids. If a rectal lump is related to internal hemorrhoids, it usually gets bigger and more prolapsed right after the bowel movement; it could be spontaneously reduced in the early stage of internal hemorrhoids. But it could be non-reducible in the late stage of hemorrhoids. It may be associated with other symptoms such as bleeding, itch or pain. The thrombosed external hemorrhoids are usually very painful if the varicose veins rupture and the blood clots develop.
    • Anal warts are caused by human papilloma virus (HPV). HPV infection is considered to be sexually transmitted diseases. Left untreated, anal warts can spread and increase the risk of cancer in the rectal and anal region.
    • Anal Fissure is a small cut or split in the anal lining often caused by a painful, hard bowel movement. Fissures are typically located anterior or posterior to the anus. Anal fissure is often associated with a lump called sentinel pile, accompanied by pain and bleeding.
    • Rectal Cancer. The rectum is the last six inches of the body’s digestive system, exiting through the anus. One cause of a rectal lump is rectal cancer. Symptoms that require doctor’s attention include blood in the stool, change in bowel habits, tired feeling, abdominal discomfort, change in appetite, or unexplained weight loss.
    • Anal cancer occurs in the anal canal, it is account for 2% of cancer in the gastrointestinal tract. An external or internal mass may be palpable. Anal or rectal cancer generally do not produce any pain; Some lesions are so soft that they are missed on palpation. Anal cancer can take several forms including ulcers, polyps or verrucous growths.

    If you feel a lump in the anal or rectal area, contact our hemorrhoid clinics in Edina or Shoreview to determine the cause and get treatment. You should seek immediate medical care if the associated symptoms are serious such as high fever, drainage of pus from a rectal lump, severe pain, or bloody stool.

    The Common Causes of Rectal Pain | Minneapolis

    Rectal pain is a common sign of anorectal diseases in Minnesota. It can be caused by various conditions. Pain caused by an acute anal fissure may occur during intense, forced bowel movements that are often accompanied by rectal bleeding. Pain that begins gradually and becomes excruciating may indicate infection. In general, external hemorrhoids don’t cause significant rectal pain in Minneapolis and St Paul. They will cause pain, however, if the varicose vein complex ruptures, as blood clots occur and build up the pressure inside the lump. This condition, known as thrombosed external hemorrhoid, causes an extremely painful bluish anal lump. The somatic nerve in the anal canal (below the dentate line) can sense pain, this is why the patients feel significant pain with the immediate onset when they develop thrombosed external hemorrhoids.

    Internal hemorrhoids, however, are not painful due to being located above the dentate line of the rectum that is supplied by the visceral nerve, like those found within the intestines, which sense pressure rather than pain. Similarly, rectal cancer typically does not cause pain unless the condition is advanced. The patients with chronic anal fissures usually have intermittent sharp rectal pain and bleeding with each bowel movement for a long time.

    Proctalgia fugax (rectal pain) is a more serious anal pain condition that involves short spasms of intense pain. This condition may occur once each year or up to three or four times each week. The pain is typically accompanied by sweating and an urge to pass stool. There is currently no treatment for proctalgia fugax, but placing oneself in warm water may provide symptomatic relief.

    The Common Causes of Rectal Bleeding Minneapolis

    Rectal bleeding refers to the passage of red blood from the rectum and anus, often mixed with stool and/or blood clots. The severity of rectal bleeding varies widely in Minneapolis and St Paul. Most rectal bleeding is mild and intermittent in Minnesota, but it also may be moderate or severe.

    Rectal bleeding can be caused by various conditions, but even the slightest amount of bleeding should be taken seriously. Common causes of bleeding are internal hemorrhoids, ruptured thrombosed external hemorrhoids, fissures, diverticulosis, colon cancer, colitis, polyps and angiodysplasias. Patients of older age or with significant family history of bowel disease or cancer should consider further examination. In addition, patients who were previously treated for rectal bleeding but continued to experience bleeding must be further examined.

    The source of rectal bleeding is determined by history, physical examination and blood tests, assisted with anoscopy, sigmoidoscopy, colonoscopy, radionuclide scans, and angiograms.

    Treatment of rectal bleeding includes correcting the low blood volume and anemia, determining the site and cause of the bleeding, and stopping the bleeding.

    The Common Causes of Anal Itching | Minneapolis

    Anal itching is a common symptom in the office visit in Minnesota. The initial relief of the itching does not necessarily mean the problem goes away. Continuous scratching or excessive cleaning of the anal area may further harm the sensitive tissues and worsen symptoms. In addition, the area can be highly sensitive to perfumes, soaps, fabrics, dietary intake and superficial trauma. When chronic itching occurs, the perianal area becomes white with fine fissures.

    Possible causes of anal itching include:

    Skin irritation: Moisture and friction can irritate the skin in the peri-anal area. Some products such as soap and toilet paper may also trigger irritation.
    Hemorrhoids: Anal itching can be a symptom of hemorrhoids.
    Digestive problems: Diarrhea or fecal leakage can cause anal irritation and itching.
    Skin disease: Anal itching could be related to a specific skin disease, such as psoriasis or contact dermatitis.
    Infections. STD, yeast infections, and the parasite may also involve the anus and can cause anal itching.
    Anal tumors: Rarely, a cause of anal itching.

    Treatments for anal itching include taking antihistamine as a sedative prior to sleeping to prevent the patient from unconsciously scratching, or using a topical corticosteroid to alleviate the itching. Underlying disorders such as hemorrhoids or infections must be considered and treated when diagnosing and treating anal itching.

    Rubber Band Ligation | Minnesota

    Rubber band ligation (RBL) is one of the common procedures to treat hemorrhoids in our clinic. RBL is an office procedure in which the prolapsed hemorrhoid tissue is tied off at its base with rubber bands. It works very well for prolapsed hemorrhoids, such as the advanced grade 2 and grade 3 hemorrhoids. It cannot be performed if there is not enough tissue to pull into the barrel in the banding device. This procedure is almost never appropriate for grade 1 or mild grade 2 hemorrhoids (treated with IRC), or most severe (grade 4) hemorrhoids (treated with surgery).

    The process involves a doctor inserting an anoscope into the anus and grasping the prolapsed hemorrhoid with a long clamp to place a rubber band around its base. With the rubber band in place, the hemorrhoid dies off in a few days or a week. The procedure is done in a doctor’s office and only a couple of minutes. Treatment is usually limited to 1 hemorrhoid each office visit and additional areas may be treated at 2 week intervals.

    After the procedure, some patients may feel tightness, mild pain or have the feeling of bowel movement. Most patients are able to return to regular activities (but avoid heavy lifting) almost immediately. If you feel some pain after banding, you may use Tylenol or Ibuprofen as needed and do a lot of sitz bath for 15-30 minutes at a time to relieve discomfort. Some patients may have slight rectal bleeding in a week. If you notice significant rectal bleeding, then you should call your doctor’s office.

    Hemorrhoid Prevention for Minnesotans

    There are many ways to prevent the hemorrhoids for the patients in Minnesota. One of the best ways to avoid hemorrhoids or a flare up is to avoid constipation by keeping your stools soft. Eating a diet that is high in fiber such as fruits, vegetables, beans, and whole grains are recommended. Taking a fiber supplement every day, such as Citrucel or Metamucil, can help keep bowel movements regular. Drinking enough fluids is equally as important so that your urine is light yellow or clear. Water is the best form of hydration. Daily exercise is also great to help the bowel move through your digestive system and prevent you from becoming constipated. Moderate activity of at least 30 minutes 3-4 times per week is recommended. Scheduling time each day for a bowel movement and keeping it a daily routine may help. Take your time and do not strain when having a bowel movement, because it is the straining that causes hemorrhoids. Straining and holding your breath when trying to pass a stool creates greater pressure in the veins in the lower rectum. Lastly, once you feel the urge, it is important to go because if you wait to pass a bowel movement, the urge goes away and your stool could become dry and be harder to pass.

    Hemorrhoid Treatment on the Road | Minneapolis & St Paul

    I have an interesting story that happened while I visited China a few years ago. I was invited to give a lecture on office procedures as a guest professor in Zhejiang University, China. After the academic exchange, I had a few days to myself, so I went to visit an old friend of mine (let’s call him Dave). We decided to go visit a new resort town a few hours away from the city. As we were talking in the hotel, he was looking a bit shifty on the couch, as if he was very uncomfortable. After spending an unbelievable amount of time in the bathroom, I asked him if he was having a problem, and he said he had a lot of pain going to the bathroom because of his hemorrhoids. Thankfully, this being an area of my specialty, I was able to diagnose him with having a thrombosed hemorrhoid that needed immediate treatment. I told him that a thrombosed external hemorrhoid is the common complication of hemorrhoids. If the blood clots, the hemorrhoid develops localized bulging and becomes extremely painful, especially when going to the bathroom.

    Dave said he would go to the hospital, but he hesitated to go because of inconvenient medical care in China. He didn’t trust the doctors in the local small hospital, and he was indecisive in choosing a larger hospital. I told him that I had fixed countless thrombosed hemorrhoids, and that if I had the tools I needed, I could fix it for him in a flash. I went to a local hospital in the town and identified myself, the medical staff believed that I was a general surgeon at Shanghai Medical University twenty years ago and that currently I practice in the US. I asked if I could get the necessary gear to do the procedure. Amazingly, the staff in the local hospital were very helpful and generous, and I managed to return with latex gloves, a scalpel, syringes, a pack of gauze, and a bottle of Lidocaine. I got him down on the bed and we did the procedure right there in the hotel.

    The procedure took only a few minutes. I gave 0.5 cc Lidociaine to numb the top of the thrombosed hemorrhoid, then sliced open the hemorrhoid with a scalpel and removed the clotted blood with a cotton-tipped applicator. Once the clot was gone, I cleaned up the area by packing large amounts of gauze. The relief was immediate and other than a little bleeding for a day or so, the problem was gone. I told Dave if he had the chance to visit Minneapolis, I can do IRC treatments to treat the root cause of problem – internal hemorrhoids.

    Infrared Coagulation (IRC) for Hemorrhoid Treatment | Minneapolis and St Paul

    Since its introduction 20 years ago, infrared coagulation has become the world’s leading office treatment for hemorrhoids. This non-surgical treatment is fast, well tolerated and remarkably complication-free. A small probe is placed on the hemorrhoid and a few short bursts of infrared light are applied. The infrared light quickly coagulates the vessels that provide the hemorrhoid with blood, causing the hemorrhoid to shrink and recede. Shrinkage of the hemorrhoidal tissue may take a few weeks.

    There may be a quick sensation of pain during the short burst of infrared light but overall the IRC treatments are very tolerable and painless. There are no post-treatment effects in 99% of patients. Usually approx 4 treatments are required. The IRC technology is very effective in treating grade 1 and grade 2 hemorrhoids, and the general treated hemorrhoids do not reoccur. Patients return to a normal lifestyle right after the treatment on the same day. There may be slight spot bleeding a few days later and up to 2 weeks. Heavy straining or lifting should be avoided and aspirin should not be taken for a few days. A sensible diet, moderate exercise and proper bowel habits will help so no further hemorrhoids will form.

    Hemorrhoid History | Minneapolis & St Paul

    As early as 2250 BC hemorrhoids have been recorded in literature to some extent. It would probably be safe to say that it is one of the oldest ailments known to people. The Egyptians were the first people who medically recorded the remedies for hemorrhoids. They used a poultice of dried acacia leaves with a linen bandage to heal protrusions and inflammations of venous material. A Greek physician named Hippocrates also wrote about hemorrhoids describing it as bile or phlegm which is determined to be the veins in the rectum. He treated the anal protusions very crudely avocating pulling the tissue off with the finger tips, or pulling the veins upward, while someone puts a hot iron to the hemorrhoid and burns it off. The first recorded endoscopy (use of speculum to inspect the rectum)can also be credited to Hippocrates. Even the bible has records of hemorrhoids in the earliest times from the Old Testament Book of Samuel 5:9 Philistines, “punished with emerods” and Samuel 5:12, “People who moved the Ark to Ekron were punished with emerods”.

    One of the earliest known hemorrhoid treatments was with the aloe vera plant. Dioscorides, a Roman physician started using that to treat inflamed hemorrhoids. Then approximately 130-200 AD a Roman physician named Emperor Marcus Aurelius (Galen) prescribed ointment, laxatives, and leeches for hemorrhoids treatment. During the same time period in India, the use of clamp and cautery was used to get rid of hemorrhoids and control bleeding.

    Between the 5th and 10th Century, Byzantine physicians used thread to ligate the base of the hemorrhoid and then followed by its amputation. Using the modern era of endoscopy, Philip Bozzini , an Italian-German physician, used an aluminum tube to see the genitourinary tract. He then earned the title “The father of endoscopy”. In 1935, Doctors E.T.C. Milligan and C. Naughton Morgan further studied the excision and ligation methods, which later became the gold standard in hemorrhoidectomy. In the 1960s, banding of larger hemorrhoids was introduced with rubber band ligation. In the 1970s, cryotheraphy, diathermy, and laser cauteries were developed for treatment. In the 1990s, Stapled Hemorrhoidopexy, also known as Procedure for Prolapse & Hemorrhoids (PPH) was first described by an Italian surgeon – Dr. Antonio Longo, and since then has been widely adopted to treat the grade 3 and 4 hemorrhoids. Moreover, Another non surgical procedure, called Infra-red coagulation (IRC) was developed to treat the early stage of hemorrhoids.

    Anal Tags | Minneapolis & St Paul

    Have you been using too much toilet paper because of pesky anal tags? Rest assured that these anal tags are harmless and very common. They are very similar to skin tags found in your armpit, neck, eyelids and sometimes groin. Anal tags are not contagious and cannot be passed from person to person.

    Anal skin tags are flaps of skin or flesh found around the anus. The tags are usually flesh colored and hang in the opening of the anus by a stalk or stem that supplies the blood to the tag.

    Anal skin tags are not caused by anal intercourse or sexually transmitted diseases. However, you need to be aware that anal skin tags are usually associated with other anorectal problems and may come about as a result of an injury, a hemorrhoid or an anal fissure.

    Causes of anal tags include:

    Hemorrhoids
    Anal fissures. An anal fissure is a small tear in the anus usually as a result of a hard stool. Or extreme stretching of the anus.
    Previous rectal surgery If you have previously had rectal surgery, those swollen skin edges may also develop into anal skin tags.
    Anal infection or injury
    Blocked anal gland
    Tight fitting clothing

    Anal tags can easily be removed in our office using local anesthetic and a radiofrequency device. The procedure only takes less than 10 minutes and you are able to drive yourself home afterwards.

    Symptoms of Hemorrhoids | Minneapolis & St Paul

    Severe pain is not a common symptom of internal hemorrhoids, because internal hemorrhoid happens in the area above the dentate line that is supplied by the visceral nerve, like those found within the intestines, which sense pressure rather than pain.

    As the venous complex of an internal hemorrhoid becomes varicose and continues to enlarge, it bulges into the anal canal and loses its normal anchoring, becoming a prolapsing internal hemorrhoid. The prolapsing hemorrhoid usually returns into the anal canal or rectum on its own, or can be pushed back inside using one’s finger, but usually prolapses again after the next bowel movement. In the anal canal, a hemorrhoid is exposed to movement caused by passing stool, particularly hard stools that can cause bleeding and pain. The painless rectal bleeding with bright red blood is a common symptom of internal hemorrhoids. The rectal mucosal lining that has been pulled down secretes mucus and moistens the anus and its surrounding skin, while the stool itself can also leak onto the anal skin. Itchiness often occurs as a result of this dual presence of stool and moisture.

    In general, symptoms of external hemorrhoids are different than those of internal hemorrhoids. External hemorrhoids can be felt as bulges at the anus, but rarely display any of the same symptoms seen with internal hemorrhoids. They will cause problems, however, if the varicose vein complex ruptures, as blood clots occur and build up the pressure inside the lump. This condition, known as thrombosed external hemorrhoid, causes an extremely painful bluish anal lump and often requires medical attention. The somatic nerve in the anal canal (below the dentate line) can sense pain, this is why the patients feel significant pain when they develop thrombosed external hemorrhoids. Thrombosed hemorrhoids may heal with scarring and leave a tag of skin protruding from the anus. Occasionally, the tag turns out to be quite large, which can make anal hygiene (cleaning) difficult or irritate the anus.

    Hemorrhoids | Minneapolis & St Paul

    Believe it or not, everyone has had a normal hemorrhoidal tissue in their rectum and anus. It’s only when your hemorrhoidal veins enlarge and become varicose veins that they’re considered abnormal or diseased.

    There are three types of hemorrhoids – internal, external, and mixed hemorrhoids that consist of both internal and external. External hemorrhoids are those that occur outside the anal verge and affect bowel cleansing after one’s bowel movement, causing skin irritation and itching. A thrombosed external hemorrhoid is usually very painful due to rupture of one’s varicose veins, which causes blood clots and is often accompanied with swelling and irritation. These external hemorrhoids are typically treated with either an incision or removal of the clot, or with an external hemorrhoidectomy performed under local anesthesia.

    Internal hemorrhoids are graded from I to IV based on the degree of prolapse. Grade I hemorrhoids bulge with defecation; grade II lesions also bulge with defecation, but then recede spontaneously. Grade III hemorrhoids require digital replacement after prolapsing, while grade IV hemorrhoids cannot be replaced once prolapsed. There are many treatment options for internal hemorrhoids that vary based on the severity of each case.

    Colonoscopys at the Procedure Clinic | Minneapolis & St Paul

    Your colon’s main function is to help your body eliminate waste, toxins and more from your blood, intestines and lymphatic system. Without your colon’s healthy function in your body, you can become seriously ill. A colonoscopy is among the most common types of exams performed on the colon. This is an invasive exam that allows a medical practitioner to view the inside of your colon through the use of a special scope. The procedure is most commonly recommended by a medical practitioner when a patient complains of symptoms such as bloody stools or blood in the toilet bowel, pain during bowel movements, abdominal pain when not having a bowel movement or any other abnormal or unexplained changes in bowel function. A family history of certain conditions may warranty the regular use of colonoscopy procedures as an early diagnostic step.

    The procedure involves probing a long tube through the anus and into the colon. A light and camera are mounted to the end of this tube to provide the medical practitioner with the ability to visibly examine the colon. The procedure is most commonly performed on a patient under conscious sedation. In order to enjoy the best diagnostic results from your colonoscopy, you do need to have a clean colon. The colon is most commonly cleaned through the patient’s use of an enema and fasting.

    Through the use of a colonoscopy, a medical practitioner can more accurately diagnose a number of colon and gastrointestinal conditions. These include colorectal polyps, colon cancer, inflammatory bowel disease, colitis and more. In certain instances, a medical practitioner may be able to take a biopsy of suspicious areas found during the colonoscopy, and some polyps or suspicious areas can be removed during this procedure. Polyps are abnormal growths and some may be cancerous in nature. Because of this, they are most commonly removed and biopsied when found during a colonoscopy. Early diagnosis of many of these colon and gastrointestinal conditions can provide a patient with the best outcome possible. Because of this, you should schedule a colonoscopy procedure immediately upon receiving the recommendation from your doctor.

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