Hemorrhoids are a common problem. They are swollen and inflamed veins that can develop in the lower rectum (internal hemorrhoids) and around the anus (external hemorrhoids). Symptoms of hemorrhoids can include bleeding, anal pain or itching. Bleeding is usually bright red blood that is seen on the toilet paper or in the toilet bowl. It is usually not mixed with stool. For more information on hemorrhoids, please go to the website:
http://digestive.niddk.nih.gov/ddiseases/pubs/hemorrhoids/ At Monmouth Gastroenterology, we offer both medical and procedure based treatments for hemorrhoids. Two of the most common procedures for hemorrhoids are infrared coagulation therapy and rubber band ligation (hemorrhoid banding). Details on these procedures are listed below.

Infrared Coagulation Therapy

Infrared coagulation therapy (IRC) is procedure used to treat small or mid-sized internal hemorrhoids. It is performed with the use of a probe which creates an intense infrared light. The infrared light then transmits heat and energy to the hemorrhoids, which then leads to scar tissue formation. The scar tissue cuts off the blood supply to the hemorrhoids making them less prone to swelling and causing symptoms such as bleeding, pain or itching.

The procedure can be performed in the doctor’s office or in the ambulatory endoscopy center. It can be performed in conjunction with other procedures such as an endoscopy or colonoscopy. The only preparation that is required is an enema before the procedure unless the IRC is being done with a colonoscopy in which case the colonoscopy preparation is adequate.

Patients are placed on their left side. The procedure can be performed with or without intravenous sedation. An anoscope (plastic device used to keep anus slightly open) is gently inserted through the anal canal. The physician will then use the infrared probe to treat the internal hemorrhoids. The procedure takes about 5 to 10 minutes.

The procedure is generally well tolerated by patients. Bleeding from the anus can occur up to 7 to 10 days after the procedure, but usually will stop on its own without any further treatment. After IRC, physicians generally will advise patients to take stool softeners and fiber supplements to prevent straining and constipation, which can aggravate hemorrhoids. To relieve any discomfort from the procedure, patients can take a sitz bath (sit in warm tub of water for 15 minutes) and mild pain relievers to relieve any discomfort from the procedure. Risks from IRC are low, but can include bleeding or infection at the anus, anorectal pain, or a temporary inability to urinate.

Rubber Band Ligation of Hemorrhoids (Hemorrhoid Banding)

Rubber band ligation is a procedure used to treat internal hemorrhoids. It works by placing rubber bands on the base of hemorrhoids, which cut off its blood supply. Hemorrhoids then shrink and slough off in about 1 week.

The procedure can be performed in the doctor’s office or in the ambulatory endoscopy center. It can be performed in conjunction with other procedures such as an endoscopy or colonoscopy. The only preparation that is required is an enema before the procedure unless the hemorrhoid banding is being done with a colonoscopy in which case the colonoscopy preparation is adequate.

Patients are placed on their left side. The procedure can be performed with or without intravenous sedation. An endoscope with the attached hemorrhoid banding device is inserted through the anal canal. The rubber bands are then deployed on the internal hemorrhoids. The procedure takes about 5 to 10 minutes.

The procedure is generally well tolerated by patients. Pain around the anus is common and can last a few days. Bleeding from the anus can occur up to 7 to 10 days after the procedure, but usually will stop on its own without any further treatment. After hemorrhoid banding, physicians generally will advise patients to take stool softeners and fiber supplements to prevent straining and constipation, which can aggravate hemorrhoids. To relieve any discomfort from the procedure, patients can take a sitz bath (sit in warm tub of water for 15 minutes) and mild pain relievers to relieve any discomfort from the procedure. Risks from rubber band ligation of hemorrhoids are low, but can include bleeding or infection at the anus, anorectal pain, or a temporary inability to urinate.