Hemorrhoids, which are swollen and inflamed blood vessels in the lower rectum and anus, are generally believed to be caused by increased pressure in the anal region. They can cause pain, itching and anal bleeding. Hemorrhoids and the resulting symptoms can often be treated at home, although further intervention may be necessary in some cases.
At-Home Treatment of Hemorrhoids
- Fiber. Because chronic constipation and straining during bowel movements can cause hemorrhoids, it is often recommended that sufferers add fiber to their diet in an attempt to loosen stools. Fiber can be found in dried fruits, vegetables, grains, and cereals. Fiber supplements may also be recommended.
- Over-the-counter ointments. Creams, gels and other topical treatments used for hemorrhoids may contain several active ingredients designed to address various symptoms or causes. These ingredients may include:
- Local anesthetics, which temporarily numb nerve endings in order to relieve pain and itching. Examples of local anesthetics include benzocaine, benzyl alcohol, dubcaine, dyclonine, lidocain, pramoxine, and tetracaine.
- Vasoconstrictors, which reduce swelling by making the blood vessels smaller. Examples of vasoconstrictors used in over-the-counter medications include ephedrine sulfate, epinephrine, and phenylephrine.
- Protectants, which form a barrier on the skin in order to prevent irritation. Aluminum hydroxide gel, cocoa butter, glycerin, lanolin, and zinc oxide are common examples of protectants.
- Astringent wipes. The use of witch hazel and other astringent to wipe the anal region can cause coagulation and relieve the discomfort of itching or burning. Gentle washing and warm baths can also help resolve symptoms.
Fixative Procedures for the Treatment of Hemorrhoids
If at-home treatments fail to alleviate symptoms, your doctor may recommend additional treatment. Non-surgical options known as fixative procedures can be completed in a doctor’s office and are designed to reduce the blood flow to the hemorrhoid, causing it shrink. Scar tissue can develop around the shrunken blood vessel, providing additional support for the anal tissue and helping to prevent hemorrhoids from recurring. There are multiple fixative procedures available for treating hemorrhoids.
- Rubber band ligation. An elastic band is wrapped around the base of the hemorrhoid, cutting off blood flow. After about a week, the hemorrhoid will fall off and be evacuated with a bowel movement.
- Sclerotherapy. During this procedure, a chemical solution is injected into the hemorrhoid to shrink the tissue.
- Coagulation. Laser, heat, or infrared light is applied to the swollen blood vessel, causing it to harden and shrivel.
Surgical Treatment of Hemorrhoids
In rare cases, at-home treatments and fixative procedures will not resolve symptoms and surgical options should be considered. Similarly, your doctor may recommend surgery if you have severely protruding hemorrhoids.
- Hemorrhoidectomy. During this surgery, small incisions are used to cut out the swollen hemorrhoids. The resulting wound may be left open or stitched shut. The biggest concern with a hemorrhoidectomy is post-operative pain, which can be treated with pain medication. Other complications may include difficulty urinating, bleeding, narrowing of the anus or infection.
- Stapled hemorrhoidectomy (hemorrhoidopexy). This procedure is used to treat severely prolapsed hemorrhoids. The hemorrhoids are anchored into their original position with temporary staples and sutures, and excess supportive tissue may be removed. At the same time, some of the arterial vessels leading to the hemorrhoids are cut, reducing blood flow and shirnking the inflamed vessels. Cuts made during this procedure will lead to the formation of strong scar tissue that anchors the hemorrhoids in their proper position after the temporary staples fall off.
- Transanal hemorrhoidal dearterialization and rectal mucosal pexy. A surgeon uses a Doppler ultrasound to identify the arteries that provide blood flow to the hemorrhoids. The Doppler can then be used to tie off the appropriate arteries. The lining of the rectum is also repaired in order to treat and prevent protruding hemorrhoids.