Category Archives: Rectal bleeding

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.

Try These 8 Tips to Relieve Constipation | Minnesota

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

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

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

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

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

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

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

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

 

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.
 

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

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

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

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

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

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

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

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

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

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

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

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

 

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.

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.

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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