Hemorrhoids

Hemorrhoids are vascular cushions in and around the anus that become swollen due to stretching under pressure. Symptoms of hemorrhoids include rectal pain, bleeding, itching and, rarely, rectal prolapse. Hemorrhoids are very common in both men and women: about half of the American population has them by age 50. Hemorrhoids may develop as a result of straining during bowel movements. They are also associated with pregnancy, heredity, aging, and chronic constipation or diarrhea. Hemorrhoids are either internal (inside the anus) or external (under the skin around the anus).

Board certified colon and rectal surgeons at Brigham and Women’s Hospital (BWH) offer minimally invasive surgery approaches and non-surgical treatment options for patients with hemorrhoids. Learn more about hemorrhoids.

Hemorrhoids Topics

Diagnosis of Hemorrhoids

Colon and rectal surgeons at BWH provide a range of procedures for diagnosing hemorrhoids, including:

  • Physical examination and digital rectal examination (DRE)
  • Anoscopy a hollow, lighted tube inserted into the anus to view internal hemorrhoids.
  • Proctoscopy a lighted tube inserted into the anus to examine the entire rectum.
  • Colonoscopy
  • Sigmoidoscopy
Treatment for Hemorrhoids

Surgical Treatment

You may need a surgical approach to remove or reduce hemorrhoids. Colon and rectal surgeons at BWH offer a range of treatments, including:

  • Sclerotherapy A chemical solution is injected around the blood vessel to shrink the hemorrhoid.
  • Hemorrhoid banding A rubber band is placed around the base of the hemorrhoid inside the rectum to cut off circulation to the hemorrhoid. The hemorrhoid gradually shrinks and withers away within a few days. This procedure is done in the office for patients with internal hemorrhoids. It is usually very successful in patients with mild to moderate symptoms.
  • Hemorrhoidectomy, a surgical procedure that permanently removes hemorrhoids for patients with large prolapsing hemorrhoids. Surgery usually requires general anesthesia, but can be performed as an outpatient procedure.

Non-Surgical Treatment

Your surgeon may recommend non-surgical treatment of hemorrhoids to relieve symptoms:

  • Warm water baths several times a day
  • Ice packs to reduce swelling
  • Application of hemorrhoidal creams or suppositories
  • Increasing fiber and fluids to soften stools
  • Stool softeners or fiber supplements

Read this article about self-care for hemorrhoids.

Read instructions for laxative and fleet enema mini prep prior to surgery.

What You Should Expect

You will receive a thorough diagnostic examination to evaluate if you have hemorrhoids and if surgery is needed. Careful monitoring and the involvement of an experienced colon and rectal surgeon are important to the successful outcome for patients with colorectal conditions.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Weiner Center for Preoperative Evaluation for pre-operative information and tests.

The day of surgery, you will be taken care of in the operating room by surgeons, anesthesiologists and nurses who specialize in hemorrhoid surgery. After surgery, you will go to the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

Learn more about your hospital stay and returning home.

Multidisciplinary Care

Brigham and Women’s Hospital provides a multidisciplinary approach to patient care, collaborating with colleagues who have extensive experience in diagnosing and treating hemorrhoids. In addition, patients have full access to BWH’s world-renowned academic medical community with its diverse specialists and state-of-the-art facilities.

Resources

Go to our health library to learn more about hemorrhoids.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Visit the Weiner Center for Preoperative Evaluation.

Access a complete directory of patient and family services.

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