Hemorrhoids are an incredibly common problem that millions of adults in the United States can expect to deal with at some point in life, especially with age. In fact, experts estimate that one in two Americans over the age of 50 have hemorrhoids at any given time.      

Often referred to as “varicose veins” of the anus and rectum, hemorrhoids can cause:

• Ongoing anal itching and irritation
• Hard, tender lumps near your anus
• Anal pain when you’re sitting down 
• Bleeding during bowel movements

Most hemorrhoids improve significantly — or resolve completely — with lifestyle adjustments and at-home care. But sometimes, these inflamed anal or rectal veins worsen or recur without warning, leaving you to wonder whether surgery is your next best option. 

Luckily, Dr. Johnny Serrano, our board-certified general surgeon in Glendale, Arizona, offers a full scope of hemorrhoid treatment options at Precision Surgery and Advanced Vein Therapy. Here, he explores six signs it may be time to consider specialist hemorrhoid care.   

Hemorrhoid formation and types

Hemorrhoids are swollen, inflamed veins that emerge around the anus or in the rectum. Like varicose leg veins, they develop when increased vascular pressure causes the affected vein to swell, stretch, and contort. There are two types of hemorrhoids:

External hemorrhoids

External hemorrhoids are visible, occurring around your anus. These swollen varicose venules are itchy and uncomfortable, leaving the overlying skin tender and sensitive. 

Internal hemorrhoids

Internal hemorrhoids appear on the inner lining of your anus or lower rectum. While you can’t see or feel these swollen veins most of the time, straining during a bowel movement may cause their painless, momentary protrusion along with mild rectal bleeding.  

Conservative hemorrhoid care is responsive 

You’re more likely to get hemorrhoids if you’re older, overweight, or pregnant simply because these conditions can weaken and destabilize the tissues that support the blood vessels in your rectum and anus. Even so, anyone can get hemorrhoids, and you’re more likely to have them — and keep them longer — if you:  

• Are constipated (ongoing bouts of bowel strain)
• Sit on the toilet longer than necessary (i.e., reading)
• Don’t eat enough roughage (dietary fiber) each day
• Don’t drink enough water (you’re often dehydrated)
• Do a lot of heavy lifting (i.e., at the gym, on the job) 

Mild hemorrhoids often resolve on their own with conservative care that’s responsive to their causes. Making stool easier to pass and alleviating constipation is the first step, and it’s one that’s supported by drinking more water, eating more dietary fiber, getting more exercise, and changing poor bathroom habits. 

Warm baths, witch hazel wipes, topical hemorrhoid creams, or hydrocortisone suppositories can help alleviate pain, discomfort, and itching as your hemorrhoids heal. 

Signs your hemorrhoids require expert care 

Hemorrhoids don’t always go away with conservative care. If your hemorrhoids don’t improve after 10-14 days of self-care, it’s a good idea to check in with your primary care doctor. 

If your hemorrhoids worsen, however, see Dr. Serrano as soon as possible. Six signs indicating you may need specialist treatment for your hemorrhoids are: 

1. Sudden, severe hemorrhoid pain
2. Intense anal swelling and/or itching
3. A hard lump on or near the anus
4. Discomfort when sitting or standing
5. Pain or bleeding when passing stool
6. A protruding internal hemorrhoid

An internal hemorrhoid can become painful and irritated if it prolapses or pushes out through your anus and doesn’t retract back inside. An external hemorrhoid can bleed and become intensely painful if it grows larger, sustains damage with the passage of hard stool, or forms a blood clot (thrombosis).  

A thrombosed hemorrhoid typically requires treatment to remove the clot or stop blood flow to the affected vein. Many prolapsed hemorrhoids also require treatment.      

Customized hemorrhoid treatment solutions

After evaluating your hemorrhoid, considering your symptoms, and reviewing your medical history and pertinent lifestyle factors, Dr. Serrano can recommend the best approach to your needs. Non-surgical treatment options include:   

Rubber band ligation

This go-to hemorrhoid removal approach uses a small elastic band at the base of the hemorrhoid to cut off its blood supply, causing it to shrivel and fall off in a few days.

Sclerotherapy

This method involves injecting an FDA-approved chemical solution into the problematic hemorrhoid, causing it to collapse inward, shrink, and gradually fade away.

Laser or infrared coagulation

Laser energy or infrared light can painlessly coagulate a bleeding hemorrhoid, causing it to harden and shrivel. 

Minimally invasive hemorrhoid removal (hemorrhoidectomy) is an in-office surgical procedure that uses tiny incisions to extract severe or recurring hemorrhoids physically. It may be the best option if you have a persistent external hemorrhoid, a large, prolapsed hemorrhoid, or an internal hemorrhoid that recurs after a non-surgical treatment like rubber band ligation. A general surgeon in Glendale, like Dr. Serrano, can perform this surgery quickly and with minimal discomfort. 

To learn more about the hemorrhoid treatment options available at Precision Surgery and Advanced Vein Therapy in Glendale, Arizona, call 623-321-5663 or click online to schedule a visit with Dr. Serrano today.