Hemorrhoids
What are hemorrhoids?
Hemorrhoids are swollen veins in the anus and low rectum. Hemorrhoids, also called piles, are similar to varicose veins. Hemorrhoids are the most frequent anorectal disease. Hemorrhoids occur in 5% – 40% of the population. Constipation and straining to have a bowel movement can make hemorrhoids worse.
Types of hemorrhoids
Internal hemorrhoids:
Internal hemorrhoids are located inside the rectum. They are often painless but tend to bleed.
External hemorrhoids:
External hemorrhoids are located outside the rectum. They can cause pain if irritated or plugged by a blood clot (thrombosed).
What are the symptoms of hemorrhoids?
Bleeding is the most common symptom of hemorrhoids.
Internal hemorrhoids can fall through the anus and become traumatized. This can lead to bright red bleeding from the anus.
Anal itching and skin irritation can occur with internal hemorrhoids.
Leakage of stool can occur when hemorrhoids fall through the anal canal and prevent proper sealing of the canal.
Painful swelling near the anus can occur when external hemorrhoids become inflamed or plugged by a blood clot (thrombosed).
How are hemorrhoids diagnosed?
Hemorrhoids are diagnosed with a medical history and physical examination. Your medical provider may inspect the area around the anus to check for any abnormal areas and a digital rectal examination may be performed.
Endoscopy:
Tests that look inside the colon (large intestine)
Anoscopy:
An anal speculum (anoscope) is placed in the anus to look at the lower rectum
Flexible Sigmoidoscopy:
A flexible camera is used to look at the colon from the sigmoid to the rectum (distal colon)
Colonoscopy:
A flexible camera is used to look at the entire colon
What are the treatment options for hemorrhoids?
There are several treatment options for hemorrhoids. Treatment may depend on how serious symptoms are.Treatments options include:
Dietary and lifestyle changes
Medication
Non-surgical minimally invasive treatments
Rubber band ligation
Radiofrequency ablation
Infrared photocoagulation
Sclerosis injection
Surgery
Doppler-guided hemorrhoidal
Ligation
Alternative non-surgical treatment
Embolization of the superior rectal arteries
Superior rectal artery embolization
Dr Rao performs this minimally invasive procedure for grade 1 through 3 internal hemorrhoids. The procedure takes place in an outpatient setting in our Interventional Radiology suite in our office. This is in an office setting and does not require hospitalization. Embolization is performed with local anesthesia and sedation (“twilight sleep”).
Internal hemorrhoids are composed of a dense artery and vein network called Corpus Cavernosum Recti (CCR). Embolization of the hemorrhoidal artery reduces blood flow in the CCR. This decreases pressure in the veins and improves symptoms.
The procedure is performed through a tiny cut in the wrist or the groin. A thin tube called a microcatheter is inserted into the rectal artery under x-ray. The catheter is guided through the superior rectal artery tree to the last branches. The doctor uses a moving x-ray called a fluoroscope to guide the procedure. Small coils and/or microspheres are placed into the last branches of the arteries to seal or “embolize” the vessels.
It may be necessary to repeat the embolization for hemorrhoids on the opposite side. Often the same entry point and the same microcatheter can be used.
Recovery
Hemorrhoidal artery embolization causes minimal pain. The procedure is approximately 1 hour, and patients can return home after 1 hour on the same day. People can often return to work the day after the procedure.
Advantages of superior rectal artery embolization
No general anesthesia needed
Preserves anal continence - avoids stool leakage
Does not create painful rectal wounds
Leaves hemorrhoidal tissue in place
Good short-term results
Our Simple Process
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