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. They are caused by a number of factors including sitting for too long, heavy lifting, obesity, aging, pregnancy, diarrhea or chronic constipation. Hemorrhoids cause symptoms when they become swollen and irritated during episodes of straining and constipation.
What are the symptoms of Hemorrhoids?
- 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 exam. This includes a visual inspection of the anus and surrounding area as well as a rectal exam. It is important to beaware that bleeding may occur with other conditions such as cancer, and your doctor could recommend other tests such as colonoscopy or CT scan if there are risk factors or warning signs.
What are the treatment options for Hemorrhoids?
- Prevention of painful hemorrhoid episodes can be achieved with lifestyle modifications, such as exercise, maintaining 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 nonsurgical 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?
- A catheter – a thin flexible tube similar to a cooked spaghetti noodle – is placed into the artery of the wrist or groin
- The doctor uses “Fluoroscopy” – a very low radiation dose video X-ray machine – to guide the catheter into the arteries supplying the hemorrhoids.
- Contrast dye is used to provide a map of the arteries and measure flow
- Through the catheter, coils are put into these arteries to selectively block blood flow.
- The hemorrhoid tissue no longer receives excess blood flow, and the veins shrink down. This provides relief of symptoms and prevents future episodes.
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