Lifewatch: Hemorrhoids

Reported by Claire Hosmann - bio|email
Posted by Debra Worley - email

(WECT) - Half of all Americans will likely suffer from hemorrhoids by the time they turn 50, but some are too ashamed to talk to their doctors about the problem or are too scared to have surgery.

Catherine Hanks has been living with hemorrhoids for ten years and nothing eased her discomfort.

"I tried everything over the counter, every prescription, diet change, increased water intake, exercise, with no relief," said Hanks.

For Hanks, surgery was out of the question.

"Many patients tell me I've lived with these for 10, 20 years or more just because I didn't want to have an operation because it was so painful," said general surgeon Dr. Jeff Crooms.

Dr. Crooms removes hemorrhoids, or swollen blood vessels, without making an incision.

An ultrasound probe pinpoints the artery that feeds the inflamed blood vessel.  Then, doctors tie an absorbable suture around it, restricting the blood supply.

The procedure takes about 20 minutes and patients go home the same day.

"I had the surgery on a Thursday and by Sunday I was off the pain medication," said Hanks.

Dr. Crooms has performed about 50 THD procedures.  He said it is designed for internal hemorrhoids, but may help with external hemorrhoids as well.

For more information, please contact:
Rachel Stiles
Public Relations
Tallahassee Memorial Healthcare
(850) 431-5874

BACKGROUND: Hemorrhoids are swollen veins around the anal canal. They can occur internally: when they form inside the anal canal, or external: when they swell near the opening of the anus. The condition is caused by excessive pressure on pelvic and rectal area veins. In a healthy individual, blood fills the tissue inside the anus to assist with bowel movements. Straining to move stool can cause the veins in the tissue to swell and stretch. Constipation and diarrhea can cause such pressure. Expectant mothers may also get hemorrhoids during their last six months of pregnancy due to increased pressure on the pelvic region. During labor, those hemorrhoids can worsen. Overweight individuals may also be more susceptible to developing them. Most often, internal and external hemorrhoids result in bleeding during bowel movements, itching and rectal pain.  A doctor can diagnose hemorrhoids by either examining the rectum with a gloved finger or using a short, lighted scope to see inside the rectum.

TREATMENT: Most of the time, diet and bowel habit changes offer relief. To prevent and alleviate symptoms, doctors recommend increasing your fiber and water intake, using a stool softener, exercising, avoiding sitting or standing for extended periods, avoiding lifting heavy objects, and sleeping on your side if you're pregnant. Ointments can also help relieve the symptoms of hemorrhoids. Often, surgery is not required for hemorrhoids. The goal of nonsurgical treatment is to reduce the blood supply to the hemorrhoid so it shrinks or goes away. Hemorrhoids may be tied off with a rubber band or heat, lasers or electric current can be used to create scar tissue.

If other treatments fail to help patients, surgery may be the answer. External hemorrhoids can only be removed surgically if they are very large and uncomfortable or if you are having surgery on the anal area for another reason. Hemorrhoidectomy, or surgical removal of internal hemorrhoids, is a last resort option. An incision is made in the tissue surrounding the hemorrhoid. The vein inside is tied off to prevent bleeding and the hemorrhoid is removed.

A NEW OPTION: "The classical hemorrhoidalectomy, where you actually cut out hemorrhoids, is a very painful procedure," Jeff Crooms, M.D., a general surgeon at Tallahassee Memorial Healthcare in Tallahassee, Fla., explained to Ivanhoe. Now there's a new, minimally invasive option for treating internal hemorrhoids. It's called transanal hemorrhoidal dearterialization (THD). During the procedure, the problematic artery is located using doppler. A surgeon then uses an absorbable suture to ligate or "tie-off" the arterial blood flow, shrinking the bulging vein. It takes just 20 minutes to do and patients can go home the same day. "The stitch is run from inside toward the outside and then tied back inside and that kind of pulls also those external hemorrhoids a little bit inside, so it does help them a little bit as well," Dr. Crooms said.