Why can’t Single Treatment Modality Fix All Hemorrhoids?
There are several types of hemorrhoids (internal, external, and mixed). Internal hemorrhoids are graded from I to IV based on the degree of prolapse. Moreover, many hemorrhoid patients have a comorbidity of anal fissure, fistula or anal warts. Because no single treatment modality can fix all hemorrhoids, a true hemorrhoid clinic will offer multiple treatment modalities and options to meet a patient’s needs and provide complete care.
If you are treated with single modality for your hemorrhoids, regardless of the severity, type of hemorrhoids, and associated anorectal conditions, it leads to poor results because of poor quality care.
No single treatment modality can fix all hemorrhoids or get rid of anorectal symptoms. Specialized hemorrhoid clinic should be able to offer multiple treatment modalities with cutting edge technologies to cure hemorrhoids and associated diseases.
Very early hemorrhoids can often be effectively dealt with by dietary and lifestyle changes. The lifestyle changes should also be part of treatment plan for the more advanced hemorrhoids.
- Eat plenty of fruit, leaf vegetables, and whole-grain breads and cereals
- Use bulk-forming stool softener and fiber supplements such as Metamucil
- Exercise regularly and lose weight
- Drinking six to eight glasses a day of water
- Avoid sitting and straining too long while using the restroom
- Avoid reading in the bathroom
- Avoid using soap or toilet paper that is perfumed which may irritate the anal area
- Avoid excessive cleaning, rubbing, or wiping of the anal area
Infra-Red Coagulation (IRC) 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 in the base of 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 hemorrhoids to shrink and recede. Shrinkage of the hemorrhoidal tissues may take a few weeks.
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 two rubber bands around the tissue. Over time, the ligated tissue dies-off. Rubber band ligation usually is performed in the clinic. Often, however, there is the need for more than one procedure to resolve the condition. Rubber band ligation downgrades the hemorrhoids to grade 1 or 2, some patients may need to do Infra-Red Coagulation (IRC) treatments after Rubber band ligation.
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 our office using a local anesthetic and a radiofrequency device. The procedure takes less than 10 minutes and you do not need a driver after the treatment.
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.
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.