Category Archives: hemorrhoid doctor

What are the Symptoms of Hemorrhoids | Minneapolis & St Paul

The most common presentation of hemorrhoid disease is rectal bleeding, pain, itcing, or prolapse. Because these symptoms are extremely nonspecific and may be seen in a number of anorectal diseases, the physician must therefore perform an adequate rectal examinationto (including anoscopy) to confirm the diagnosis.

Minor rectal bleeding is one of the common symptoms that the hemorrhoid patients seek for the medical care. Most hemorrhoidal bleeding occurs with bowel movement, and it is caused by passing stool, particularly hard stools, and a lot of times that bleeding is a bright red in nature, and it may drip into the toilet sometimes.

Severe pain is not a common symptom of 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. Mild aching pain and skin iritating pain in the rectum is common because of local inflammation.

As the vessel 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 after bowel movement, or can be pushed back inside using one’s finger, but usually prolapses again after the next bowel movement.

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. Occasionally, the external hemorrhoids or anal tag turns out to be quite large, which can make anal hygiene (cleaning) difficult or irritate the anus.

When the varicose vein complex of hemorrhoids ruptures, 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.

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.

 

Excessive Smartphone Usage May Be Giving You Hemorrhoids | Minnesota

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

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

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

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

Tips for Better Bathroom Habits

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

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

    What is an anoscopy?

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

    How is an anoscopy performed?

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

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

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

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

    How do you prepare for an anoscopy?

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

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

     

    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 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).

     

    The Treatment of Hemorrhoids in Ancient and Modern Times | Minnesota

    Hemorrhoids, a condition that involves swelling of the veins in the rectum, have been a nuisance since the dawn of man. Accounts of hemorrhoids date back to the earliest of civilizations, including the Egyptians, the Greeks and the Romans.

    Ancient Egyptian documents directed caregivers to apply an ointment made from ground acacia tree for an unnamed, but painful, perianal disease that was most likely hemorrhoids. The word “haemorrhoid” has Greek roots: haema (blood) and rhoos, coined by Hippocrates in 460 BC. Hippocrates provided some of the earliest recorded methods of surgical procedures, including a ligation procedure that involved tying thick woolen thread around the hemorrhoid to cut off its blood supply. Later writings also described excision of hemorrhoids. The Roman, Arab and Indian societies also recorded writings that described their own ligation and excision techniques.

    During the Middle Ages, these procedures were often performed by literal barber instead of physicians, who thought themselves to be above performing surgery. Barbers often had various tools essential to their trade that doubled as makeshift surgical equipment. Science and surgery met once again the during The Renaissance, where documents indicated the usage of ligation with needle and thread, followed by excision.

    Clearly, ligation was the preferred way of operating on hemorrhoids. It was simple to do and only required readily available material. Even today, ligation is an incredibly common procedure offered by many clinics, including One Stop. Rubber band ligation, the modern version of the procedure, is not far off from that of ancient times. The procedure involves inserting an anoscope into the anus, grasping the hemorrhoid, then attaching a rubber band tightly around the base of the hemorrhoid. The hemorrhoid then shrivels up and falls off in about a week.

    Nowadays, ligation is just one of multiple options and is performed depending on how advanced the hemorrhoids are. Infrared Coagulation Therapy, or IRC, is a procedure that has gained popularity for small to medium sized hemorrhoids. The device is inserted through an anoscope and will then apply infrared light directly to the hemorrhoid, which causes clotting and scar tissue. Scarring causes the hemorrhoid to shrink. Rubber band ligation is slightly more painful, but IRC has slightly higher chances of relapse. Ultimately, they are similar in effectiveness.

    Hemorrhoids have been an issue for people for as long as civilization has existed, and it’s fascinating to see its presence so universally throughout history. It’s important to remember that everyone suffers from hemorrhoids, so don’t be afraid to have them checked out by your doctor.

    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.

    Infrared coagulation (IRC) – Non Surgical Solution for Internal Hemorrhoids | Minnesota

    Hemorrhoids describes both a series of blood vessels in the perianal area as well as the condition that afflicts them, typically in older adults. With age these hemorrhoids can become swollen and inflamed, resulting in itching, pain, bleeding, thrombosis, and infection. While not deadly, hemorrhoids can often be a nuisance to the point of debilitation. So how do we treat them?

    There have been many methods devised to treat hemorrhoids since ancient times, ranging from medicinal plants, topical creams, to hemorrhoidectomy, rubber band ligation, and more. The most common method, which we use most often, is infrared coagulation, or IRC. Infrared coagulation is a non-surgical procedure that is a convenient and minimally invasive way to treat hemorrhoids.

    There is generally no special preparation needed for IRC. During the procedure, a small probe will be placed into the anus which will flash infrared light onto the surface of the hemorrhoid. The heat from the infrared probe will burn the hemorrhoid, creating scar tissue that cuts off blood supply to the hemorrhoid and causes it to shrink and die.

    You may feel some heat and pain, but the discomfort is minimal, and the treatment only takes a few minutes.

    After the procedure you may feel the urge to defacate or a feeling of fullness in the lower abdomen. These are temporary. It is also possible to experience some rectal bleeding, which should stop on its own.

    It’s a good idea to take some stool softener to help ease bowel movements in the days following the procedure. Do not take aspirin or any NSAIDs. It is also a good idea to regularly exercise and maintain proper diet and bowel habits going forward.

    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

    Your Recovery after Hemorrhoids Removal | Minneapolis & St Paul

    After you have hemorrhoids removed, you can expect to feel pain, bleeding, swelling in the first week. This is most likely when you have a bowel movement. It is important to keep stool soft and do Sitz bath, and you will feel much better in the second week. It is common to have some light bleeding and clear or yellow fluids from your anus in the first 2 weeks. You will notice the swelling of wound edges and hardness of the tissue around anus, and it may last for 1 to 2 months after surgery.

    After the first few days, you should be able to do most of your normal activities. But don’t do things that require a lot of effort. It is important to avoid heavy lifting and straining with bowel movements while you recover.

    Post-op instructions:
    1. You may shower in the evening or next morning. Good hygiene is essential for proper healing.
    2. Water is your best friend. It is important to take a sitz bath after each bowel movement or at least three times a day.
    3. Wearing soft gauze pads or Maxi pads in your underwear helps to control bleeding, fluid /mucous drainage.
    4. Avoid foods which make you constipated. Be sure to include wheat bran, fresh fruits and plenty of vegetables in your diet.
    5. Take Metamucil to increase fiber intake.
    6. Take stool softener, such as Colace.
    7. Drink plenty of water, otherwise, fiber and stool softener won’t work.
    8. Avoid straining, especially the first week after surgery.
    9. If you develop hard stool or constipation, A laxative, Miralax is recommended.
    10. Mild to Moderate exercise is encouraged. You may walk as much as you like.
    11. Avoid heavy lifting.
    12. You are able to drive right after the surgery, and you may return to work with restriction in 2 days.
    13. You may take Tylenol or Ibuprofen (Advil, motrin, etc.) for mild pain. Should these not be effective in relieving the pain, prescription pain medications will be given on an individual basis.
    14. Please call the office to report any of the following: excessive bleeding, fever, Signs of wound infection, persistent moderate to severe pain, and constipation.

    What are the Best Treatments for Hemorrhoids? | Minneapolis & St Paul

    The term “hemorrhoid” has been used to refer to both normal anatomic tissue and pathologic structure. Hemorrhoid diseases are swollen and varicose blood vessels in the lower rectum. They are among the most common causes of anal complaints in the office visits.

    Hemorrhoids diseases include internal hemorrhoids, external hemorrhoids, anal tags, thrombosis of hemorrhoids and mixed hemorrhoids. Internal hemorrhoids are graded from I to IV based on the degree of prolapse. Besides causing anal itching, pain, bleeding and prolapse, hemorrhoids could cause other complications, such as thrombosis, anemia, and infection. Moreover, many hemorrhoid patients have a comorbidity of anal fissure, fistula, or anal warts. Because no single treatment modality can fix all hemorrhoids, a true hemorrhoid clinic will offer multiple treatment modalities and options to meet a patient’s specific needs and provide complete care.

    If you are treated with single modality for your hemorrhoids, regardless of the severity, type of hemorrhoids, and associated anorectal conditions, it leads to poor results because of poor quality care.

    Internal hemorrhoid Grade 1
    Very early hemorrhoids can often be effectively dealt with by dietary and lifestyle changes. The lifestyle changes should also be part of the treatment plan for more advanced hemorrhoids.
    1. Eating plenty of high-fiber foods
    2. Drinking plenty of fluids
    3. Keeping stool soft
    4. Good toilet habits
    5. Doing exercise regularly, but avoid heavy lifting
    6. Reducing weight

    Internal hemorrhoid Grade 1-2
    Infrared coagulation (IRC) is a non-surgical treatment that is fast, well tolerated, and remarkably complication-free. The infrared light quickly coagulates the vessels that provide the hemorrhoid with blood, causing the hemorrhoids to shrink and recede.

    Internal hemorrhoid Grade 3
    The third grade internal hemorrhoids can be treated with the combination of infrared coagulation and rubber band ligation (banding). Rubber band ligation is widely used for the treatment of more advanced (more prolapsed) internal hemorrhoids where the prolapsed hemorrhoidal tissue is pulled into a double-sleeved cylinder to allow the placement of rubber bands around the tissue. Over time, the ligated tissue dies off. Rubber band ligation downgrades the hemorrhoids to grade 1 or 2, so some patients may need to do Infra-Red Coagulation (IRC) treatments after rubber band ligation.

    Internal hemorrhoid Grade 4
    A hemorrhoidectomy surgically removes the tissue that causes bleeding or protrusion. It is done in a doctor’s office, surgical center, or hospital under anesthesia and may require a period of inactivity.

    External hemorrhoidal tags (anal tags)
    Small and asymptomatic tags don’t need any treatment. If symptomatic, anal tags can easily be removed in the office using a local anesthetic and a radiofrequency device.

    Thrombosed external hemorrhoids
    These hemorrhoids are typically treated with either incision to remove the clot or with external hemorrhoidectomy. Simply draining the clot usually relieves the pain immediately, but it may not work well if multiple thromboses exist as it can also lead to recurrence, so it is better for patients with multiple thromboses to completely excise the thrombosed hemorrhoids.

    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.

    How to Treat if I Have Both Hemorrhoids and an Anal Fissure? | Minneapolis & St Paul

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

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

    An anal fissure is a tear in the anal canal in the lower rectum. Anal fissures are typically thought to be caused by trauma from a hard or painful bowel movement. Many patients report bright red blood on the toilet paper or the stool, though bleeding is usually not significant.

    If hemorrhoids and anal fissures occur together, the patients have to treat anal fissure first. Not only is anal fissure more painful, but also is hemorrhoids usually treated under anoscope which creates more pain and makes anal fissure worse.

    Hemorrhoids and anal fissures are initially treated with high fiber diet (such as fruits, veggies and whole grains) , taking an over-the-counter stool softener and using creams or ointments especially for hemorrhoids. It can also help to soak your bottom in warm water for 2-3 times a day, and Sitz baths after bowel movements are effective in relieving symptoms.

    If these first-line treatments do not work, the patient will focus on the definitive treatments for anal fissure with the topical agents such as Nifedipine and nitroglycerine (NTG) ointment in conjunction the treatments listed above.

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

    After anal fissure heals, the attention turns to treat the hemorrhoids with infra-red coagulation, banding or surgery if necessary.

    Four Cardinal Symptoms of Hemorrhoids | Minnesota

    Although hemorrhoidal symptoms and complaints are common and typically not a serious concern, all patients should be examined for signs of possible cancer and other associated diseases. There are four cardinal symptoms of hemorrhoids, including rectal pain, bleeding, anal itching, and rectal mass or lump.

    Anal Itching
    Anal itching is the most common complaint in the hemorrhoid patients. It often comes and goes. 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.

    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 hemorrhoids and other rectal diseases must be considered and treated when diagnosing and treating anal itching.

    Anal pain
    Anal pain is a common sign of hemorrhoids. The patients with hemorrhodis often complain the aching pain, irritating pain, and spasmodic pain. If the hemorrhoid patient also has anal fissure, sharp pain may occur during intense, forced bowel movements that are often accompanied by rectal bleeding. Immediate onsets of intense pain accompanied by a palpable mass are usually a result of an external thrombosed hemorrhoid, which may last a few days to a couple of weeks. Internal hemorrhoids, however, are not very painful due to being located above the dentate line of the rectum.

    Proctalgia fugax is a more serious anal pain condition that involves short spasms of intense pain at night. Hemorrhoids could be its trigger or cause.

    Rectal Lump
    A palpable anal 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 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.

    The thrombosed external hemorrhoids often cause very painful, bluish anal lumps when the hemorrhoidal veins rupture and the blood clots develop.

    Rectal bleeding
    Rectal bleeding can be caused by hemorrhoids and other 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.

    FAQs of Infrared Coagulation | Minnesota

    A hemorrhoid is a common illness that numerous Americans suffer from. Approximately three out of four adults will have hemorrhoids at some point in their life. If you have anorectal symptoms, such as anal itching, rectal bleeding, anal lumps, and you suspect hemorrhoids , you should always be evaluated with a thorough evaluation by a physician for an accurate diagnosis and treatment plan and to exclude a serious illness.

    GREAT NEWS ABOUT HEMORRHOIDS! Infrared coagulation, or IRC, a minimally invasive, non-surgical procedure is available to treat hemorrhoids. This blog is to answer the common questions on the IRC with the FAQs.

    What is infra-red coagulation?
    Infrared coagulation (IRC) has quickly become the world’s leading office treatment for hemorrhoids and is preferred over other methods because it is fast, well-tolerated, and virtually complication-free. A small probe is placed in the base of the hemorrhoid, and a few bursts of infrared light are applied. The vessels that provide the hemorrhoid with blood are then congealed, and the hemorrhoids shrink away. It may take a few weeks for all the hemorrhoids to shrink completely.

    IRC is more effective and fewer infections than sclerotherapy, and may be better tolerated than rubber band ligation in most cases.

    How long is the procedure?
    Each treatment lasts about a couple of minutes, but the severity of the hemorrhoid as well as your comfort level is considered.

    Does it hurt?
    The procedure is very tolerable. You’ll probably feel a brief sensation of heat rather than any actual pain. You may feel some discomfort from anoscope. This treatment is available to be done during a regular office visit and does not require any special preparation, anesthesia, or medication or salves.

    How should I prepare for the procedure?
    In most cases, there is no preparation necessary. The physician will need to examine you to decide on the ideal treatment plan. Try to have a bowel movement 30 minutes before coming into the office.

    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.

    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.
    How many visits are required?

    This depends on how severe the hemorrhoid problem is, the location of the hemorrhoids, and your individual response to the procedure. Most patients require 4 visits every two weeks.
    Will the hemorrhoids come back?

    Does it come back?
    Recurring hemorrhoids in different locations may occur in some patients. If this happens, infra-red coagulation, rubber band ligation or repeat hemorrhoidectomy may be necessary. Also, a sensible diet, moderate exercise, and proper bowel habits are helpful.

    Do you offer other treatment options?
    An expert in proctology, Dr. Shu does hundreds of hemorrhoid treatments every year. He offers rubber band ligation and hemorrhoidectomy for the most severe cases if necessary. He also treats other anorectal diseases such as anal fissure, anorectal abscess, anal polyp and anal warts.

    Dr. Shu has had extensive experience in treating hemorrhoids with non-surgical IRC treatments in the past two decades, and he has successfully treated more than 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 Diet and Preventing hemorrhoids | Minneapolis & St Paul

    There is a strong correlation between diet and hemorrhoids. Turns out that what you eat, and what it subsequently turns into, has a huge effect on the health of your bowels- and that includes hemorrhoids, those pesky swollen veins that no one wants to talk to their doctor about. Basically, repetitive stress on the vascular hemorrhoidal cushions causes the supporting tissue to weaken and become inflamed, which results in the hemorrhoids getting blown up like a balloon. Trust me, you don’t want any balloons down there. With the skin and tissue stretched so thin, it can tear and bleed onto your toilet paper, an alarming sight for anyone procrastinating at work. It can get a lot worse than that too, like if it develops into an external hemorrhoid, becomes thrombosed, or, god forbid, gets infected. But that’s not what this is about. Today we’re talking prevention.

    There are three big things when it comes to hemorrhoids: stool hardness, toilet habits, and inflammation. Don’t strain too long or too hard on the toilet, as it puts pressure on the hemorrhoids.

    Have you gotten your fiber today? It’s recommended that women consume at least 25 grams of fiber a day, and that men consume 30-38 grams of fiber a day. Most likely, you’re one of the 95% of people in America that don’t get the proper fiber intake they need. Fiber adds bulk to stool, making it easier to pass and reducing the chance of constipation. Constipation is problematic. The less fiber you eat and water you drink, the harder your stool. The harder your stool, the more constipated you get. The more constipated you get, the more you strain. The more you strain, the more pressure you put on the hemorrhoidal cushions, and, well, you know the rest.

    Good toilet habits: move your bowels as soon as you feel the urge; Do not sit on the toilet for long periods of time.

    Inflammation is swelling. increased blood flow. Heat. Irritation. Hemorrhoids. Diet can be a big factor in inflammation. Here are a few things to take note of:

    -Reduce refined carbohydrates and animal products
    -Reduce alcohol consumption
    -Get enough micro minerals such as zinc and chromium
    -Get enough essential fats such as Omega-3 fats
    -If possible, don’t be overweight

    How Many Times can You Have the Rubber Band Ligation Treatments | Minnesota

    Rubber band ligation (RBL) is one of the common procedures to treat hemorrhoids. RBL is an office procedure that mainly treat the prolapsed hemorrhoids in the advanced grade 2 and grade 3 hemorrhoids.

    RBL is very effective in treating hemorrhoids, but it is not very efficient because RBL treatment is usually limited to one hemorrhoid each office visit and additional areas may be treated at 2 week intervals. Most patients need 2-4 RBL sessions. The patients will have more rectal discomfort, rectal tenesmus (feeling of incomplete defecation), and pain if given the RBL in two locations at the same time.

    The hemorrhoid tissue has to be prolapsed enough to be tied off at its base with rubber bands, so it cannot be performed if there is not enough tissue to be pulled into the barrel in the banding device. This procedure is almost never appropriate for grade 1 or mild grade 2 hemorrhoids. The infra-red coagulation (IRC) is the better option for early and mild hemorrhoids.

    The RBL 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.

    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 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.

    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 External Hemorrhoidectomy Recovery Process

    What happens afterwards? The External Hemorrhoidectomy Recovery Process.

    If you’ve only local anesthetic was used, you’ll be able to go home right after surgery. Most external hemorrhoidectomies are performed under local anesthesia without any sedation. If you have large external hemorrhoids or mixed hemorrhoids, you may be given oral or intravenous sedation, and you leave once the sedative wears off, you need to arrange a driver . General anesthesia is typically unnecessary for external hemorrhoidectomy.

    Following an external hemorrhoidectomy, the recovery should involve a little time off work (a couple of days), and avoiding intense physical strain; that said, it is important to try to remain active while you recuperate.

    Pain management after an external hemorrhoidectomy is important part of recovery. Your bowels still need to keep work while recovering, except now it has a wound in it. It is almost certainly going to be quite sore at first.

    Most patients go through bowel preparation before surgery, and as a result usually don’t have any bowel movements in the first day or even 2nd day. You should reduce the amount of food you eat in the first 2 days in order to reduce the bowel movements. You’ll also get some fiber and medication to soften your stool, allowing you to pass it more easily and with less disturbance to the operative wounds. For similar reasons, you should make sure you drink plenty of water, at least 6 to 8 glasses every day. This also helps keep your stools soft and easy to move.

    Tylenol or Ibuprofen is usually sufficient for pain control. If the pain is severe, stronger painkillers such as narcotics may help keep it in check. That said, you are discouraged from using them since narcotics may cause constipation, which affects the wound healing.

    It is also important to give yourself a Sitz bath three times a day, 15 minutes each time to help the wound healing and prevent infection. Wash or soak after each bowel movement, and Keep the anus clean and dry.

    The pain ought to lessen as the wound heals over, which is a fairly fast process – everything should be back to normal, and pain-free, within two to three weeks.

    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.

    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.

    The Unfortunate Condition of Anal Itching | Minnesota

    When you watch hospital dramas on TV you get this impression of the medical world being this dramatic place where love and life are in constant peril. This is not the case in reality. If they made a TV show about the mundane things most people go to the doctor for no one would want to watch it. In fact, it’s part of the joke in shows like House where Dr. House is punished by clinic duty.

    That being said, let’s talk about pruritus ani, a rare and exotic disease caused by a river parasite in the Himalayas. OK, so that’s a lie. It’s just a fancy term for anal itching. If that’s not obvious enough, anal itching is when the skin around your anus (perianal skin) becomes intensely itchy. And now you have to go to work constantly repressing the urge to scratch your bum. If you’re reading this, you may be one of the 1-5% of the population that anal itching effects, and you’re four times as likely to be a man.

    There are two types of anal itching. Primary, where there is no definitive cause, and secondary, where anal itching is the symptom of an underlying medical issue. Some of the myriad of potential causes include:

    – Hemorrhoids
    – Skin tags
    – Poor hygiene (residual fecal matter)
    – Sweat
    – Diabetes
    – Incontinence
    – Anal fistulas
    – Anal fissures
    – Anal warts
    – Repetitive scratching/trauma/irritation
    – Medication (e.g.antibiotics)
    – Skin conditions like psoriasis
    – Infection
    – Psychosomatic; your own mind tricking you into thinking you have anal itching (i.e. anxiety, schizophrenia, etc)
    – Diet

    Here are some ways to manage the symptoms. Just keep in mind that, if anal itching is a symptom of an underlying disease, merely treating the symptoms may not actually fix the cause of anal itching.
    – Cleaning the anus by using a wet unscented wipe or toilet paper or washcloth.

    – Avoid scrubbing.

    – Avoid medicated powders, lotion, soaps, and sprays.

    – Do not wear clothing that is too tight, too often.

    – DO NOT ITCH. Just don’t. Wear mitten to sleep.

    – Do Sitz Bath with warm water

    – May take Benedry for a few nights

    Most of the time, as long as you follow these steps itching should go away on it’s own, unless of course, you have an underlying condition that is causing the itching such as hemorrhoids or a fistula.

    If the anal itching is associated with any type of rash, lump, discharge, bleeding, or fever, call your doctor.

    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.

    Normal Things that Can Give You Hemorrhoids | Minnesota

    There are few things more annoying than suffering from hemorrhoids. Even with Grade I hemorrhoids, you will usually find out when there’s blood on their toilet paper or occasional itching and irritation around anus. God forbid it becomes Grade IV mixed hemorrhoid. It’s ghastly sight. Who wants to see that? You notice the blood and feel the itch, as well as mild anxiety- you look up the symptoms, and WebMD tells you that you probably have hemorrhoids. Then you have to pretend like you don’t have a itchy swollen bleeding vein in your rectum while you talk to your coworkers. And you’ll wonder: what did I do to deserve this?

    Well, a lot of things. You’re probably doing one of them right now. Old habits die hard, or give you hemorrhoids. Here’s a list of everyday things that are actually giving hemorrhoids:

    Straining too hard/long- Your colon and rectum can only take so much straining while you relieve yourself. This is usually because of constipation or diarrhea, or because you had eyes glued to your phone for 25 minutes. Eat your beans and keep trips to the bathroom short.

    Weight/pregnancy- Putting on weight of any kind is going to put pressure on your rectum. And, for those who are overweight, diet and aerobic exercise will help keep you in shape and prevent hemorrhoids.

    Lifting too hard/long- If your job often requires heavy lifting, or you never figured out how to deadlift correctly, the physical strain can injure your rectum and give you hemorrhoids.
    Being born- Unfortunately, some people are just more genetically inclined to get hemorrhoids. For whatever reason, God decided you were gonna have weak easily-swollen veins that’ll start bleeding at 27.

    Thankfully with modern medical technologies like IRC and old, but reliable rubber band ligation and surgical excision, and an ever growing understanding of hemorrhoids, even those destined to have an itchy rectum can still have a normal, nuisance-free existence.

    The Combined Modalities Achieve the Best Result in the Treatment of Hemorrhoids | Minnesota

    Hemorrhoids diseases begin internally, then external hemorrhoids develop when the internal hemorrhoids get worse over a period of time. Internal hemorrhoids are graded from I to IV based on the degree of prolapse. 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 a 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. Based on his hemorrhoid treatment experience for the past 20 years, Dr. Shu developed a practical and effective treatment strategy based on the severity of hemorrhoids.

    For example, if you have to push the prolapsed hemorrhoids back with your finger after bowel movements, it suggests you may have grade three internal hemorrhoids. Dr. Shu will perform rubber band ligation one to three times to downgrade your hemorrhoids from grade three to grade one to two, then he will perform infrared coagulation to further treat the remaining hemorrhoids. The result of the combination treatments is much better than that of either single modality.

    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 for the placement of rubber bands around the tissue. Over time, the ligated tissue dies off.

    Infrared coagulation (IRC) is a non-surgical treatment that is fast, well tolerated, and remarkably complication-free. An infrared light quickly coagulates the vessels that provide the hemorrhoid with blood, causing the hemorrhoids to shrink and recede.

    Dietary and lifestyle changes should also be part of the treatment plan for more advanced hemorrhoids.

    If you have grade four internal hemorrhoids, large external hemorrhoids and/or persistent symptomatic external hemorrhoids, you may need surgery (external hemorrhoidectomy) to have them removed.

    Kegel Exercises and How They Can Help to Prevent Hemorrhoids | Minneapolis & St Paul

    Hemorrhoids, a disease that affects almost 75% of people at some point in their lives, can be a real nuisance for a busy adult. The itching, bleeding, and pain of hemorrhoids make them as annoying as they are unsightly, and getting rid of them may take a while or require going to a doctor’s office, which is why the best way to deal with hemorrhoids is preventing them from occurring in the first place!

    Exercise may help to prevent hemorrhoids. Many people are under the impression that exercise can make hemorrhoids worse or even cause hemorrhoids, but this is only true for certain exercises such as weightlifting, typically due to bad form. Certain exercises are very good for hemorrhoid relief.

    One method is kegel exercises. Kegel exercises, also known as pelvic exercises, involve contracting and relaxing the pubococcygeal, or PC, muscle in the pelvic floor in order to strengthen it. It’s the same muscle you contract and relax in order to go to the bathroom. They are commonly used to prevent urinary incontinence as well as other pelvic floor problems. Doing this exercise regularly may also reduce the chances of hemorrhoids, and can be done discreetly almost everywhere, either sitting, standing, or lying down, and requires no equipment, so it’s great to do it at work or at home!.

    To perform a kegel exercise:
    Squeeze the PC muscle for 3 seconds
    Relax the PC muscle for 3 seconds
    Perform steps 1. and 2. in succession for 10 reps
    Take a 30 second break and perform the set of 10 reps two more times
    3 sets of 10 reps should performed three times a day

    This is by no means the only way to do kegels- feel free to modify as you see fit.

    The Elephant Foot Yam: a Potential Future Hemorrhoid Treatment? | Minnesota

    Amorphophallus paeoniifolius, or the elephant foot yam, when cut in half, looks exactly like it’s described: an elephant foot. While it’s not a pretty looking root, there may be more than meets the eye with this humble looking root. Basically, the elephant foot yam is this wide-spread vegetable is grown in places in Africa, Southeast Asia, and tropical Pacific islands. It’s almost unheard of in America for the most part, but in the areas it is cultivated, such as India, it is often fried or cooked into delicious curries.

    However, not only is it prized for its subtle, mild, taste, but it’s also coveted for its medicinal effects by those who study alternative and traditional medicine. Like many health superfoods it has a reputation for being a cure-all, with a wide variety of positive health benefits ranging from lowering cholesterol to treating diabetes to “detoxification”. While some of these unsubstantiated claims might make you roll your eyes, don’t dismiss the elephant root yam just yet- when it comes to hemorrhoids, research suggests that yam could be answer.

    A recent paper from the Regional Ayurveda Research Institute suggests that extracts of the Amorphophallus paeoniifolius tuber could be effective in treating hemorrhoids. In the paper, published in the Journal of Ethnopharmacology, researchers searching for potential new drugs induced hemorrhoids in rats using croton oil, a foul smelling oil made from the seeds of the Asian croton tree. Once the rats had developed hemorrhoids, indicated by the inflamed tissue and the presence of blue dyes added by the researchers, they administered various kinds of extracts of the root as well as normal hemorrhoid medication from the drugstore. The results were quite interesting- the root resulted in reductions in hemorrhoid size and inflammation comparable to that of the medication. There was a clear healing effect observed, as the control group with no medication saw no reductions in hemorrhoid size or inflammation.

    Of course, there is a long way to go before a marketable drug or even clinical testing on humans is possible, but this study could certainly result in lot of interesting follow up research. While the mechanism of how the tuber’s healing effects are not exactly known, an analysis of the compounds within the tuber give some hints as to what the secret of the tuber is. Various flavonoids and phenolic compounds were found that could potentially explain the root’s anti-inflammatory and curative effects on hemorrhoids. While no one should be holding their breath waiting for a miracle hemorrhoid drug coming anytime soon, these studies show the enormous potential of this native plant and sheds light on an interesting and uncommon medical field. In the meantime, make sure you get enough daily fiber.

    Hemorrhoids and Pregnancy | Minensota

    Hemorrhoids are very common complaints during pregnancy. It afflicts 20 to 50 percent of all pregnant women in Minnesota. Pregnancy changes your body in more ways than you might think. Why does pregnancy make women more prone to hemorrhoids? There are several reasons on it.

    1. Hemorrhoids are a type of venous disease similar to varicose veins; it is surely not perfect designing in its anatomy and physiology with intrinsic defects.

    2. 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.

    3. Constipation is another common problem during pregnancy, which can also aggravate hemorrhoids due to the straining.

    4. 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.

    5. The pushing process involved in labor also makes the existing hemorrhoids worse.

    Many women in the Minneapolis and St Paul areas develop the new hemorrhoids during their pregnancy; others have the preexisting hemorrhoids even before they get pregnant. 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 typical hemorrhoids symptoms during pregnancy are anal itching, rectal bleeding, pain, and bulging out. The good news is that hemorrhoids will begin to improve soon after giving birth.
    The most conservative hemorrhoid treatments are usually prescribed for hemorrhoids occurring during pregnancy and soon after childbirth. Local application of over-the-counter ointments, fiber supplements, Sitz bath and cold packs are often sufficient to relieve the symptoms. If the patients develop the hemorrhoid complications, commonly painful thrombosed external hemorrhoids, then the simple surgical procedure with incision and drainage is necessary to remove the blood clots and alleviate excoriating rectal pain. Occasionally, the limited external hemorrhoidectomy is needed in some severe cases.

    The patients are encouraged to see hemorrhoid doctors, family physicians or colorectal surgeons for hemorrhoid evaluation in 2-3 months after delivery if they have severe hemorrhoids during pregnancy or the symptoms linger even a few months after giving birth.

    The good thing is that minimally invasive hemorrhoid procedures, such as Infrared coagulation (IRC) and banding, can effectively treat most hemorrhoids without cutting or stapling to postpartum women. For the extensive or severe hemorrhoid cases that do not respond to conservative methods, hemorrhoidectomy is needed to remove them completely. Dr. Shu prefers to perform less invasive hemorrhoidectomy, not traditional hemorrhoidectomy, in combination with banding and IRC, The patients usually have good result with quicker recovery with this approach.

    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.

    History of Hemorrhoid Treatments | Minnesota

    Hemorrhoids may be one the oldest conditions known to man. Hemorrhoids is a condition that involves swelling and inflammation of the veins and other vessels surrounding the anal canal. It is surprisingly common, especially among adults above 40. Today, common methods of treatment include infrared coagulation, rubber band ligation, surgical excision, and classic methods of conservative treatments like topical drugs, diet, Sitz baths, etc. The first mention of hemorrhoids were found on Egyptian papyrus dated 1700 BC, which gives the following advice:

    “… an ointment of great protection; acacia leaves, ground, triturated and cooked together. Smear a strip of fine linen therewith and place in the anus, that he recovers immediately.”

    While it was a very archaic remedy, their thinking was not unsound. Acacia leaves have been shown to exhibit anti-inflammatory properties, which may have helped relieve pain and swelling in hemorrhoids.

    In 460 BC, Hippocrates described what may be the first recorded surgical treatment of hemorrhoids.

    “And hemorrhoids in like manner you may treat by transfixing them with a needle and tying them with very thick and woolen thread, for application […] and always leave one behind; and when the patient recovers, let him be put on a course of Hellebore.”

    This is essentially a primitive form a rubber band ligation, in which a rubber band is used instead of thread. Hellebore was a poisonous plant used as a laxative by Hippocrates. Galen (AD 129-~AD 200), a famous Greek physician, suggested severing arteries from veins to relieve pain and prevent the spread of gangrene.

    In the Middle Ages, a common treatment in Europe involved cauterization of the hemorrhoid with a hot iron or cutting it with a sharp knife, and unpleasant and most likely excruciatingly painful procedure.

    In the 19th century, anal stretching was used as a treatment. In the US, Carbolic acid was injected into hemorrhoids. By the 20th century, more contemporary methods like rubber band ligation, hemorrhoidectomy, etc. became commonplace.

    Hemorrhoid Myth-busting | Minnesota

    Hemorrhoids are uncommon
    FALSE– Hemorrhoids are actually incredibly common. A whopping 75% of adults will suffer from hemorrhoids at some point in their life.

    Only old people can get hemorrhoids
    FALSE– While hemorrhoids are most commonly found in people aged 45-65, it’s definitely possible to find it in younger adults and even children.

    Spicy foods can give me hemorrhoids.
    FALSE– There is no evidence that spicy foods will cause hemorrhoids or make them worse. Those that eat spicy food while having hemorrhoids do not report any increased pain or discomfort with their bowel movements either.

    Sitting on the toilet too long can give me hemorrhoids
    TRUE– This is actually true. Sitting on the toilet too long, especially straining for long periods of time, puts pressure on the veins in the rectum, increasing the chances of developing hemorrhoids. Put away the phone and do your business.

    Cold surfaces can give me hemorrhoids
    FALSE– There’s no evidence that suggests sitting on a cold surface would increase the chances of developing hemorrhoids.

    I shouldn’t exercise if I have hemorrhoids
    FALSE– Exercise actually helps prevent hemorrhoids. However, weightlifting with poor form can increase the chances of developing hemorrhoids and make existing hemorrhoids worse.

    Hemorrhoids could give me cancer
    FALSE– There is no evidence hemorrhoids will increase the chances of cancer.

    Anal Fistula & Hemorrhoids | Minnesota

    An anal fistula is an inflammatory tunnel under the skin, connecting the anal canal and the surface of the surrounding skin. 80% occur as a result of an anorectal infection, wherein the anal crypts are infected and cysts containing pus form near the anal canal. If the abscess breaks or is opened a fistula is often formed.

    Symptoms of an anal fistula can be similar to those of hemorrhoids, manifesting as drainage from the anus, itchiness, and constant, throbbing pain, and is exacerbated by bowel movement. An anal fistula is commonly mistaken for a hemorrhoid upon first notice; however it eventually has episodes of recurrent infection. They are two very different issues that are important to distinguish. The patients with anal fistula usually have the history of anal abscess and recurrent fistula infection.

    In the complex cases advanced diagnostic methods may be necessary.

    1. Fistula probe, a thin metal instrument specially designed to be inserted through a fistula.
    2. Anoscope, a small tube used to view the anal canal
    3. Flexible sigmoidoscopy
    4. An injected dye solution into fistula.
    5. Imagine tests with endoscopic ultrasound and MRI
    6. Fistulography with X-ray of the fistula after a contrast solution is injected.

    Treatment varies depending on the severity and location of the fistula. Antibiotics, antipyretics and, pain medication is prescribed if there is drainage (indicating abscess). For simple rectal abscesses, antibiotics are usually not needed. The surgical procedure for simple fistulas are called a fistulotomy, where the fistula tract is cleared out surgically and allowed to heal properly. For simple fistulas, success rate with fistulotomy is over 90%. More complex fistulas may be to twisted or branching for a fistulotomy so fibrin glue or fibrin plug may be used instead. Fibrin glue is largely out of favor now due to its low success rates. The fistula is filled with this glue, which hardens and then dissolves, allowing scar tissue to form and the fistula to heal. Fibrin plug is a similar concept, but it is not a liquid. Like the glue, it dissolves, allowing growth of scarr tissue. Fibrin treatment has the advantage of not causing incontinence, which can be a risk of fistulotomy. Though in common, staged surgery may be needed.

    With this condition, it is better to seek help sooner than later. Advanced abscesses that become complex are much more difficult to treat. For most however, it seems procrastination is not much of a problem- pain is a very effective motivator.

    Dr. Shu manages the simple or superficial anal fistula with fistulotomy or fistulectomy, and he usually refers the patients with complex anal fistula to the colorectal specialist for further evaluation and treatment.

    Importance of Diet in the prevention and treatment of hemorrhoids | Minnesota

    The importance of diet to the prevention and treatment of hemorrhoids is often understated. Even for the most severe hemorrhoids, good diet is important for proper treatment and recovery. To prevent and manage hemorrhoids, one must ensure that they take in enough fiber. Fiber is interesting, as it’s not a nutrient in the same sense as minerals and vitamins are, but that doesn’t mean it’s not important. Most dieticians agree that Americans don’t eat enough fiber- the recommended amount is 32 grams per day. The average American doesn’t even come close at 15 grams a day. In fact, research shows that a whopping 97% of Americans do not meet the minimum nutritional standard.

    So what is fiber exactly?

    Fiber is a carbohydrate, the same class as starches, sugars, but are different because they are not digestible by the human body. Fiber regulates your body’s sugar intake, and keep hunger and blood sugar in check.

    Fiber comes in two varieties, soluble and insoluble. Soluble fiber can be dissolved in water, lowers glucose levels, maintains blood cholesterol, and most importantly, ensures passage of stool without constipation thanks to its water-absorbing properties. It’s contained in barley, nuts, seeds, beans, lentils, etc. Insoluble fiber is found in wheat bran, vegetables, and whole grains. Insoluble fiber adds bulk to stool, which helps food pass quickly through the intestines. It’s what your grandmother might have called “roughage”. It’s the tough parts in stalks, stems, and seeds. The positive effects of fiber on your digestive system help prevent and manage the symptoms of hemorrhoids.

    What are good foods for fiber?

    Beans, lentils, and nuts all contain large amounts of fiber. Just a half cup of beans will have about 7-10 grams of fiber, about a third of your daily minimum, containing a mixture of soluble and insoluble fibers. Beans are fairly cheap, as well as a good source of protein. Almonds and pecans have around 3 grams of fiber per half cup, as does edamame.

    Grains are another great source. Look for whole-grain items as opposed to the white variety. Bread, pasta, and crackers made from flours, buckwheat, cornmeal, or rye will contain insoluble fiber. Oats and barley will also contain fiber. Lots of cereals have fiber, either naturally or added artificially- fiber containing cereal is a good way to start the day!

    Fruit and vegetables contain loads of fiber, and also have many other nutritional benefits.

    Plant foods with skin contain insoluble fiber as well as flavonoids that help control intestinal bleeding. Fruit with lots of colour and darker vegetables contain a lot of fiber. Adding fruit to cereal, apples to salad, spinach with eggs, or zucchini in spagheti are great ways to add fiber.

    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.

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

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

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

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

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

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

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

    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.

    How to Correctly Use Hemorrhoid Cream | Minneapolis & St Paul

    Over-the-counter (OTC) hemorrhoid cream is widely available in store pharmacies in Minnesota, and it’s an effective way to temporarily improve hemorrhoidal symptoms, such as pain, irritation, itching and swelling. However, they do little to actually the hemorrhoid disease itself and prevent it from recurring.

    Many patients in Minnesota don’t use hemorrhoid cream correctly, and others are not sure if they should apply hemorrhoid cream around the outside of their anus, or internally.

    Here are our instructions for using hemorrhoid cream:

    You may use hemorrhoid creams externally or internally, depending on your symptoms.

    If you have hemorrhoid symptoms that are more towards the outside of your anus, you may use the cream externally:

    • Apply a small amount of cream around the outside of your anus with your finger.
    • You may use hemorrhoid cream 2-3 times daily.
    • Wash your hands after each application.
    • Only use the cream for a short period of time; no more than a week each course. Stop at any time once the symptoms improve or disappear.
    • You may use the cream again when hemorrhoid symptoms recur.

    If external use does not provide enough relief from your symptoms, you may have swollen hemorrhoidal tissues inside your rectum. In this case, you may apply hemorrhoid cream internally to further reduce inflammation and swelling.

    • Try to have a bowel movement prior to using the cream.
    • Squeeze the cream tube gently to fill the applicator.
    • Lubricate the end of the applicator with KY Jelly or petroleum jelly.
    • Gently insert the applicator into your rectum.
    • Squeeze the tube of hemorrhoid cream gently
    • Remove the applicator and wash it and your hands with soap and warm water.
    • Try not to have a bowel movement within two hours after an application.
    • Only use the cream for a short period of time; no more than a week each course. Stop at any time once the symptoms improve or disappear.
    • You may use the cream again when hemorrhoid symptoms recur.

    Please remember, if you suffer from hemorrhoid symptoms repeatedly, you should seek medical attention in a hemorrhoid clinic and have definitive treatments.

    Differences Between Hemorrhoids and Anal Abscesses | Minnesota

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

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

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

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

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

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

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

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

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

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

    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.

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