Category Archives: Hemorrhoidectomy

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.

 

Major Moments in Hemorrhoids History | Minnesota

Hemorrhoids have plagued humans for thousands of years, with the earliest known mention of its symptoms dating back to roughly ~2250 BC in the kingdom of Babylon in the Code of King Hammurabi. Fast forward to 1700 BC in Egypt, and we stumble upon the first-ever recorded case of hemorrhoids, which also happened to highlight an important topical wound ointment.

The first use of the word “haemorrhoids” in the English language occurred in 1398. The term derived from the Old French word “emorroides,” taken from Latin derivative “hæmorrhoida-ae,” which in turn originated from the Greek word for “haimorrhois.”

Below is a timeline of key events in the history of hemorrhoid development:
 

Hemorrhoid History: A Timeline

~2250 BC: Babylon Code of King Hammurabi described the symptoms of hemorrhoids

1700 BC: Egyptian papyrus pronounced a topical astringent lotion

1552 BC: Egyptian medical record detailed remedies for hemorrhoids

1046 BC: Old Testament, 1 Samuel 5:9 Philistines punished with “emerods”, and in 1 Samuel 5:12 People who moved the Ark to Ekron were punished with “emerods”

460–375 BC: Hippocratic Treatises described hemorrhoid treatment by cautery and excision, and first recorded use of speculum to inspect the rectum (endoscopy)

25 BC–AD 50: Celsus describes Pile ligation

41–68: Roman physician Dioscorides defined Aloe Vera use for easing hemorrhoids

130–200: Roman Emperor Marcus Aurelius’s physician Galen pronounced hemorrhoids treatment ointment containing laxatives and leeches. He also explained thread use to tie off piles causing them to shrivel up

4th–5th Century: Indian Susruta Samhita text defined clamp and cautery use

5th–10th Century: Arab physician El-Zahrawy defined cautery irons use, whilst Byzantine physicians ligated with thread on the hemorrhoid base, before amputating

1307–1370: John of Ardene’s exposition transcribed hemorrhoids and fistula treatment, and enemas use

1806: Modern era of endoscopy was piloted by Bozzini with his aluminum tube to expose the genitourinary tract

1835: St.Marks Hospital London was founded by Frederick Salmon providing modern hemorrhoids and fistula treatment

1849: Introduction of anal dilation for hemorrhoids treatment

1935: St.Marks Hospital further developed excision and ligation methods at the hands of ETC Milligan and C Naughton Morgan – nowadays defined as the gold inhemorrhoidectomy standard

1952: Modification to the Milligan-Morgan procedure introduced by Ferguson

1955: A.G. Parks’ developed his closed method surgical treatment the hemorrhoidectomy

1963: J Barron developed an out-patient rubber band procedure to tie hemorrhoids

1970: Development of cryotheraphy, diathermy, infrared coagulation and laser cauteries

1975: PH Lord developed his anal dilation hemorrhoid treatment method, whilst WHF Thompson postulated that hemorrhoids developed from anal cushions that are part of the normal anatomical structures

1997: Italian A Longo introduced his stapled hemorrhoidectomy procedure for prolapsed hemorrhoids
 
Due to lack of studies and documentation on hemorrhoids, as well as lack of patients seeking medical assistance, the exact prevalence of hemorrhoids is unknown. However, it’s estimated that roughly half of Americans develop hemorrhoids by age 50, with roughly five percent of the US population affected.

The outlook for hemorrhoid treatment and rehabilitation is generally positive. While some individuals suffer from flare-ups and recurring hemorrhoids, only a small portion of patients require surgery.

 

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.

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.

    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 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.

    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.

    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.

    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.

    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.

    What Can I Expect After Hemorrhoidectomy? | Minnesota

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

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

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

    How Will I Manage The Pain After Surgery?

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

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

    What Else Do I Need To Know About Aftercare?

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

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

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

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

    How to Prevent the Hemorrhoids in Minnesota

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

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

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

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

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

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

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

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

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

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

    How to Manage the Hemorrhoids During Pregnancy in the Minnesotan Women

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

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

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

    Hemorrhoids During Pregnancy In the Minnesota Women

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

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

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

    Interesting Story about Hemorrhoids | Minneosta

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

    Patron Saint of Hemorrhoid Sufferers

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

    Napoleon Bonaparte’s Hemorrhoids

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

    Complications of Hemorrhoids in Minnesota

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

    Complications of hemorrhoids in Minnesota include:

    Anal Itching

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

    Thrombosed External hemorrhoid

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

    Anemia

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

    Strangulated hemorrhoid

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

    Infection

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

    The Common Causes of Rectal Lumps | Minnesota

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

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

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

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

    The Common Causes of Rectal Pain | Minneapolis

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

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

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

    The Common Causes of Rectal Bleeding Minneapolis

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

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

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

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

    The Common Causes of Anal Itching | Minneapolis

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

    Possible causes of anal itching include:

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

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

    Rubber Band Ligation | Minnesota

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

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

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

    Hemorrhoid Prevention for Minnesotans

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

    Hemorrhoid Treatment on the Road | Minneapolis & St Paul

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

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

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

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

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

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

    Hemorrhoid History | Minneapolis & St Paul

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

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

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

    Anal Tags | Minneapolis & St Paul

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

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

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

    Causes of anal tags include:

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

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

    Symptoms of Hemorrhoids | Minneapolis & St Paul

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

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

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

    Hemorrhoids | Minneapolis & St Paul

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

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

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

    Colonoscopys at the Procedure Clinic | Minneapolis & St Paul

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

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

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

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