Questions and answers about different types of hemorrhoids, their symptoms and treatments provided at our offices... What are "internal" and "external" hemorrhoids?...    Hemorrhoids are enlarged veins in the lower end of the rectum just inside the anus. Under certain conditions these veins may become swollen and can actually protrude or prolapse from the anus during a bowel movement. When this occurs the hemorrhoid may become irritated and painful, with occasional bleeding.    "Internal" hemorrhoids are enlarged veins that appear just above the "dentate" line, which is the natural boundary between the mucosal lining of the rectum and the anal skin.    Internal hemorrhoids may look like "external" ones when they are large and protrude through the anus.    "External" hemorrhoids are those that appear below the "dentate" line, protruding through the anal skin layers. What are the symptoms of hemorrhoids?...    Hemorrhoids can often be felt as a swelling in the area of the anus. The most common symptoms of internal hemorrhoids are soreness, bleeding during a bowel movement, discharge and itching.    External hemorrhoids develop around the anus and can be very painful, especially if a blood clot develops within them. They can be felt as a sensitive, firm lump or lumps around the anus. What causes hemorrhoids?...    The cause of hemorrhoids is not clear. They are most common after the age of fifty; constipation caused by a low fiber diet may contribute to their appearance. Pregnancy, heavy lifting and straining may have a role also. Are hemorrhoids preventable?...    Hemorrhoids may be preventable. A diet rich in fluids, fruits, vegetables and fiber [multigrain breads, for instance] contributes to good bowel habits and, possibly, to the avoidance of hemorrhoids, as is regular exercise, including walking or just moving about. It also helps to avoid excessive straining, taking warm baths and spending too much time in the toilet. How Are Hemorrhoids Treated?...    The treatment of choice for internal hemorrhoids at our practice is the application of "Infrared Coagulation" [IRC] by means of a specialized medical device. The application of IRC on the origin of the enlarged vein in the rectum would cause it to close down with a formation of a thin layer of scar tissue, sloughing off within two weeks, when it is eliminated along with a few drops of blood.    The application of IRC does not cause any pain; patients may feel only a slight warm sensation for about two seconds during the procedure.    Internal hemorrhoids could also be treated by "Rubber Band Ligation" if they are fairly large. This is a procedure that consists in applying a small rubber band around the enlarged vein. Left in place, this band would cause the vein to slough off within two weeks, when it is eliminated along with a few drops of blood.    Most external hemorrhoids will respond to a conservative treatment of rest and warm sitz baths after the initial episodes; usually, soreness or pain subside within a few days. However, this is a temporary solution; unfortunately, when the hemorrhoid increases in size, the frequency and intensity of the symptoms will also increase.    If external hemorrhoids are not treated, a blood clot may form inside them. This clot feels like a firm lump to the touch. If pain is severe, the treatment would include making a small incision under local anesthesia and removing the clot, providing immediate relief. By the time a patient consults a physician for external hemorrhoids, they may be fairly large and not treatable at the doctor's office. In this situation, the patient may need to be admitted to a hospital where a surgeon would remove them under sedation plus local anesthesia, or under general anesthesia, depending on the patient's sensitivity, general health condition or multiple hemorrhoids with blood clots. Are there complications after treatments?...    Both treatments, infrared coagulation and rubber band ligation of hemorrhoids, are very safe and generally do not cause complications. Rubber band ligation may cause occasional soreness and mild discomfort after its application; however, the use of an anesthetic ointment applied to the treated area brings immediate relief. These symptoms disappear after the remaining vein is eliminated within two weeks after the procedure is done. How many treatments are required to treat hemorrhoids?...    The number of treatments depends on the type, number and size of the hemorrhoids. Usually, for multiple hemorrhoids, three to four separate treatments would be required. It is advisable to wait from ten to fourteen days between treatments; this time would allow for proper healing of the treated tissues. Would the hemorrhoids come back?...    Hemorrhoids treated with either infrared coagulation or rubber band ligation do not generally recur. New ones may appear if, for instance, constipation is not resolved, and a proper diet with enough fiber is not adopted... Click here to read, print or save a PDF file with the text contents of this page. Copyright © 2007 McLean Hemorrhoid Center® Home  ::  About Hemorrhoids  ::  Questions & Answers  ::  Procedures  ::  Insurance Plans  ::  Brochure  ::  Locations Guestbook  ::  Privacy  ::  Testimonials  ::  Health Articles  ::  Tell a Friend  ::  Special Offers The information in our pages is published for educational purposes only and must not be taken as medical advice or medical treatment in any form. For health problems, visitors to our site are encouraged to seek help from licensed, competent physicians.