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.