Hemorrhoids are enlarged bundles of blood vessels in and around the anal area. There are both external (outside) hemorrhoids and internal (inside) hemorrhoids. Outside hemorrhoids often cause pain as a result of a blood clot, which causes swelling of the external hemorrhoid. Internal hemorrhoids often cause painless bleeding and protrude with bowel movements.
Hemorrhoids are caused by aging, constipation, diarrhea, pregnancy and bowel irregularities. Most people with hemorrhoids have some type of rectal bleeding. This rectal bleeding cannot be presumed to be secondary to hemorrhoids alone without performing some type of screening examination such as a Colonoscopy.
Hemorrhoids are treated initially with conservative therapy such as a high fiber diet including supplemental fiber, warm sitzbaths, and increasing fluid intake. If these measures do not relieve symptoms, there are many options available for the treatment of hemorrhoids. These include ligation with rubber bands, which can be performed in the office, and excision of external hemorrhoids under local anesthetic, which also can be performed in the office. Infrared coagulation of hemorrhoids also is used to treat internal hemorrhoids. This is a painless procedure which causes the hemorrhoids to shrivel up.
For more severe cases of hemorrhoid disease or the larger-type hemorrhoids, treatment includes a surgical hemorrhoidectomy. This can be done with conventional techniques, and recently, the use of a Harmonic scalpel has been employed to perform the surgical hemorrhoidectomy. A Harmonic scalpel coagulates the tissue without the use of heat and cuts through the tissue with the use of a fast vibrating blade. Using the Harmonic scalpel in hemorrhoidectomies has decreased the amount of post-operative pain and decreases the time needed for recovery after surgery.