Tag Archives: Anorectal Diseases

How to Prevent the Hemorrhoids | Minneapolis & St Paul

Hemorrhoids are a varicose vein disease. More than 10 million people in the United States suffer from hemorrhoids. Three out of four people will develop hemorrhoids at some time in their lives. Although they can be extremely unpleasant and painful sometimes, they can be easily treated with non-surgical therapy and they are preventable. Moreover, if patients don’t take preventive measures, it is possible to relapse after hemorrhoid care, especially in advanced hemorrhoids.

There are many ways to prevent hemorrhoids for patients in Minnesota.

1. One of the best things you can do to prevent hemorrhoids is to make important dietary changes to keep your stools soft and prevent constipation. Why is fiber so very important? People in Minnesota who do not get enough fiber in their diet tend to have constipation with hard stool and strain when going to the bathroom. In turn, this pressure constitutes one of the greatest risk factors to those who are vulnerable to developing hemorrhoids. Constipation with hard stool and straining often causes the rupture of hemorrhoidal veins and anal skin tearing.
Eating a diet that is high in fiber such as fruits, vegetables, beans, and whole grains is recommended. Taking a fiber supplement every day, such as Citrucel or Metamucil, can help keep bowel movements regular. Drinking enough fluids is equally as important so that these bulking agents work better (6-8 glasses of water daily).

Frequent diarrhea does not help, either. Straining related to diarrhea also can rapidly increase the pressure in the abdomen and hemorrhoid venous complex, too.

2. Daily exercise is also great to help the bowel move through your digestive system and prevent you from becoming constipated. Moderate activity of at least 30 minutes 3-4 times per week is recommended.

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

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

5. You should have a good toilet habit. The toilet time should not be too long; you should avoid the bad habit of reading newspapers or surfing on the Internet on the toilet. Scheduling time each day for a bowel movement and keeping it a daily routine may help. Take your time and do not strain when having a bowel movement, because it is the straining that causes hemorrhoids. Straining and holding your breath when trying to pass a stool creates greater pressure in the veins in the lower rectum. Lastly, once you feel the urge, it is important to go because if you wait to pass a bowel movement, the urge goes away and your stool could become dry and harder to pass.

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

The Common Causes of Minor Rectal Bleeding | Minneapolis & St Paul

Minor rectal bleeding is one of the common symptoms that the Minnesotan patients seek for the medical care. It refers to the passage of small amount of bright red and fresh blood from the rectum and anus, which may appear on the surface of stool, on the toilet paper or in the toilet bowl.

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

The source of minor rectal bleeding is determined by history, physical examination and endoscopies. In the initial office visit, your doctor may inspect the anus visually to look for anal warts, anal fissures, cancer or external hemorrhoids, and followed by the digital examination with a gloved, lubricated finger and then anoscopy to look for abnormalities and sources of bleeding in the lower rectum and anal canal. If indicated, your doctor may also perform endoscopies, either sigmoidoscopy or colonoscopy.

Anoscopy is a rectal exam with a very short (3 to 4 inch) rigid metal tube to examine the lower rectum and anal canal, it is very useful when your doctor suspects hemorrhoids, anal fissures and other anorectal diseases.

A flexible sigmoidoscopy is to uses a short (24 inches) and flexible tube with a camera to examine the lower colon and rectum.

Colonoscopy is a test that examines the lining of the entire colon for abnormal growths, such as polyps or cancer. A long tube is passed into your bowel, and a light on the end allows the examiner to see the inside of the bowel. If anything abnormal is found, a small biopsy will be done, and polyps or growths can be removed.

The management of minor rectal bleeding mainly focuses on the treatments of the underlying diseases.

Treatment of External Thrombosed hemorrhoids | Minneapolis

External hemorrhoids occur outside the anal verge. Thrombosed external hemorrhoids occur if varicose veins rupture and blood clots develop. It is often accompanied by swelling with a bluish-purplish discoloration and severe incapacitating pain.

The symptoms may improve in some patients with conservative nonsurgical treatment – the anal care I coined includes stool softeners, increased dietary fiber, increased fluid intake, warm Sitz baths, and analgesia. For most patients, surgical excision is often more effective and efficient in treating thrombosed external hemorrhoids. Surgical excision is an office-based procedure performed under local anesthesia. This safe office procedure offers low complication and recurrence rates and high levels of patient satisfaction.

Procedure
After cleaning the anal area with an antiseptic, lidocaine with epinephrine is locally injected in the surgical area. The thrombosed hemorrhoid is unroofed by making an elliptical incision in the hemorrhoid, then the blood clots are removed, and the procedure is finished for a simple case. Simply draining the clot usually relieves the pain immediately, but it may not work well if multiple thromboses exist as it can also lead to recurrence, so it is better for patients with multiple thromboses to completely excise the thrombosed hemorrhoids. The external hemorrhoidectomy may be performed, then the hemorrhoidal tissue with blood clots is removed together, and the bleeding in the wound is stopped with a cautery. The wound in the anal area is covered with sterile gauze.

Postoperative Care
The patient will be instructed to do anal care measures, including warm Sitz baths three times a day for 15-30 minutes at a time. Acetaminophen or ibuprofen should be used for pain control. The patient should remain well hydrated and take a stool softener to keep stool soft.

Complications
Common complications of thrombosed external hemorrhoid excision include pain, bleeding, infection and delayed healing. A perianal skin tag could develop in some patients. Stricture and incontinence are extremely rare complications.

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