This content does not have an English version. This content does not have an Arabic version. During a digital rectal exam, your doctor inserts a gloved, lubricated finger into your rectum. He or she feels for anything unusual, such as growths. The exam can suggest to your doctor whether further testing is needed. Because internal hemorrhoids are often too soft to be felt during a rectal exam, your doctor may also examine the lower portion of your colon and rectum with an anoscope, proctoscope or sigmoidoscope. Often these are the only treatments needed. Eat more fruits, vegetables and whole grains. Doing so softens the stool and increases its bulk, which will help you avoid the straining that can worsen symptoms from existing hemorrhoids.
Add fiber to your diet slowly to avoid problems with gas. Apply an over-the-counter hemorrhoid cream or suppository containing hydrocortisone, or use pads containing witch hazel or a numbing agent. Soak regularly in a warm bath or sitz bath. Soak your anal area in plain warm water 10 to 15 minutes two to three times a day. A sitz bath fits over the toilet. Gently pat the area dry or use a hair dryer. To help keep the anal area clean after a bowel movement, use moist towelettes or wet toilet paper that doesn’t contain perfume or alcohol. Apply ice packs or cold compresses on your anus to relieve swelling.
With these treatments, hemorrhoid symptoms often go away within a week. See your doctor if you don’t get relief in a week, or sooner if you have severe pain or bleeding. Medications If your hemorrhoids produce only mild discomfort, your doctor may suggest over-the-counter creams, ointments, suppositories or pads. These products contain ingredients, such as witch hazel, or hydrocortisone and lidocaine, that can relieve pain and itching, at least temporarily. Don’t use an over-the-counter steroid cream for more than a week unless directed by your doctor because it may cause your skin to thin. This procedure is most effective if done within 72 hours of developing a clot. Sliding the ligator’s cylinder upward releases rubber bands around the base of the hemorrhoid.
Rubber bands cut off the hemorrhoid’s blood supply, causing it to wither and drop off. Minimally invasive procedures For persistent bleeding or painful hemorrhoids, your doctor may recommend one of the other minimally invasive procedures available. These treatments can be done in your doctor’s office or other outpatient setting and do not usually require anesthesia. Your doctor places one or two tiny rubber bands around the base of an internal hemorrhoid to cut off its circulation. The hemorrhoid withers and falls off within a week. This procedure is effective for many people. Hemorrhoid banding can be uncomfortable and may cause bleeding, which might begin two to four days after the procedure but is rarely severe. In this procedure, your doctor injects a chemical solution into the hemorrhoid tissue to shrink it. While the injection causes little or no pain, it may be less effective than rubber band ligation.
Coagulation techniques use laser or infrared light or heat. They cause small, bleeding, internal hemorrhoids to harden and shrivel. Surgical procedures If other procedures haven’t been successful or you have large hemorrhoids, your doctor may recommend a surgical procedure. Your surgery may be done as an outpatient or may require an overnight hospital stay. In this procedure, called hemorrhoidectomy, your surgeon removes excessive tissue that causes bleeding. The surgery may be done with a local anesthetic combined with sedation, a spinal anesthetic or a general anesthetic. Hemorrhoidectomy is the most effective and complete way to treat severe or recurring hemorrhoids. Complications may include temporary difficulty emptying your bladder and resulting urinary tract infections. Most people experience some pain after the procedure.
Soaking in a warm bath also may help. This procedure, called stapled hemorrhoidectomy or stapled hemorrhoidopexy, blocks blood flow to hemorrhoidal tissue. It is typically used only for internal hemorrhoids. Stapling generally involves less pain than hemorrhoidectomy and allows for earlier return to regular activities. Compared with hemorrhoidectomy, however, stapling has been associated with a greater risk of recurrence and rectal prolapse, in which part of the rectum protrudes from the anus. Talk with your doctor about the best option for you. You can help your doctor by being prepared with as much information as possible.
Here are some suggestions to help you get ready for your appointment. At the time you make the appointment, ask if there’s anything you need to do in advance. Write down any symptoms you’re experiencing and how long you’ve noticed them. Write down key personal information, including typical bowel habits and diet, especially your fiber intake. Make a list of all medications, vitamins or supplements that you’re taking. Write down questions to ask your doctor. What’s the likely cause of my symptoms? Is my condition likely to be temporary or permanent?
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