Hemorrhoid Treatment

Hemorrhoids are dilated veins and vessels in the anal canal. They are a part of normal anatomy but when dilated can be bothersome and cause symptoms such as swelling, pain, bleeding, anal discomfort, leakage, and more.

In general no, however some patients do have significant bleeding from hemorrhoids and in this case it is of high medical importance to treat hemorrhoids to decrease chronic blood loss. Furthermore we do recommend an exam by a medical provider to ensure that what is thought to be hemorrhoids is not really something more serious like an anal mass (which can be firm, irregular, or not go away or fluctuate in size with time).

Initially we recommend a non-operative approach that consists of:

• Treating and preventing constipation: We often recommend utilizing Miralax and prunes and dietary adjustments.

• Treating flare-ups:

  1. Cool soaks in the tub.

  2. Preparation H or Anusol suppositories.

If patients continue to have significant symptoms and decreased quality of life due to hemorrhoids, we generally recommend aiming to treat the hemorrhoids by reducing or removing them. First-line procedural treatments entail less painful and invasive techniques. Here are two that we often recommend:

• Banding: This can be done in-office, has some discomfort, and is moderately successful, and may require multiple treatments over the course of a few months. Currently we do not offer in-office banding.

• HemWell: This is our preferred non-surgical procedure as it is fairly successful and can decrease symptoms even in grade III and IV hemorrhoids (i.e. larger hemorrhoids with external components). It does require anesthesia, but there is usually minimal pain afterwards.

We generally offer hemorrhoid surgery as a last resort for patients with very large and troublesome hemorrhoids. Hemorrhoid surgery is very often quite painful and recovery can take 3-4 weeks. Of note there are other procedures with a growing experience such as hemorrhoid artery embolization available at certain endovascular centers.

We are in-network with Medicare and accept a wide variety of insurance plans. If we are not in network with your plan our billers can often negotiate with payors such that patients pay the same as they would with an in-network provider. In the event that our biller is unable to obtain in-network rates for you, we will inform you and quote any out-of-pocket costs upfront.