Internal hemorrhoids and external hemorrhoids

Hemorrhoids are veins in the lower rectum that have become swollen. Hemorrhoids can occur either inside the body (internal) or outside the body (external). If not treated, hemorrhoids can cause pain and other complications. We provide suitable treatment options for hemorrhoids in Raleigh to help our patients get rid of their hemorrhoids.

Internal hemorrhoids

Internal hemorrhoids are a normal part of the anal canal; everyone has them. Internal hemorrhoids are columns of tissue made up of blood vessels, and they can break down and weaken over time. When this occurs, it can cause painful and irritating symptoms. On occasion, internal hemorrhoids can be quite extensive. When they extend to the external tissue in or around the anus, they are called mixed internal-external hemorrhoids.

Causes of internal hemorrhoids

Complications related to internal hemorrhoids develop over time. Any stress on the pelvic floor muscles, such as when you strain too hard while having a bowel movement, can worsen them. Constipation and diarrhea can also irritate internal hemorrhoids.

Symptoms of internal hemorrhoids

Symptoms of internal hemorrhoids vary in severity from person to person and can include:

  • Bleeding
  • Itching
  • Leaking fluid (blood or mucus)
  • Prolapsed (out of place) tissue extending from the anus

Treatment for internal hemorrhoids

As a first step to treating internal hemorrhoids, your surgeon will likely recommend some combination of the following medical options:

  • Increased dietary fiber to make your stool softer and easier to pass
  • Lifestyle modifications, such as eating plenty of fruits, vegetables, and whole grains and drinking several glasses of water each day
  • Prescription suppositories to temporarily relieve pain and itching due to hemorrhoids

If medical options are not enough to manage your internal hemorrhoid symptoms, your surgeon may recommend one of these treatments:

  • Rubber band ligation. Your surgeon places a small rubber band around the hemorrhoid in this treatment. Lack of blood flow causes it to fall off after about a week. Your surgeon can perform rubber band ligation right in our clinic without any sedation.
  • Hemorrhoidal energy therapy (HET). With HET, your surgeon applies gentle pressure and low heat to the hemorrhoids to minimize blood flow and reduce their size. You’ll be under mild sedation for this treatment.
  • Hemorrhoidectomy. If the hemorrhoids are not responsive to any of the above treatments or if you need immediate surgical intervention, your surgeon may perform a hemorrhoidectomy to remove the hemorrhoid tissue. Surgeons perform this procedure while you are under sedation.
External hemorrhoids

External hemorrhoids are skin tags that surround the anus. They can interfere with cleaning the area (while bathing or after a bowel movement) and become increasingly sore or irritated over time. The most common issue with external hemorrhoids is thrombosis (a collection of blood clots) that can gather under the skin just outside the anus.

Causes of external hemorrhoids

The most common causes of thrombosis in external hemorrhoids are:

  • Constipation or diarrhea
  • Heavy lifting
  • Other routine pelvic floor straining
  • Pregnancy

Symptoms of external hemorrhoids

Symptoms from external hemorrhoids are often quite severe if there is a thrombosis. Blood clots cause the skin to stretch and tighten, forming a firm knot. External hemorrhoids can make it very painful to sit or move around.

Treatment for external hemorrhoids

In most cases, your surgeon can make a small incision in the hemorrhoid and remove the blood clot(s). Your surgeon performs this procedure right in our clinic, which typically relieves your pain immediately.

If your surgeon determines that they cannot drain the hemorrhoid, they will recommend medical treatment with steroid creams and supportive care, such as using witch hazel pads on the area or soaking in a warm bath. Occasionally, people with severe external hemorrhoids will need a hemorrhoidectomy (surgery to remove the hemorrhoid tissue, which is done under anesthesia).

When to seek hemorrhoid treatment

Patients are recommended to look for treatment as early as the first signs of hemorrhoids. Patients who are suffering from either internal or external hemorrhoids are ideal candidates for hemorrhoid treatment. Candidates should follow through with the recommended treatment plan to achieve complete relief from the condition.

Your consultation

Your consultation will start by meeting with one of our providers, who will listening to your symptoms and experience. Tell your provider about any treatments you have tried for your hemorrhoids.

Your provider will perform a physical exam to determine the nature and extent of your hemorrhoids. Based on their findings, they will lay out all suitable treatment options and discuss them. They will work with you to find your ideal treatment.

For instances where diet or lifestyle changes or medications are not sufficient, a procedure may be required. Your provider will create a personalized procedure plan and explain all its details to you. They will discuss any required preparation and aftercare steps. Any questions you may have will be answered.

Set Up an Appointment

If you are looking for a relief from hemorrhoids in Raleigh, contact us today and schedule your consultation. We will be available to address any and all questions and concerns.

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