Ok, here it is…the topic nobody wants to talk about!  Don’t worry, it’s my job to talk about hemorrhoids so if you ever need to talk to me about this topic, please don’t be embarrassed…it just so happens that EVERYONE has hemorrhoids.  Let me explain.

Like my other articles, lets start with a little anatomy.  Like I said, it turns out that everyone has hemorrhoids.  Hemorrhoids are actually little “cushions” of tissue in the rectal area.  They serve the purpose of being the cushion for the stool on the way out.  Everyone has 3 of these patches of tissue.  Two on the right (one in front, one toward the back) and one on the left side, inside the rectum.  When there is increased pressure in the abdomen or colon (which happens as the stool is being expelled), blood is pushed into these patches of highly vascular tissue and they engorge to do their job.

We get into trouble when the tissue gets engorged too much over and over.  This causes bleeding, itching and sometimes pain.  Typically, this is from either constipation or diarrhea lasting a long period of time.  Both of these cause us to increase the abdominal pressure, engorging this tissue over and over.  Often times women acquire hemorrhoids after childbirth, since there is an increase in the abdominal pressure over a long period of time.

Since many cases of hemorrhoids are caused by constipation or diarrhea, fixing either one of these can be the first in the treatment.  I often recommend increasing the fiber in your diet to about 20 grams per day.  Most people don’t get much fiber at all, and once they start keeping track, they realize they are WAY behind.  So correcting you daily fiber intake can decrease and even resolve your hemorrhoid symptoms.

The second step in treatment is a hemorrhoid “Banding”.  There are a few ways to band hemorrhoids, but essentially the mechanisms are the same.  Banding works by taking either the hemorrhoid, or the tissue above the hemorrhoid into a small rubber band to cut of the blood supply to the tissue.  This either “kills” the hemorrhoid tissue, or forms scar tissue above the hemorrhoid so the hemorrhoid cannot be engorged by blood anymore.  Hemorrhoid banding is extremely effective in most patients.

Finally, the last step in treatment is the surgical hemorrhoidectomy.  This is reserved for only the most severe cases of hemorrhoids.  This procedure actually surgically removes the hemorrhoid tissue and then the remaining rectal tissue is sutured back together.  Alternatively, there are stapling devices which do essentially the same thing, but in a more controlled fashion.

Well I hope you have a better understanding of hemorrhoids, their cause, symptoms and treatment after reading this article.  Like I said, don’t be embarrassed about having hemorrhoids…..EVERYONE has them!

-Dr. Buck