Hemorrhoids (HEM-uh-roids) are swollen veins in your anus and lower rectum, similar to varicose veins. Hemorrhoids may result from straining during bowel movements or from the increased pressure on these veins during pregnancy.
What Are Hemorrhoids?
Hemorrhoids are painful swollen veins in the lower part of the anus and rectum. Hemorrhoids cause symptoms when they become swollen and irritated during episodes of straining and constipation. Hemorrhoids are caused when the veins in the rectum are experiencing an increase in pressure. This can happen numerous ways including:
- Sitting for too long
- Heavy lifting
- Chronic constipation
What Are the Different Types of Hemorrhoids?
Hemorrhoids come in two different forms: external and internal.
External hemorrhoids can either be in the rectum or around the anus. These hemorrhoids usually cause more pain than internal ones because they are in sensitive areas, and they come with their own set of symptoms. If you have external hemorrhoids, you are likely experiencing constant itching, swelling, and pain around the anus area. If you are noticing a hard lump along with swelling and pain around the anus, you may have a blood clot called a thrombosed external hemorrhoid.
Internal hemorrhoids are in the rectum and they are likely to cause bleeding. These hemorrhoids don’t usually cause any discomfort unless they are more serious.
What Are the Symptoms of Hemorrhoids?
Hemorrhoids can happen to anyone. In fact, most of the people in the U.S. will experience hemorrhoids at least once in their life. If you have hemorrhoids, you will likely encounter one or more of the following symptoms:
- Bleeding is the most common presenting symptom, as irritated hemorrhoids receive elevated blood flow from the arteries
- Pain, discomfort and soreness in the anal area associated with lumpiness and swelling
- The lumpiness may bulge out of or “prolapse” from the anus
- The surrounding skin is typically itchy and irritated
How are Hemorrhoids diagnosed?
In most cases, hemorrhoids are diagnosed through history and physical exams. This includes a visual inspection of the anus and surrounding area as well as a rectal exam. It is important to be aware that bleeding may occur with other conditions such as cancer, and your doctor could recommend other tests such as a colonoscopy or CT scan if there are risk factors or warning signs.
What Are the Treatment Options for Hemorrhoids?
There are many treatment options for you if you are suffering from hemorrhoids, including:
- Prevention of painful hemorrhoid episodes can be achieved with lifestyle modifications, such as exercise, maintaining a healthy body weight, and keeping stools thin.
- Over-the-counter pain medications, topical creams and ointments, cold compresses, and warm water baths often alleviate symptoms, but they do not eliminate the Hemorrhoids.
- Patients with recurrent symptoms or those lasting more than one week may be appropriate candidates for the following:
- Hemorrhoids may be tied off with an elastic band (“rubber band ligation”), injected directly with a destructive foam (“sclerotherapy”) or destroyed with energy (“photocoagulation” or “electrocoagulation”)
- Hemorrhoids that stick out from the anus (“prolapse”) may require surgical removal (“hemorrhoidectomy”) under general anesthesia, especially if there is compromised blood flow.
- Hemorrhoidal Artery Embolization (“Embroid”) is a non-surgical procedure to permanently reduce blood flow to the Hemorrhoids, alleviating symptoms and preventing recurrence.
- The Embroid procedure is indicated for patients with Grade II and Grade III internal hemorrhoids who have failed to experience improvement after rubber band ligation or other non-surgical options.
How is the Embroid procedure performed?
The Embroid procedure is performed by inserting a thin catheter into the artery of the wrist or groin before our experienced practitioners use “Fluoroscopy,” a very low radiation dose video X-ray machine, to guide the catheter into the arteries supplying the hemorrhoids. Contrast dye is then used to provide a map of the arteries and measure flow before coils are inserted into the catheter to go to the arteries to selectively block blood flow. Once this is completed, the hemorrhoid tissues will no longer receive extra blood flow, and the veins will shrink. This procedure will relieve any symptoms and prevent future hemorrhoids from forming.
Why should I consider Embroid?
- No incision or needle puncture into the rectum or anus
- Performed safely in an outpatient setting without general anesthesia
- Recovery in one day or less for the majority of patients
- Far less painful compared to surgery
- Generally, the outcomes following Embroid are excellent, with over 80% of patients experiencing a significant reduction in hemorrhoid symptoms and bleeding within 1-2 weeks
Schedule a Consultation
If you would like to discuss your treatment options with one of our physicians at the Vascular Institute of Virginia, please fill out our contact form or call our office at 703-763-5224 to schedule an appointment. Our team of experienced and well-trained providers will provide you with the best care possible and help you decide which hemorrhoid treatment is right for you!