When the vein clusters around the rectum and anus become inflamed and swollen, hemorrhoids, also known as piles, can develop.
Hemorrhoids can be inside the body in the rectum and lining of the anus (internal hemorrhoids), or outside the body in the skin near the anus (external hemorrhoids). In some cases, internal hemorrhoids can prolapse, falling through the opening of the anus and causing symptoms similar to external hemorrhoids.
Hemorrhoids can be incredibly uncomfortable. They can itch, bleed and cause pain.
Painless hemorrhoid treatment options are available, and in many cases, piles treatment doesn’t require surgery.
If hemorrhoids recur frequently, and noninvasive treatments do not resolve them, surgery might be necessary. If you are concerned about hemorrhoids, consult with your doctor who can review your symptoms and help you choose the most effective treatment option.
If you have hemorrhoids regularly or if you experience bleeding from your hemorrhoids, your doctor might recommend one of the following minimally invasive treatments.
Which treatment is most appropriate for you depends on the type of piles you have and how advanced they are.
Hemorrhoid banding, or rubber band ligation, is one of the more commonly performed non-invasive piles treatment options. The procedure gets rid of hemorrhoids without the need for surgery or an extensive preparation period.
It is most effective on internal hemorrhoids or on external symptoms that have developed as a result of internal prolapsed hemorrhoids.
During treatment, a physician places a rubber band around the affected tissue. The band creates pressure, which cuts off the flow of blood to the pile. After not getting blood for a few days, the hemorrhoid shrinks down and eventually falls off. Scar tissue that develops in place of the hemorrhoid prevents bleeding, reduces the chance for prolapse, and helps redirect the flow of blood.
There are three ways a physician might perform hemorrhoid banding:
Traditional: During a traditional rubber band ligation, a doctor uses metal forceps to hold the affected veins in place while they wrap the rubber band around them. The forceps can cause discomfort during and after the treatment and may cause bleeding. In some cases, it can take a few days before the bleeding occurs.
Endoscopic: During an endoscopic banding procedure, a physician inserts a small camera, called an endoscope, into the rectum. The camera lets the doctor see where they are working and eliminates the need for larger incisions. Of the three hemorrhoid banding treatment options, the endoscopic technique is often the most invasive and complex. Usually, a person needs to fast before the treatment and prepare their bowels, similar to the preparation before a colonoscopy. During treatment, they are sedated. After the treatment, it’s common for patients to note discomfort in the area.
CRH O’Regan: The CRH O’Regan hemorrhoid banding system offers an improvement over traditional and endoscopic banding treatments. Instead of metal forceps, the method uses a disposable ligator to create gentle suction which holds the affected vein in place as the band is wrapped around it. Many patients describe the procedure as being painless. Post-banding bleeding or discomfort is also much less common than with other methods. Unlike traditional or endoscopic banding, no preparation is needed before treatment with the CRH O’Regan system.
Doctors often use sclerotherapy to treat varicose veins or spider veins in the legs. Since hemorrhoids are a sort of varicose vein that develop in the anus, sclerotherapy can help to treat them, as well. Sclerotherapy works best on relatively small piles — the treatment is better suited for people who have mild grade 1 or grade 2 hemorrhoids.
During sclerotherapy treatment, a doctor injects the affected veins with a chemical solution. The chemical solution, which might contain zinc chloride or quinine, damages the vein and causes it to shrink down. Many people who undergo sclerotherapy for piles need a series of treatments to get the best results.
The injections are usually not painful, but it’s common for people to have some discomfort following the procedure. Patients often report feeling fullness or pressure in the treated area, and bleeding is common. The results from sclerotherapy can be long lasting, but some people do see their hemorrhoids return after a couple of years.
Coagulation is the process that turns a liquid, such as blood, into a solid. When blood clots, it coagulates. Hemorrhoid coagulation can be a minimally invasive treatment for internal hemorrhoids — particularly for hemorrhoids that are in the earliest, smallest stages.
The treatment uses either infrared light or a laser beam to produce heat. The heat creates scar tissue in the vein near a hemorrhoid, cutting off blood flow to the pile. Without a fresh supply of blood, the treated hemorrhoid shrivels up and dies. The scar that forms on the vein keeps the rest of the blood vessels in place, so they don’t bulge or swell.
Coagulation can be an effective hemorrhoid treatment, but it is also slow. During the procedure, a physician can only treat one hemorrhoid at a time. If a person has multiple hemorrhoids, treatment needs to be spaced out into 10-day intervals. After the treatment, it’s common for people to feel full in the area or the sensation of the need for a bowel movement. Bleeding is also common and typically occurs about a week after coagulation treatment when the hemorrhoid drops off. The bleeding is usually mild and stops on its own.
Surgical Hemorrhoid Treatments
Fortunately, a majority of people with piles don’t need surgical hemorrhoid treatments.
Generally, surgery is only necessary if hemorrhoids don’t respond to other treatment options or if the hemorrhoids are too large. If your doctor believes surgery is the right option for you, they will let you know which method would best meet your needs:
Hemorrhoid stapling: A surgeon typically performs a stapled hemorrhoidectomy on internal hemorrhoids. The surgery works by cutting off the flow of blood to the piles, effectively “stapling” the veins shut. It is less invasive than other surgical options, but can lead to complications such as bleeding and rectal prolapse. Hemorrhoids treated with stapling are more likely to recur compared to other surgical options.
Laser removal: Laser hemorrhoid removal is also less invasive compared to other surgical options. During the treatment, a doctor uses a laser beam to heat up and close off the affected vein, so the hemorrhoid falls off.
Hemorrhoidectomy: Hemorrhoidectomy was considered the gold-standard surgical treatment to address piles for years. It’s one of the most effective ways to remove large hemorrhoids, but is also one of the most involved. Depending on your surgeon’s recommendation and your preference, you might be given general anesthesia, local anesthesia with sedation or spinal anesthesia before the surgery. The recovery after surgery is often painful and can take a few weeks and there is the risk of complications, such as urinary tract infections.
Harmonic scalpel removal: Harmonic scalpel removal uses ultrasound energy to help reduce the amount of bleeding associated with hemorrhoid removal. The surgery is less invasive than other options and has a somewhat lower risk of complications.
Atomizing: Atomizing is a relatively new surgical treatment for hemorrhoids. The procedure breaks up large hemorrhoids into small pieces, then uses a vacuum device to remove the pieces from the body.
How to Get Relief From Hemorrhoids
Hemorrhoids can cause itching and general discomfort. They can make it difficult to sit for any length of time and can otherwise interfere with life. There are several things you can do at home to get relief from hemorrhoids while you wait for treatment.
Here’s what you can do to try to ease any discomfort you’re experiencing. For some people, home hemorrhoid treatments can provide significant temporary relief:
Soak in a bath: Soaking the affected area in a warm bath several times a day, for at least 10 minutes at a time, can help provide relief. To ease this process, you can purchase a sitz bath that rests on top of the toilet seat.
Try an OTC pain reliever: Aspirin, acetaminophen and ibuprofen can all provide some mild, temporary pain relief. Follow the instructions on the medication package and talk to your doctor before use.
Apply heat and cold: Alternating cold compresses and warm compresses for 10 minutes several times a day can reduce discomfort.
Natural Hemorrhoid Remedies
A few natural remedies might also provide temporary relief from the itching and discomfort associated with hemorrhoids. Talk to your doctor before you try a natural remedy to get a better sense of its effectiveness and to confirm it won’t interact with any medicines you are currently taking:
Apple cider vinegar: You might get some relief from inflammation and itching if you apply apple cider vinegar to the affected area. Soak a cloth or cotton pad with the vinegar and apply.
Aloe vera: Many people use aloe to help provide soothing relief from sunburns and other types of burns. It might also cool down any burning sensations you’re experiencing due to hemorrhoids. Apply a thin layer of the gel to external hemorrhoids to get some relief.
Witch hazel: Witch hazel is an astringent that is known for reducing inflammation. While it won’t cure your hemorrhoids, you can try applying it to the external area for relief from discomfort.
Epsom salt: You can make a compress with Epsom salt and glycerin and apply it directly to the affected area to get some relief from inflammation. Some people also dissolve Epsom salts in their sitz bath for additional relief.
How to Prevent or Reduce the Chance of Piles
There are several things you can do to lower your chances of developing piles or to keep hemorrhoids from recurring. Hemorrhoids develop when there is excessive pressure on the rectum and anus. Finding ways to reduce that pressure can reduce the chance of hemorrhoid formation.
Allowing your body to perform its natural functions: One way to reduce pressure is to avoid straining when you use the bathroom and avoid forcing a bowel movement. Alternatively, when you feel the urge to go to the bathroom, don’t put it off. Delaying a bowel movement can cause the stool to dry out, making it harder to pass.
But also, don’t spend a lot of time in the bathroom: Although it’s common for people to keep reading materials in the bathroom or bring their tablets or phones in with them, try to avoid doing so. The longer you spend on the toilet, the more likely you are to strain. Sitting on the toilet for extended periods puts additional pressure on the rectal area.
Avoid sitting for long periods of time: It’s a good idea to try to limit how much you sit during the day. If you have an office job, try to get up and take walks at regular intervals to reduce the pressure on your backside.
Increasing exercise: Generally speaking, the more exercise you get and the more you’re able to move, the lower your risk of developing hemorrhoids will be. Increasing the amount you exercise can also help you reach weight loss goals, and losing weight can reduce your risk of hemorrhoids.
Eat more fiber: The more fiber you eat, the more regular your bowel movements may be. If your current diet is low in fiber, it’s important not to add too much at once. Going from a low-fiber to a high-fiber diet too quickly can cause gas, diarrhea and general digestive discomfort. Work with your doctor to add fiber gradually, such as another serving of vegetables at each meal. You may also want to try a fiber supplement if your physician recommends it.
Stay hydrated: Along with focusing on what you eat, pay attention to what you drink. Aim to drink six to eight glasses of water each day. The more water you drink, the more hydrated you’ll be and the softer your stool may be. Drinking an adequate amount of water each day is particularly important if you are taking fiber supplements. Without the right amount of water, the supplements can make constipation worse.
Find a CRH O’Regan Certified Physician Today
There are many options when searching for relief from hemorrhoids, and you can likely choose a minimally invasive and pain-free solution. Work with a CRH O’Regan-certified physician today to learn more about how a minimally invasive procedure can give you the long-lasting relief you’ve been looking for.