Category Archives: Hemorrhoid Care

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.

 

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.

 

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.

 

Here’s What to Expect After Undergoing Rubber Band Ligation | Minnesota

Rubber band ligation (RBL) is a common treatment method for hemorrhoids, especially prolapsed hemorrhoids, in Minnesota. This office procedure is almost never appropriate for grade 1 or mild grade 2 hemorrhoids (which are treated with IRC) or more severe grade 4 hemorrhoids (which are treated with surgery). RBL involves a doctor inserting a scope into the anus and clamping onto the prolapsed hemorrhoid to place a rubber band around its base, cutting off the blood flow to the hemorrhoid and causing it to shrink and die off. The procedure only takes a few minutes but is usually limited to one hemorrhoid per office visit. RBL downgrades hemorrhoids to grades 1 or 2, and any remaining hemorrhoids are typically treated with infrared coaguation (IRC).
 

What Happens After the Procedure?

After rubber band ligation, you’ll typically experience a bit of pain and a feeling of fullness in the lower abdomen, as well as an urge to have a bowel movement. These sensations are totally normal and usually subside within a few days. You may also experience small amounts of anal/rectal bleeding for about 7 days after procedure due to the hemorrhoid falling off. It’s encouraged to avoid physically intense activities that strain the body for at least 2-3 weeks. While some patients are able to return to regular activities immediately, others may need a couple days of downtime and bed rest.

Below are a few guidelines for navigating your post-rubber band ligation recovery process:

Avoid any strenuous exercises, such as biking/cycling, jogging, weight lifting, and aerobics, for 2-3 weeks or until your doctor gives you the green light.

Avoid lifting heavy objects for 2-3 weeks, including groceries, backpacks/briefcases, dog food, children, etc.

If you previously took any medications or blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, your doctor will let you know when it’s okay to restart your meds.

Take your post-surgery pain medications exactly as directed, but do not take two or more types of pain meds at the same time unless instructed to.

Take showers/baths as usual, but make sure to thoroughly dry the anal area dry.

Drink plenty of fluids, and eat lots of high-fiber foods to aid your bowel movements.

Take stool softener such as Colace to keep stool soft.

Try to avoid straining during bowel movements.

To speed up your recovery process, take a sitz bath (sit in 2-3 inches of warm water for 15-20 minutes) three times daily AND after bowel movements. Remember to pat the anal area dry afterward.

Call your doctor immediately if you cannot pass stools or gas, see bright red blood soaking through the bandage, or see signs of infection (increased pain, swelling, redness, pus draining from the area, fever).

 

Battling Hemorrhoids? Try These Exercises to Alleviate Symptoms | Minnesota

Dealing with hemorrhoid discomfort can be a real pain (literally). In addition to visiting your doctor for a full exam, home remedies and lifestyle changes can help with relieving hemorrhoid symptoms. One important activity that can significantly assist your hemorrhoid prevention progress is exercising, which can include anything from simple walking to more intense cardio workouts.
 

Kegel Exercises

Also referred to as pelvic exercises, kegel exercises strengthen the muscles in the pelvic area and can help prevent hemorrhoids by increasing blood flow to the anal region and improving blood circulation. Strong anal muscles provide good support for internal hemorrhoids while also preventing existing ones from enlarging or protruding. Kegels can also help tighten tissues and control leaking around hemorrhoid problem areas.

The most basic Kegel exercise consists of simple pelvic muscle contractions. Similar to squeezing your pelvic region when you feel the need to urinate, squeeze and hold that same movement for five seconds. Release and relax for five seconds. Repeat this exercise 10 times per session, three times daily.

And contrary to popular belief, kegel exercises can be done by both men and women!
 

Brisk Walking

One of the easiest activities to incorporate into your daily lifestyle, brisk and regular walking for 20-30 minutes daily can help with hemorrhoid symptoms. Begin by walking slowly to warm up. Increase your pace after a few minutes to increase your heart rate and improve your body’s blood circulation.

Remember: the goal is to improve blood flow to your pelvic region, so walking keeps your body upright rather than sedentary on a couch.
 

Aerobics/Cardio Workouts

Aerobic exercises are ideal for treating hemorrhoid symptoms, as they get the blood flowing and help relax any strained muscles in the lower part of the body. Performing aerobics—or other forms of cardio—regularly improves blood circulation not only throughout the entire body, but also to the pelvic/anal regions. On top of that, more cardio workouts means more sweat and drinking more water; aerobics can also help you avoid constipation, one of the primary causes of hemorrhoids. Good examples of aerobic activities are running, swimming, spinning/cycling, dancing, and aerobics classes.

 

These Everyday Habits May Be Giving You Hemorrhoids | Minnesota

As unpleasant as hemorrhoids may sound, they are, believe it or not, quite common. With over three million cases reported each year, hemorrhoids are merely swollen veins caused by pressure on the bowels. While major lifestyle changes, such as pregnancy, can cause hemorrhoid development, many cases actually develop from seemingly insignificant everyday habits that build up over time. From diet choices to fitness and movement, below are a few common habits to be mindful of if you’re worried about hemorrhoids:
 
1. Not enough fiber – Low fiber intake can lead to constipation, which directly causes overstraining during bowel movements and, thus, inflamed veins. Try to aim for 25-50 grams of fiber everyday, eating more whole grains, fruits, vegetables, beans and nuts. For more on increasing your fiber intake, check out our post on the best and worst foods for preventing hemorrhoids.
 
2. Straining/overexerting yourself during workouts – If a weight is too heavy, DON’T force yourself. Suddenly increasing weight amounts too quickly puts a burst of pressure on your lower region, which is NOT what you want for your blood vessels.
 
3. Sitting too long on the toilet – Sitting for too long is never a good thing for your body! Hemorrhoids usually worsen or develop when there’s an increased, downward pressure, so the longer you sit on the toilet checking Twitter, the more your blood pools downward and adds pressure to the veins. Adding onto the fiber point above, eating more fiber should help increase the speed of your bowel movements and prevent added toilet-squatting time.
 
4. Eating too much processed food – Fast food, frozen meals and pre-packaged junk food are absolutely terrible diet options, as they contain few nutrients and loads of sodium. They also contain inflammation-promoting ingredients that increase constipation and bloating. Avoid!
 
5. Sitting for long periods of time – It’s not just excessive toilet-sitting that’s frowned upon. Sitting and binge-watching four straight hours of Keeping Up With the Kardashians will essentially produce the same negative results. Decreased mobility can cause blood flow to also decrease, and blood is more likely to gather up/pool in the anal veins, causing irritation and swelling that can develop into hemorrhoids.
 
6. Not hydrating enough – Along with increasing your fiber intake, drinking more fluids (preferably water) throughout the day helps promote good digestion and proper stool passage. Aim for at least eight cups of water daily.
 
If you do develop hemorrhoids, you may be able to alleviate discomfort using these home remedies. However, it’s important to still visit your doctor for a full examination and treatment rundown.

 

The Best & Worst Foods to Eat When You Have Hemorrhoids | Minnesota

Dealing with hemorrhoids is no walk in the park, but knowing the right kinds of food to incorporate into your daily diet can make a major difference in treating and preventing flare-ups. While it’s always encouraged to fill your diet with high-fiber foods, the vast amount of fiber-filled options can be pretty overwhelming! Below is a quick and dirty breakdown of the best and worst foods to consume while dealing with hemorrhoids.

 

 

BEST FOODS

EAT plenty of fruits and vegetables. Apples, berries, broccoli, leafy greens and winter squash are great options. It goes without saying that fruits and vegetables provide valuable nutrients, and most people don’t consume enough of them. In addition to easing constipation symptoms, fruits and vegetables add bulk to your stool and may reduce strain during bowel movements.

EAT whole grains. Oatmeal is one of the most popular whole grain foods, as well as whole grain breads, brown rice and popcorn. Whole grains have NOT been refined and contain all the nutritious parts of the original grain, providing more fiber, protein and micronutrients.

EAT more legumes (beans, lentils, nuts). Black beans, almonds, chickpeas and edamame contain large amounts of fiber even in very small portions. The legume family is also credited for helping decrease blood sugar levels and increase healthy gut bacteria.

EAT flax, hemp and chia seeds. These are all good sources of soluble fiber.

DRINK LOTS OF WATER! In addition to helping with your increased fiber intake, water throughout the day is crucial for good digestion. Aim for at least eight cups of water daily.

Remember: Shoot for 25-50 grams of fiber everyday. Too much fiber in one sitting can cause gas and bloating, so be sure to add it to your diet in small increments.
 

WORST FOODS

AVOID refined grains. This includes white bread, bagels, white rice and pretty much anything made from white flour. Refined grains have been milled, which removes the bran and germ and, consequently, any nutrients the grain originally contained.

AVOID processed foods as much as possible. Fast food, frozen meals and pre-packaged junk food are absolutely terrible options, as they contain few nutrients and tons of sodium. They also contain inflammation-promoting ingredients that increase constipation and bloating.

AVOID excessive alcohol. This can be tough, but alcohol dehydrates your body and can lead to constipation and disrupt the digestive balance in your stomach.

AVOID dairy. Milk and cheese products can irritate hemorrhoids since they often cause gas and bloating, which can contribute to hemorrhoid pain and stomach cramps if you are already constipated.

AVOID fried, salty food. Fries, fried chicken, fritters, the list goes on. These items scream inflammation and can cause your body to hang onto water, putting more pressure on your blood vessels. More pressure means more likelihood of developing hemorrhoids. Fried foods are also difficult to digest.

AVOID spicy food. Again, inflammation.
 
 

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.

     

    How Aging Increases Your Chances of Getting Hemorrhoids | Minnesota

    As we grow older and experience a variety of physical and mental changes to our bodies, we also become more susceptible to disease and illness. Because our regenerative powers slowly decrease over time, our bodies have a tougher time battling symptoms as we age—making hemorrhoids all the more common and bothersome.

    How Aging Affects the Development of Hemorrhoids

    Hemorrhoids, which develop when the veins in the anus and rectum become distressed and swollen, are much more of a threat when the body is sedentary. Decreased mobility (and increased amounts of time sitting), typically associated with aging, can cause blood flow to the lower part of the body to also decrease. The blood is then more likely to gather up/pool in the anal veins, causing irritation and swelling that can develop into hemorrhoids.

    Older individuals are also more prone to constipation as a result of having a more sedentary lifestyle. The straining that occurs from constipation, due to passing hard and dry stools, can cause prolonged stress to the anal and rectal veins. Once the blood vessels in these veins become extremely irritated, hemorrhoids can develop.

    Preventing Hemorrhoids in Old Age

    Diet Changes

    Hemorrhoids in the elderly can be effectively prevented by making conscious diet and lifestyle changes. A high-fiber diet helps maintain healthy bowel movements, thereby lowering chances of constipation and anal vein swelling. Consuming more fruits and vegetables, as well as legumes (chickpeas, lentils, soybeans) and whole grains (oatmeal, brown rice, barley), easily adds more fiber to your diet.

    Oatmeal bowlChickpeas

    DRINK. MORE. WATER. Consuming plenty of fluids helps keep the bowel healthy and functioning, and stools remain soft. This further prevents constipation and lowers your chances of having hemorrhoids.

    Exercise

    For elderly individuals who are capable of moderate levels of exercise, this is another good way to improve overall bowel movement and lower body blood circulation. Daily short walks, light swimming, and gardening are all appropriate examples of moderate exercise. However, you should always consult your doctor before starting any new diet or exercise routine.

    Treating Hemorrhoids at Home

    If the above prevention methods fail, and you find yourself with pesky hemorrhoids, there are a few home remedies that can help alleviate your symptoms. Sitz baths (soaking the affected area in warm water for 10-15 minutes) can soothe anal tissues and decrease pain and discomfort. Oils and creams may also be good options for early-stage hemorrhoids, such as witch hazel ointment or witch hazel hemorrhoidal pads.

    If symptoms do not clear up (or become worse) despite home treatment efforts, make sure to see a doctor for a full examination and advanced treatment method.

    Treating Hemorrhoids With Witch Hazel: The Rundown | Minnesota

    No, witch hazel isn’t some concoction brewed in a cauldron—but it most certainly can have beneficial health effects, especially on pesky hemorrhoids.

    One of history’s most powerful natural healing agents, witch hazel has long existed as an anti-inflammatory compound. Dating back hundreds of years, it was used by both Native Americans and European settlers to reduce inflammation and bleeding within the body, and has since been touted for its natural astringent properties. Witch hazel has been an effective at-home remedy to treat hemorrhoid discomfort, yeast infections and acne.

    In essence, witch hazel derives from the leaves and bark of the North American witch-hazel, Hamamelis virginiana. Its healing properties come from tannic acid, a chemical that can help constrict and cool the blood vessels and skin at the end of the rectum, which in turn reduces swelling and bleeding.

    Thayer's Witch HazelWitch Hazel Hemorrhoidal Pads

    How Do You Use Witch Hazel?

    Witch hazel can be purchased in liquid form or ointment form. Apply a pea-sized amount directly to the hemorrhoid three times daily AND after every bowel movement.

    Witch hazel can also be found in products like hemorrhoidal pads and medicated wipes. For best results, use witch hazel products after taking a sitz bath (soaking the affected area in warm water for 10-15 minutes).

    Are There Any Potential Risks or Side Effects?

    Stomach discomfort may result if witch hazel is taken orally. Very rarely, topical witch hazel (applied directly to the skin) can cause inflammation. Overall, witch hazel is considered to be safe.

    Keep in mind that while witch hazel can help alleviate hemorrhoid pain, it’s mostly used for basic, non-severe hemorrhoids. In the case of severe hemorrhoids or increased hemorrhoid flare-ups, witch hazel might not prove as effective. It is extremely important that anyone who suffers from hemorrhoid discomfort visits a doctor for a full evaluation or follow-up even after seeing signs of improvement from using witch hazel. Home remedies certainly help with symptoms, but it’s always best to see a doctor for a complete, thorough treatment method.

    Proctalgia Fugax Means “Fleeting” Rectal Pain | Minneapolis & St Paul

    8%-18% of people have it. And of those people, only 20-30% seek a professional diagnosis for it. Patients suffer from episodes of severe pain that can make it difficult to function in their daily lives. What is this mysterious ailment?

    Proctalgia fugax is the answer. Proctalgia fugax, fugax meaning “fleeting” in Latin, is a condition that causes severe episodic pain in the anorectal area caused by cramps in the levator ani, the main pelvic floor muscle. Attacks typically occur at night and are often mistaken as an urge to defecate. When the levator ani spasms, the result is anorectal pain lasting anywhere from a few seconds to 30 minutes. Men may even get an involuntary erection! This condition typically starts around the age of 45. While it does not cause physical damage to the body, proctalgia fugax can be very painful and debilitating.

    Proctalgia fugax cannot be cured, but its symptoms can be managed. Here’s a list of some of the many treatments that can help ease the pain during an attack:
    1. Warm baths
    2. Warm enemas
    3. Cold packs
    4. Relaxation techniques
    5. Salbutamol inhaler – Usually used for bronchitis, salbutamol inexplicably seems to shorten episodes of pain
    6. Botox – Inhibits acetylcholine, the neurotransmitter that controls muscle, which reduces contractions
    7. Topical calcium channel blockers – Vasodilates blood vessels, reduces muscle contractions
    8. Counseling – Stress can be a major trigger of proctalgia fugax. Eliminating stress may reduce the frequency of attacks.
    9. Galvanic stimulation – High voltage stimulation has been shown to reduce frequency of attacks
    10. Treatments of the underlying diseases, such as hemorrhoids and anal fissures.

    Overall, proctalgia fugax can be a real nuisance. The 8%-18% figure above may be even greater in reality because so few people seek treatment. And it’s understandable why people don’t- it’s an uncomfortable and embarrassing thing to talk about. Many will just try to ride it out. Proctalgia fugax can be a struggle. It’s not worth the loss in quality of life. If you feel that proctalgia fugax is making your life worse, it might be time to see your doctor.

    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.

    Three KEY BENEFITS OF INFRARED COAGULATION THERAPY FOR INTERNAL HEMORRHOIDS | Minneapolis & St Paul

    Many Americans experience hemorrhoids. The exact prevalence is unknown because most patients are asymptomatic and do not seek care from a physician. It may affect approximately half the population by the age of 50. Hemorrhoids are more prevalent in persons 45 to 65 years of age.

    Although the precise cause is not well understood, hemorrhoids are associated with intrinsic weakness in rectal hemorrhoidal tissues with conditions that increase pressure in the hemorrhoidal venous plexus, such as straining during bowel movements secondary to constipation. Other risk factors include obesity, pregnancy, constipation, chronic diarrhea, anal intercourse, and pelvic floor dysfunction.

    Hemorrhoidal size, location, and thrombosis, determine the extent of pain or discomfort. Internal hemorrhoids, proximal to the dentate line, are traditionally graded from I to IV based on the extent of prolapse. External hemorrhoids and anal tags, distal to the dentate line, develop secondary to internal hemorrhoids or result of thrombosis.

    The ideal treatments for early stages of internal hemorrhoids are always debated. Some are more effective but are more painful, others are less painful but their efficacy is also lower. Thus, comfort or efficacy is a major concern.

    Medical management (e.g., stool softeners, topical over-the-counter preparations), dietary modifications (e.g., increased fiber and water intake), and behavioral therapies (good toilet habit, sitz baths) are the mainstays of initial therapy.

    If conservative management is unsuccessful, office-based, non-surgical treatments of grades I to III are the preferred next step and the common treatment options include infra-red coagulation and rubber band ligation. The studies showed that band ligation, although more effective in controlling symptoms and obliterating hemorrhoids, is associated with more pain and discomfort to the patient. As infrared coagulation can be conveniently repeated in case of recurrence, it could be considered to be a suitable alternative office procedure for the treatment of early stage hemorrhoids.

    Excisional hemorrhoidectomy leads to greater surgical success rates but also incurs more pain and a prolonged recovery than office-based procedures; therefore, hemorrhoidectomy should be reserved for recurrent or higher-grade disease.

    3 KEY BENEFITS OF INFRARED COAGULATION THERAPY FOR INTERNAL HEMORRHOIDS

    Infrared coagulation is quick and near painless
    Infrared coagulation can reduce or eliminate the hemorrhoid with a series of a few quick and near painless treatments using short bursts of hot light.

    The primary benefits of infrared coagulation are the quick and near painless treatments. While a series of 3 or 4 treatments is normally required over a 2 month period to reduce hemorrhoid, the individual treatments only take a few minutes, and require no recovery time. This is a big perk compared to taking several days off for surgery and recovery, which can be required in the most severe cases.

    Infrared coagulation is nonsurgical

    While many people associate hemorrhoids with painful surgery, only a small percentage of patients actually require surgery. Hemorrhoidectomy is a surgical procedure to remove most severe hemorrhoids. Instead, infrared coagulation, or other nonsurgical treatments, can reduce or eliminate the source of a hemorrhoi. The treatment is performed right in the office with no anesthesia, incisions, or stitches.

    Infrared coagulation is effective
    Nonsurgical treatments are simple, quick and convenient, but they must also offer a certain level of effectiveness. To that end, infrared coagulation is up to 95% effective.
    If you’d like to see how infrared coagulation can help you, give Procedure Clinic a call today at (952) 922-2151 to schedule a consultation. You can enjoy lasting relief from hemorrhoid pain!

    The Management of Anal Tags | Minneapolis & St Paul

    Anal tagHave you been using too much toilet paper because of pesky anal tags? Hemorrhoidal skin tags are flaps of skin or flesh found around the anus. They often form as a result of an existing hemorrhoid.

    Anal tags are the shapeless lumps and flaps of skin and tissue found at the anal verge. They’re quite common and usually come with other anorectal problems, such as hemorrhoids.

    Anal skin tags often occur if an individual heals the thrombosed external hemorrhoids at home without surgery, the thrombosed hemorrhoids may leave behind skin tags. Anal sentinel tags may also form because of non-hemorrhoid causes, such as anal fissure, surgery, or infection, etc.

    Despite the fact that people often confuse them with cancerous growths, skin tags are benign and present no serious health concerns.

    Hemorrhoidal skin tags often don’t cause significant rectal symptoms, but they often affect the cleansing after bowel movement. If feces become trapped beneath the skin tags, it can cause irritation and lead to itching and further inflammation. Skin tags can also cause pain when it flairs up or if there’s another underlying rectal problem.

    Patients suffering discomfort or itching due to hemorrhoidal skin tags can treat the condition with the following:

    • Thorough cleaning of the affected area after bowel movement. May use gentle cleansers, such as witch hazel or aloe vera extract.
    • Do a Sitz bath with warm water.
    • May use OTC hemorrhoid cream to reduce irritation and swelling.
    • If the skin tags frequently cause symptoms, individuals may consider having them removed surgically.
    • Most patients who have anal tags often have hemorrhoids, too, they should consider complete care by treating internal hemorrhoids before removal of anal tags or at the same time.

    Excision of anal tags:
    Anal tags can easily be removed in the office using local anesthetic. A radiofrequency device is used to get rid of skin tabs and resurface the anal area to acquire a good cosmetic result. The procedure takes less than 10 minutes and patients are safe to drive immediately afterwards. There may be mild postoperative pain and discomfort with bowel movement in the first week. The patients are typically able to go back to work next day although the whole healing process may take a few weeks. If the patient needs a hemorrhoidectomy, anal tags can be removed together as part of hemorrhoidectomy. If the anal tag is extensive, two stages of surgery may be necessary to avoid anal stenosis.

    Dr. Steven Shu Participating in International Medical Mission in the Sixth Time | Minnesota

    Dr. Steven Shu, medical director of One Stop Medical Center, lead a group of Chinese American doctors from the United States going to the Haiti in the mid of January, 2018 to provide free medical care for local residents. This is the sixth time that he has been active in international medical mission since 2015, and it is the fourth time that he goes to the Haiti.

    Dr. Shu and another surgeon Dr. Dean Currie performed about 40 office procedures. Three other team physicians (Keyi Yang, a neurologist from Seattle, Ming He from New Jersey, a neuro-ophthalmologist and Jerri Mao, an internist from San Jose) went to the mobile clinic with other medical mission group and provided general care to the hundreds people in the villages.

    Over the past 14 years, Dr. Shu has been enjoying making his contributions to local communities. Since 2015, he has been focusing more on his international volunteer work in Haiti and Philippines. In 2017, he became a founding president of Medical Volunteers International (MVI), a new non-profit organization for the Chinese American physicians dedicating the medical missions in the poorest countries around world. The MVI collaborated with the faith-based non-profit organization Mission of Hope Haiti and carried out the first Haitian International Medical Program.

    Dr. Shu’s medical mission dream is to establish the surgical center in Haiti.

    Find a Qualified Hemorrhoid Doctor | Minnesota

    A hemorrhoid is a common illness that numerous Minnesotans suffer from. If you suffer from hemorrhoids, the good news is that the symptoms of mild hemorrhoids usually improve on their own with at-home treatments. But what if they get to the point where you need to see a doctor for an evaluation or treat them? How do you choose where to go and what doctor is right for you?
    Here’s what you should know about finding the right hemorrhoid doctor for you:

    The hemorrhoid procedures are usually conducted by colorectal surgeons, general surgeons, and family physicians. Here are some tips to help find a qualified doctor who can provide hemorrhoid care.

    1. Check doctors’ credentials; besides basic medical credentials, the most important questions you need to ask are:

  • How many hemorrhoid procedures does the doctor performs every week?
  • How many years has the doctor been providing hemorrhoid care?
  • Does the doctor provide complete hemorrhoid care by offering all available hemorrhoid procedures such as IRC, banding and surgeries?
  • What is the complication rate?
  • Does the doctor offer the convenient and alternative hemorrhoid care delivery system?
  • Experience matters.

    2. You may ask if the doctor uses any newer non-surgical technologies or surgical techniques. It makes a big difference in many aspects between the combined non-surgical and surgical approach and traditional hemorrhoidectomy only approach since not every patient needs hemorrhoidectomy. Some family doctors offer hemorrhoid cream only and other surgeons offer hemorrhoidectomy only. In fact, hemorrhoid care should be based on the severity of hemorrhoids, and the treatment plan should be customized based on each patient’s needs.

    3. There are a multitude of sources that offer information on hemorrhoid doctors in a patient’s area. These include Google searches, insurance companies, and primary-care doctors. If the patient knows any friends, family members and colleagues who have had hemorrhoid treatment, ask them about their personal experience with that particular hemorrhoid doctor and clinic. This information may be more in-depth, and can also provide the patient with a better understanding of the whole process of hemorrhoid care and what to expect.

    4. Once a number of hemorrhoid doctors have been identified, try to find out more about them. While credentials and clinical experience are important to consider, there are also practical considerations to take into account. These factors indirectly indicate how much the doctors are committed to hemorrhoid care and quality of hemorrhoid care.

    a. You should review their website to see if:

  • It is an informative and well-designed website
  • The contents are frequently updated
  • There is a user friendly online registration.
  • It is a dynamic website with ongoing blog posting
  • There are positive testimonials. There is a big difference in the evaluation of patient satisfaction between a few outdated testimonials and hundreds of recent testimonials.
  • b. If the price is affordable, ask about the total cost.

    c. You should find the whole hemorrhoid care system to be a friendly and patient-oriented service. For example, One Stop Medical Center offers the Easy Hemorrhoid Care with one trip care system.

    d. Consider the office location and convenience.

    e. Evaluate the quality of customer service: how the patient is treated on the phone during inquires, the cleanliness of the office, the attitudes of the staff during initial contacting, the level of the procedure room (simple office room or higher level of Surgicenter), and other less-tangible measurements should also influence your decision.

    When Should I Call a Doctor in the Hemorrhoid Clinic to Treat My Hemorrhoids? | Minneapolis & St Paul

    Hemorrhoid disease is not a cancer, and it usually doesn’t kill you. However, it often affects the quality of life. Letting a hemorrhoid go untreated can lead to serious complications
    If you suffer from hemorrhoids, you’re not alone. 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 on a daily basis. Approximately three out of four people will develop hemorrhoids at some time in their lives. And while sometimes the symptoms are minor enough to be managed by yourself with home remedies. It’s important to know when you need to call a doctor.

    For the majority of hemorrhoid cases, using home remedies will only temporarily help to relieve the symptoms for a short period of time while prolonging the problem since it typically only addresses the symptoms rather than the root cause of hemorrhoids, Talking to a doctor can put you on track toward correct diagnosis and the treatment that will relieve you of your painful, inflamed hemorrhoids for good. Plus, hemorrhoids can be a sign of more serious medical issues, such as colon cancer or rectal cancer – so it’s important to get them checked out by a physician.
    Contact a doctor to treat hemorrhoids if:

    • Experiencing any rectal bleeding.
    • Having black stool
    • Noticing an anal lump
    • Experiencing changing and worsening rectal symptoms
    • Have abdominal symptoms such as bloating, diarrhea or constipation
    • Having very thin and small size of stool

    What About Non-surgical Hemorrhoid Treatments?
    The non-surgical hemorrhoid treatments like the infrared coagulation and the rubber band ligation are quick, simple, and virtually pain-free, and they are safe and effective office procedures. One Stop Medical Center offers the Easy Hemorrhoid Care with convenient, minimally invasive hemorrhoid treatments.

    Do I have Internal or External Hemorrhoids? | Minnesota

    You’re might be reading this because you saw blood on your toilet paper. Or maybe it was because it’s so itchy down there and it makes your life a living hell in public, or even worse- it hurts when you have a bowel movement. Well, you and 75% of the population are or will be wondering the same thing. Most likely, you have hemorrhoids.

    Now, you probably want to know more about them. It’s your body, after all. Essentially, there are three types of hemorrhoids – internal, external, and mixed, which are usually the result of intrinsic weakness of local hemorrhoid tissue with other factors, including excessive or prolonged straining, pregnancy, constipation, heavy lifting, or just unfortunate genetics.
    Internal hemorrhoids form above the dentate line, while external hemorrhoids form below the dentate line. Mixed hemorrhoids can either refer to lesions formed at the dentate line, or to the presence of both internal and external hemorrhoids. Luckily, all of them can be treated fairly easily in a clinical setting.

    External Hemorrhoids
    External hemorrhoids are pretty easy to figure out when you feel bulges or bumps around the anus. It usually affects the cleansing after the bowel movement and cause the skin irritation and itching. The thrombosed external hemorrhoids occur if the varicose veins rupture and the blood clots develop, it is often accompanied by severe pain and swelling. Lots of people can self-diagnose external hemorrhoids, but a doctor’s visit is required to make sure since there are several other medical conditions look similar to external hemorrhoids, such as anal warts, sentinel pile of anal fissure, anal polyp and anal cancer.

    Internal Hemorrhoids
    Internal hemorrhoids, while not as apparent as external hemorrhoids, are far more common. It is the root cause of hemorrhoid disease. In fact, they are so common that 100% of the population has them. Normal hemorrhoidal tissue is actually a physical part of your body, not an affliction. They only become a problem once the connective tissue around it weakens and the veins become swollen.

    For many, the only sign of internal hemorrhoids might be bleeding. As the hemorrhoid grows, it may become prolapsed, which is certainly not a pretty sight. This means the hemorrhoid is bulging out of the anus. Prolapsed hemorrhoids will be pretty obvious and can be painful and itchy. They can often be pushed back in manually if they aren’t too big. Note that external hemorrhoids and internal prolapsed hemorrhoids are not the same thing, but many patients with external hemorrhoids also have internal hemorrhoids, and your doctor will be able to tell you which it is if you aren’t sure.

    Ten Ways to Temporarily Alleviate Symptoms of Hemorrhoids | Minneapolis & St Paul

    You come home one day and in the bathroom you notice blood on the toilet paper after you wipe. It might hurt, and it might be itchy, and, like most adults, you probably haven’t been meeting your daily requirement for fiber lately. If you tick all these boxes, well, congratulations! You probably have hemorrhoids! and you should call your doctor’s office to make an appointment for the evaluation and treatment, especially when you have rectal bleeding. While you wait for your doctor’s appointment, you can start treating the rectal symptoms by yourself to temporarily alleviate the hemorrhoidal symptoms.

    1. Keep the area clean and dry. Do not wipe or rub vigorously.
    2. Take sitz bath in warm water for 15-20 min, 2-3 times a day and after every bowel movement. Sitz baths will help relieve discomfort and clean the area.
    3. Good toilet habits: move your bowels as soon as you feel the urge; Do not strain and bear down; Do not sit on the toilet for long periods of time.
    4. Avoid constipation by eating plenty of high-fiber foods, drink plenty of fluids, and exercise. If your diet is lack of fiber, y can also take two tablespoons of fiber supplement. If you develop constipation with hard stool, you may use a stool softener with or without laxative.
    5. Do not stay seated for more than two hours.
    6. Avoid heavy lifting for a few weeks.
    7. Do not drink alcohol or reduce alcohol intake.
    8. Apply hemorrhoid creams.
    9. Witch Hazel is found in many OTC hemorrhoid creams, you may use it since Witch hazel is an astringent that reduces swollen hemorrhoids.
    10. Put cold on the hemorrhoids every 5 minutes for a few times if you have the flair-up with swollen prolapsed hemorrhoids.

    Infrared coagulation (IRC) is a fast and effective non-surgical solution for hemorrhoid treatment!

    A hemorrhoid is a common illness that numerous Minnesotans suffer from. Approximately three out of four people will develop hemorrhoids at some time in their lives. While many people associate hemorrhoid treatments with painful surgery, only a small percentage of hemorrhoid patients actually require hemorrhoidectomy. A fast and simple non-surgical office procedure has taken the fear out of hemorrhoid treatments. The majority of hemorrhoid patients in Minnesota are good candidates for non-surgical Infrared coagulation (IRC) treatments.

    What is Infrared Coagulation (IRC)?
    IRC is a FDA approved office procedure that uses infrared light to treat symptomatic internal hemorrhoids, and it takes just a couple of minutes for each treatment. IRC is a safe, fast, and effective solution for hemorrhoids. Therefore, IRC has quickly become the most widely used office procedure for hemorrhoid clinics 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 1.5 second. This coagulates the veins above the hemorrhoid, causing it to shrink.
    With IRC, hemorrhoid 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.

    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.

    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.

    Rectal Bumps : Hemorrhoids or Something else? | Minnesota

    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. 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. It can be caused by prolapsed 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 anorectal 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.

    Anal polyps are the growth in the anal canal that must be removed for the biopsy. Further examination with colonoscopy is required for polyps confirmed to be adenomatous in order to check for proximal lesions in the rectum and colon.

    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 does 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.

    The Easy Hemorrhoid Care™ (EHC) | Minnesota

    One Stop Medical Center invites you to experience an elevated level of care for your hemorrhoid treatments, with Minnesota’s first ever Easy Hemorrhoid Care™ Experience.

    For nearly 20 years, Dr.Steven Shu has been providing exceptional hemorrhoid care utilizing the state-of-the-art medical techniques and technology available. Now he and his team offer Easy Hemorrhoid Care™ , a new care delivery system for hemorrhoid treatment with minimal invasive procedures, including Infrared Coagulation (IRC), rubber band ligation, and modified hemorrhoidectomy. It is an efficient system that requires only one trip. We provide patients a new experience in hemorrhoid care, from procedure through recovery. These advancements reduce discomfort, time, decrease the chance of complication and reduce the total recovery time.

    For the first time in Minnesota, a personalized approach to meet your specific hemorrhoid care requirements is now available! The Easy Hemorrhoid Care™ Experience has been designed to take the stress and worry out of your hemorrhoid treatment. This package provides the most comfortable and seamless hemorrhoid care experience possible, with enhanced, customized hemorrhoid care, saving you precious time in your busy schedule.

    Benefits of the Easy Hemorrhoid Care™ (EHC)
    In the standard hemorrhoid care, the patients with hemorrhoids require multiple office visits with Infrared Coagulation and/or rubber banding ligation for their internal hemorrhoid treatments, followed by external hemorrhoidectomy and/or excision of anal hemorrhoids. It is a long process, but it is usually covered by your medical insurance.

    The Easy Hemorrhoid Care™ (EHC) is a specially designed hemorrhoid care delivery system that aims to shorten the whole process of hemorrhoid treatment, to reduce discomfort, the chance of complications, and total recovery time. Patients are given Botox during the procedure to relax anal sphincter muscles, reducing post procedural pain. It is an efficient system that requires only one trip where you receive premium medical care, but it is not covered by your insurance.

    To learn more about our Easy Hemorrhoid Care™ Experience in One Stop Medical Center, please contact us by calling at 952-922-2151 or email at info@shuMD.com.

    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.

    Pregnancy and Hemorrhoids | Minnesota

    Going to the doctor again for hemorrhoids is one of the last things a woman wants to deal with after pushing a child out of their body, but the only thing less appealing than that is actually having hemorrhoids. Pregnancy brings a lot of changes to a woman’s body, one of which is an increase in progesterone, a hormone that is responsible for regulating pregnancy. Aside from one of the greatest joys in life, progesterone also causes one of the greatest inconveniences: hemorrhoids. The combination of progesterone and intense pushing during labor makes hemorrhoid a common ailment among women.

    One of the things that can affect the likelihood of developing hemorrhoids during pregnancy is whether the birth is vaginal or a C-section. A vaginal birth is much more likely to result in hemorrhoids, due to all the pushing and strain on the anorectal area. Straining that area of your body can cause hemorrhoids whether your pregnant or not (so don’t spend too much time reading the news on your phone in the bathroom), and anyone that has had experience with childbirth will know that women have to push very very hard, and that’s putting it lightly.

    C-sections are less likely to result in hemorrhoids because the entire process of straining and pushing the baby through the birth canal is avoided. However, this all depends on how much straining the pregnant woman does before the procedure.

    Usually, very conservative treatment is given to women with hemorrhoids, as additional stress from a procedure is usually not the best for a pregnant woman. Typically, fiber intake, topical ointments, and cold packs are enough to manage hemorrhoids. However, in more severe cases, a procedure may be required to deal with it. In this case, it is best to go with your doctor’s recommendation as to what is best for you and the baby.

    Epidemiology on Hemorrhoids | Minnesota

    Hemorrhoids are swollen blood vessels in the lower rectum and anus. They are among the most common causes of anorectal complaints, and only a small proportion of those people seek therapy. This blog will summarize the current epidemiology of hemorrhoids.

    Prevalence
    The prevalence of hemorrhoids is not well documented due to the lack of clinical research on this topic. There has been a scarcity of literature reporting on the epidemiology of hemorrhoids.
    It is estimated that the overall prevalence of symptomatic hemorrhoids in the general population is about 4.4%, but the true prevalence of hemorrhoids, including asymptomatic hemorrhoids should be much higher than 4.4%.

    According to a study done in a hemorrhoid center, estimates suggest that around half of Americans develop hemorrhoids by time they are 50. The number of people in the US suffering from symptomatic hemorrhoids is estimated to be around 10 million, with 1 million new cases occurring each year. Up to one third of those 10 million people with hemorrhoids seek medical treatment.

    Trends
    It is noticed that the number of people visiting hospitals for hemorrhoidectomies has fallen. A peak of 117 hemorrhoidectomies per 100,000 people was reached in 1974; this rate declined to 37 hemorrhoidectomies per 100,000 people in 1987, and the number should be much lower now. Office treatment of hemorrhoids with non-invasive methods account for some of this decline.

    Gender
    There is no known sex predilection, although men seem to be more likely to seek medical attention. However, the physiological changes that occur during pregnancy also increase the likelihood that hemorrhoids will become symptomatic and may increase the incidence of thrombosis in females.

    Race
    Caucasians are more frequently present with hemorrhoidal disease and seek treatment more often than other races.

    Genetics
    Some individuals are more genetically predisposed to hemorrhoids than others. But there are no indicative factors that can be used to identify this group of patients.

    Age
    The prevalence of hemorrhoids increases as people age. In most cases, hemorrhoids develop in individuals who are over 30 years old, with a peak in persons aged 45-65 years, although they can develop at any age. External hemorrhoids tend to occur more commonly in younger adults.

    Socioeconomic Status
    People who live in rural areas and those with a higher socioeconomic status appear to be more likely to develop hemorrhoids.

    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.

    9 Tips for Recovering After Infrared Coagulation (IRC) Treatment of Hemorrhoids | Minnesota

    If you’re suffering from hemorrhoids, Infrared coagulation (IRC) is often an initial treatment of choice, especially for early stage of internal hemorrhoids. In this procedure, an intense infrared light heats the hemorrhoidal tissue, creating scar tissue that blocks blood supply to the hemorrhoid, which shrinks and dies.

    In general, IRC is a very safe office procedure that takes less than a minute in each treatment. It is relatively painless and no anesthesia or painful injections are needed. It produces very good results in the early stages of hemorrhoids with minimal complications and quick recovery. The recovery time after IRC treatment is minimal with very little pain or discomfort. It is important to take care of the rectal area after the IRC procedure to avoid a recurrence of the hemorrhoids. Here at the Procedure Clinic in Edina, MN, we offer the following tips on recovering from IRC treatments.

    1. Keep the area clean and dry. Do not wipe or rub vigorously.

    2. Take sitz bath in warm water for 15 min, twice a day and after every bowel movement. Sitz baths will help relieve discomfort and clean the area.

    3. Good toilet habits:
    a. Move your bowels as soon as you feel the urge.
    b. Do not strain, bear down, or hold your breath during a bowel movement.
    c. Do not sit on the toilet for long periods of time. If you cannot empty your bowel, you may re-visit the toilet at a later time.

    4. Avoid constipation and straining during bowel movements:
    a. You are encouraged to eat plenty of high-fiber foods, drink plenty of fluids, and exercise. The high fiber food includes vegetables , fruits, , beans, and whole grains.
    b. If your diet is lack of fiber, y can also take two tablespoons of any over the counter fiber supplement such as natural wheat bran, natural oat bran, flax, Benefiber with a lot of water.
    c. If you develop constipation with hard stool, you may use a stool softener with or without laxative.

    5. Do not stay seated for more than two hours. Do the muscle exercise by tightening your buttock muscles 10 times and take 10 deep breaths every a couple of hours.

    6. Avoid heavy lifting for a few weeks.

    7. Do not drink alcohol or reduce alcohol intake.

    8. Apply hemorrhoid creams when the symptoms flair up.

    9. Be sure to follow your doctor’s instructions.

    When to Call Your Doctor
    Problems are not common with the IRC treatment. However, if there is a substantial amount of bleeding, severe pain, chills, fever or difficulty passing urine (very rare), you should call your doctor to seek medical attention.

    Effective Non-surgical Treatment Protocol | Minnesota

    The effective Non-surgical Treatment Protocol we use is based on 17 Years Clinic Experience and About 3000 Hemorrhoids Cases with More Than 10,000 Treatments. It takes out your fear of hemorrhoid treatment!

    Infrared coagulation (IRC) and rubber band ligation (banding) of hemorrhoids are fast and effective non-surgical solutions.

    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 treatments, or Infrared coagulation (IRC) and rubber band ligation (banding).

    Recently, we reviewed the hemorrhoid cases treated in the past 17 years. We accumulated extensive clinical experience on hemorrhoid treatments due to the vast numbers of hemorrhoid cases and treatments we did, which helped us to consistently refine the treatment protocols based the type of hemorrhoids and severity of hemorrhoids. Therefore, each patient can be offered with a customized treatment protocol with better results.

    The IRC and banding both are office-based procedures takes just a few minutes and uses infrared light or tiny rubber bands to treat symptomatic internal hemorrhoids. 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. IRC can be used to treat the early stages of hemorrhoids, and it is most effective in grade 1-2 hemorrhoids, and banding can be used to treat more advanced hemorrhoids, such as prolapsed grade 2-3 hemorrhoids.

    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.

    After the IRC or banding 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.

    Are You Going to the Bathroom the Wrong Way? | Minnesota

    According to the American College of Gastroenterology, 2.5 million people see a doctor for constipation a year and 75% will experience hemorrhoids someday. The average American will spend almost a year sitting on the toilet in their lifetime. Going to the bathroom’s is more important than people give it credit for. We’ve gotten used to our porcelain thrones and the pleasure of distracting ourselves with smart phones while we’re one them. But there might be more to this than a just a way to procrastinate- sitting on the toilet for an extended amount of time might not be good if you’re trying to avoid hemorrhoids.

    First of all, you should probably limit cell phone usage on the toilet. Besides being a little gross, sitting on the toilet is not good for bowel movements and can increases the chances of hemorrhoids in the future. Sitting during a bowel movement puts pressure on the anorectal area, irritating the veins in the bowels that cause hemorrhoids. In most places outside the US, squatting toilets are used, where there is no seat and one must squat over the toilet. This has been shown to be better for bowel movements and more natural. In America, products that keep your feet elevated while on the toilet try to achieve this natural squat position, though the efficacy of such a device is still being studied.

    Dietary fiber is also very important, in both soothing hemorrhoids and preventing them in the future. Fiber bulks stool ensures its smooth passage through the intestines. Dietary Guidelines recommend 25 grams of fiber for women under 50, and 35+ for men under 50. This is much more than the average person gets, and it’s imperative that people get an adequate amount of fiber in their diet. These bulking agents work better if you drink plenty of water every day (6-8 glasses of water daily). Diet and toilet habits are the best preventative measure for hemorrhoids.

    Why Are Infected Hemorrhoids So Rare? | Minnesota

    Have you ever noticed blood on the tissue after wiping too hard, or experienced bleeding due to hemorrhoids? Blood indicates the presence of a wound, fecal matter is obviously teeming with harmful bacteria, and most people in America do not use anything other than dry toilet paper to wipe. Yet, hemorrhoidal infections are incredibly rare, especially in healthy people.

    Why is this?
    First, it’s important to note the immune system is different in different parts of the body- the Immune system in the gut is very well adapted to prevent serious infection. Immune cells constantly “sample” bacteria in the gut and create antibodies that bind the proteins on surface of the bacteria which prevents them from passing through the epithelium (wall of cells lining the inside of the intestines). This keeps the bacteria inside the intestine and outside the body. This “scanning” of the bacteria is something unique to the gut; this does not occur on the skin or elsewhere.

    After a small tear in the epithelium occurs, there is an immediate inflammatory/clotting response around the broken blood vessels. This prevents the bacteria from spreading deeper into the surrounding tissue. The bacteria that do make it past that are met with a strong response. The antibodies marking the bacteria are used by the immune cells to target them, and not enough bacteria makes it through to cause a severe infection. The particular antibody used, known as “IgA” is non-inflammatory, which is why there are no symptoms typically associated with infection (swelling, pain, itching, etc).

    That said, this only applies to small tears and hemorrhoids- large tears and injuries increase the risk of infections. While rare, the risk of infection holds serious consequences and it is best not to delay treatment of hemorrhoids.

    Although the infection of hemorrhoids is rare, anorectal abscess is relatively common. Anorectal abscess is a different disease from hemorrhoids, and it is the result of infection of anal glands in the lining of the anal canal. Most perirectal abscesses form from obstruction of the anal gland crypts.

    Procedure Clinic can diagnose and treat both hemorrhoids and anal abscess at low cost and little down time.

    Surgical Excision is Often More Effective and Efficient in Treating Thrombosed External Hemorrhoids | Mineapolis & St Paul

    Everyone in Minnesota has normal hemorrhoids tissue- clusters of venous complex that reside below the mucus membrane of the rectum and anus. They become an issue once they become swollen and prolapsed as a result of prolonged pressure. External hemorrhoids are formed under the skin around the anus secondary to internal hemorrhoids. The skin outside of an external hemorrhoid can be irritated, which can be very uncomfortable in flare-up. If thrombosis (blood clot) occurs after hemorrhoidal veins rupture, it can cause severe pain and swelling of the external hemorrhoid, identifiable by the blue-purple discoloration of the swollen hemorrhoids, which can easily observed looking at the anus. Risk factors associated with thrombosed external hemorrhoids could be related to increased rectal pressure during bowel movement, heavy lifting, constipation and traumatic vaginal delivery.

    The symptoms of thrombosed external hemorrhoids appear within 48-72 hours. If the rectal pain is not severe, and thromboses is relatively small, they can be managed with conservative treatment, including stool softeners, fiber, fluid intake, warm baths, and pain relief. However, for most patients, surgical excision is often more effective and efficient in treating thrombosed external hemorrhoids. Surgical excision is an office-based procedure performed under local anesthesia. This safe office procedure offers low complication and recurrence rates and high levels of patient satisfaction.

    One study showed that surgical treatment resulted in significant faster symptom resolution (3.9 days post procedure compared to 24 days if left untreated). 24 days is a long time to deal with acute anorectal pain- most would opt for the procedure. Afterwards a skin tag may be left which can be surgically removed.

    If you have thrombosed external hemorrhoids, please consider Procedure Clinic in Edina, MN to take care of your needs.

    Surgical Options for the Advanced Hemorrhoids | Minneapolis & St Paul

    While nonsurgical procedures work for the majority of hemorrhoid people in Minnesota with , surgical treatments may still be needed if you have advanced hemorrhoids with more prolapsed tissue, or if your hemorrhoid condition does not respond to other treatments. Hemorrhoidectomies may be used in these advanced cases.

    A hemorrhoidectomy can be performed in a surgical center or in a well-equipped office, and it is most commonly done under local anesthesia in conjunction with a sedative during the surgery or traditional general anesthesia.

    During this procedure, the prolapsed tissue is surgically removed with a radiofrequency device. After the hemorrhoid is removed, the incision is sewn or cauterized shut. Medicated gauze is then placed over the remaining wound.

    Recovery usually includes a few days to a week off of work. Pain during bowel movements is expected in the first two weeks, although it gradually becomes less painful over time. The complete healing time is generally about four weeks. During this time, you must increase fiber intake, drink plenty of fluids, and take stool softeners to keep your stool soft.

    Are There Other Surgical Options?
    There are other surgical procedures that may be used to treat hemorrhoids although our clinic does not offer these treatments. These include:

    A stapled hemorrhoidopexy, also known as a stapled hemorrhoidectomy, is the Procedure for Prolapse and Hemorrhoids (PPH). This procedure utilizes a specially-designed circular stapling device. These staples affix the prolapsing tissue to the rectal wall, effectively resecting the hemorrhoid. Because this procedure is less invasive than a traditional hemorrhoidectomy, it often requires less post-operative recovery. The recurrent rate is slightly higher than traditional hemorrhoidectomy.

    Transanal Hemorrhoidal Dearterialization (THD) is considered a minimally invasive operation used to treat internal hemorrhoids. It does not remove any hemorrhoid tissue. The procedure starts with Doppler testing to locate the arteries that feed the hemorrhoids. Stitches are then used to close these arteries, which decrease the blood flow from these arteries to hemorrhoid complex. The hemorrhoid is then sutured higher up into the rectum, thus reducing the prolapse.

    Comparison of Non-Surgical Methods of Treating Hemorrhoids | Minnesota

    Hemorrhoids can be an embarrassing nuisance for a busy adult in Minnesota, and any would like to know what the best treatment is. While many people in Minneapolis and St Paul areas associate hemorrhoids with painful surgery, only a small percentage of patients actually require surgery. There are four non-surgical methods of treating hemorrhoids: sclerosing injection, electric desiccation, infrared coagulation, and rubber band ligation. This blog will go over the pros and cons of each one.

    Sclerosing injection is a procedure used to reduce or remove abnormal veins, such as varicose veins. It can also be used for treating hemorrhoids. Essentially, the injection of sclerosing agents such as 5% phenol in almond oil (PAO) or Aluminum potassium sulfate and tannic acid (ALTA) induces inflammation in the area, and causes the walls of the vein to harden and thicken, reducing the flow of blood or completely eliminating it with a small enough vein. The procedure takes about 5-10 minutes, and it is tolerable with mild discomfort and pain. It takes about 6 weeks for the injections to take full effect. The treatment usually lasts up to about 6 months. Repeat treatments are usually necessary. The complications included pyrexia, low blood pressure, perineal pain, rectal ulcers and infection. However, this treatment is no longer often used in the US because it is only really effective for very small and early hemorrhoids and relatively high complication of infection. This treatment is not provided at Procedure Clinic in lieu of other, more effective methods.

    Bipolar diathermy is the method of electric desiccation involves using high frequency electrical currents to dehydrate hemorrhoid tissue. The hemorrhoid subsequently dries, shrinks, and sloughs off. Larger hemorrhoids require more current. This method is not to be used in advanced cases, or if the patient has complications. The procedure itself also takes a considerable amount of time, which for many people is not convenient, especially when quicker methods are available. This procedure is not done at Procedure Clinic.

    Infrared coagulation (IRC) is the most commonly used procedure of treating hemorrhoids in the US, so is our clinic. It is often used for small to medium sized internal hemorrhoids. In this procedure, an intense infrared light heats the hemorrhoid, creating scar tissue. The scar tissue blocks blood supply to the hemorrhoid, which shrinks and dies, leaving a scar that keep the veins from bulging into the anal canal. The procedure can be done every 10-14 days. This treatment works best for early-stage hemorrhoids, and has the advantage of being quick, from procedure to recovery time. Most people can go to work right away. The effectiveness of IRC is quite high. As we know, regardless of treatment methods, hemorrhoid is more prone to return if the patients don’t follow the instructions of prevention. The good news is that the IRC procedure can be repeated easily.

    Rubber band ligation involves tying off the hemorrhoid tissue with a rubber band, mechanically cutting off blood supply to the tissue. It is best for more advanced hemorrhoids , such as grade 2 or 3 hemorrhoids- it is not appropriate for early or very late stage hemorrhoids (which is the may require surgery). The recovery time is longer compared to infrared coagulation, and patients report more pain after the procedure. However, ligation is generally more effective and hemorrhoids are less likely to return for this method. The procedure, like infrared coagulation, is usually limited to once every two weeks.

    Procedure Clinic uses infrared coagulation and rubber band ligation to cover a wide range of hemorrhoids at different stages. Dr. Shu also performs the hemorrhoidectomy to treat the most advanced hemorrhoids. The best method will vary from person to person, and depends on various factors. By scheduling an appointment, you could find out which is the best method for you.

    Google Searches for Hemorrhoids Information Skyrocketed Since 2008 | Minneapolis & St Paul

    A few years ago, I read an interesting article on hemorrhoids written By Bahar Gholipour on LiveScience. It reported that the number of Americans searching online for hemorrhoids and how to treat them has skyrocketed since 2008. Information gathered from Google searches suggests that searches have doubled from 2008 to 2013. The term “hemorrhoids” was searched about 40,000 times weekly between 2004 and 2008, but this number started to rise during mid-2008, crept up to about 80,000 weekly searches in 2010, and reached nearly 120,000 during some weeks in 2013. I believe that the number could have tripled by now.

    There could be two reasons why more people go online to search for hemorrhoid information. First, more people are becoming more comfortable with the Internet. More often than before, I’ve heard even from the elderly patients that they found our hemorrhoid clinic through Internet. Second, diseases such as hemorrhoids may be among the most searched-for online because people could be embarrassed to talk about them with a doctor. Many patients don’t realize that hemorrhoids are a common medical condition that affects many Americans. “Nobody has it but me” is one of the misconceptions about hemorrhoids.

    If you search for “hemorrhoids” on Google, it shows about 8,220,000 results. Not all webpages are informative and useful. We have built an informative hemorrhoids website, hemorrhoidheal.com, that provides essential information about hemorrhoid care.

    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.

    Hemorrhoid Disease and its Anatomy | Minnesota

    Hemorrhoids are swollen clumps of vessels, smooth muscle and connective tissue in the anus and lower rectum. They are similar to varicose veins, but they are not considered the same. Hemorrhoids are quite common; about 75% of adults will have hemorrhoids in their life. Sometimes they are very benign; other times they may cause significant symptoms, such as itching, pain, prolapse and rectal bleeding.

    Hemorrhoid cushions are a normal part of the body and only pose an issue when become engorged, prolapsed and inflamed. In their normal state, they have an important role in continence, and make up 15-20% of anal pressure at rest. When bearing down, the cushions expand to maintain anal closure as intra-abdominal pressure grows. Increased sphincter pressure may result due to hemorrhoid inflammation because of this effect.

    Hemorrhoids are classified into internal and external hemorrhoids. Internal hemorrhoids develop deeper in the rectum, above the dentate line, from the embryonic endoderm and are covered by columnar epithelium. There are few somatic sensory nerves in this area, and as a result are not painful. Patients often only notice the blood after a bowel movement as a result of internal bleeding. External hemorrhoids are located around the anus, below the dentate line, derived from the ectoderm and covered in squamous epithelium. There are many sensory nerves here, so external hemorrhoids can be quite painful when the complication of thrombosis happens.

    Hemorrhoid inflammation is often caused by excess pressure in the region. This can be exacerbated by straining when defecating, constipation/diarrhea, low-fiber content in diet, lack of fluid, sitting too long, weight, and lack of exercise. Proper rectal function and physical fitness are essential in preventing hemorrhoid formation.

    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.

    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.

    How to Prevent the Hemorrhoids | Minneapolis & St Paul

    Hemorrhoids are a varicose vein disease. More than 10 million people in the United States suffer from hemorrhoids. Three out of four people will develop hemorrhoids at some time in their lives. Although they can be extremely unpleasant and painful sometimes, they can be easily treated with non-surgical therapy and they are preventable. Moreover, if patients don’t take preventive measures, it is possible to relapse after hemorrhoid care, especially in advanced hemorrhoids.

    There are many ways to prevent hemorrhoids for patients in Minnesota.

    1. One of the best things you can do to prevent hemorrhoids is to make important dietary changes to keep your stools soft and prevent constipation. Why is fiber so very important? People in Minnesota 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. Constipation with hard stool and straining often causes the rupture of hemorrhoidal veins and anal skin tearing.
    Eating a diet that is high in fiber such as fruits, vegetables, beans, and whole grains is 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 these bulking agents work better (6-8 glasses of water daily).

    Frequent diarrhea does not help, either. Straining related to diarrhea also can rapidly increase the pressure in the abdomen and hemorrhoid venous complex, too.

    2. 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.

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

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

    5. You should have a good toilet habit. The toilet time should not be too long; you should avoid the bad habit of reading newspapers or surfing on the Internet on the toilet. 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 harder to pass.

    6. 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 the 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.

    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.

    Treatment of External Thrombosed hemorrhoids | Minneapolis

    External hemorrhoids occur outside the anal verge. Thrombosed external hemorrhoids occur if varicose veins rupture and blood clots develop. It is often accompanied by swelling with a bluish-purplish discoloration and severe incapacitating pain.

    The symptoms may improve in some patients with conservative nonsurgical treatment – the anal care I coined includes stool softeners, increased dietary fiber, increased fluid intake, warm Sitz baths, and analgesia. For most patients, surgical excision is often more effective and efficient in treating thrombosed external hemorrhoids. Surgical excision is an office-based procedure performed under local anesthesia. This safe office procedure offers low complication and recurrence rates and high levels of patient satisfaction.

    Procedure
    After cleaning the anal area with an antiseptic, lidocaine with epinephrine is locally injected in the surgical area. The thrombosed hemorrhoid is unroofed by making an elliptical incision in the hemorrhoid, then the blood clots are removed, and the procedure is finished for a simple case. 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. The external hemorrhoidectomy may be performed, then the hemorrhoidal tissue with blood clots is removed together, and the bleeding in the wound is stopped with a cautery. The wound in the anal area is covered with sterile gauze.

    Postoperative Care
    The patient will be instructed to do anal care measures, including warm Sitz baths three times a day for 15-30 minutes at a time. Acetaminophen or ibuprofen should be used for pain control. The patient should remain well hydrated and take a stool softener to keep stool soft.

    Complications
    Common complications of thrombosed external hemorrhoid excision include pain, bleeding, infection and delayed healing. A perianal skin tag could develop in some patients. Stricture and incontinence are extremely rare complications.

    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.

    Rubber band ligation for the Treatments of Internal Hemorrhoids | Minnesota

    Rubber band ligation is one of the most common outpatient treatments available for the Minnesotan patients with internal hemorrhoids. It is a better option for patients with prolapsed hemorrhoids. A number of prospective studies have found rubber band ligation to be a simple, safe, and effective method for treating symptomatic second- and third-degree internal hemorrhoids as an office procedure with significant improvement in quality of life. This procedure is almost never appropriate if there is insufficient tissue to be pulled inside the band ligator drum, such as grade 1 or mild grade 2 hemorrhoids, and it should not be done with the most severe (grade 4) hemorrhoids, either.

    Rubber band ligation is an office procedure in which the prolapsed hemorrhoid tissue is tied off at its base with rubber bands, cutting off the blood flow to the hemorrhoidal mass. It is contraindicated in the patients using anticoagulants and other anorectal diseases, such as local infection, acute thrombosis and chronic anal fissure.

    The process involves a doctor inserting an anoscope into the anus and identifying and grasping the prolapsed hemorrhoid with an instrument to place a rubber band around its base. With the rubber band in place, the hemorrhoid shrinks and recedes, dying off in a few days or a week. The reduced volume of venous tissue with the scar formation prevents hemorrhoid tissue from bulging into the anal canal. The procedure is usually done in a doctor’s office and only takes a couple of minutes. Treatment is limited to one to two hemorrhoids each office visit, and additional areas may be treated at two week intervals.

    What to expect after the rubber band ligation treatment:

    After the banding procedure, most patients don’t feel much discomfort; some may feel tightness and mild pain or feel as if you need to have bowel movement. People respond differently to this procedure. Most patients are able to return to regular activities (but avoid heavy lifting) almost immediately. Others may need a few hours or a day of rest. If you feel some pain after banding, you may use Tylenol or Ibuprofen as needed and take a lot of Sitz baths for 15-30 minutes at a time to relieve discomfort.

    Some patients may have slight rectal bleeding after a week, when the rubber band falls off. The bleeding usually stops by itself; however, if you notice significant rectal bleeding, then you should call your doctor’s office. It is also very important to make sure that your stool is soft by taking stool softeners containing fiber and drink more fluids.

    Infrared Coagulation (IRC) for Internal Hemorrhoids | Minnesota

    Infrared coagulation (IRC) is a medical procedure used to mainly treat grade 1 to grade 2 internal hemorrhoids. This treatment is also used as an adjunctive treatment in conjunction with banding therapy or surgery for more severe hemorrhoids such as grade 3 and 4. During the procedure, the doctor uses an IRC device that creates an intense beam of infrared light. Heat created by the infrared light destroys vein complex and causes scar tissue, which cuts off blood supply to the hemorrhoid. Over the several weeks following the IRC treatments, the hemorrhoid shrinks and a scar formed in the lining of the anal canal, which holds nearby veins in place to prevent their prolapse.

    Only one area of internal hemorrhoids can be treated at a time. Hemorrhoids patients typically get four IRC treatments at two week intervals.

    Infrared coagulation is usually done in a doctor’s office in Minnesota. You may briefly feel heat and some stinging pain during the procedure, which lasts only 1-2 seconds in each touching.

    What To Expect After Treatment:

    Intermittent rectal bleeding could occur at any time within 14 days after the IRC procedure. Bleeding is usually minimal and mild, and resolves by itself after the treated areas heal.

  • You may use mild pain relievers such as Tylenol and sit in a shallow tub of warm water (sitz bath) for 15 to 30 minutes at a time to relieve discomfort.
  • To reduce the risk of bleeding, avoid taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) for a week both before and after the infrared coagulation.
  • You take stool softeners that contain fiber to ensure smooth bowel movements and avoid strain.
  • One Stop Medical Center in Minnesota offers comprehensive hemorrhoid care, please call 952-922-2151 if you need a consultation.

    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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