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Dr to treat hemorrhoid: 4 Signs Your Hemorrhoids Warrant a Doctor’s Visit


4 Signs Your Hemorrhoids Warrant a Doctor’s Visit

“If you have already been diagnosed with hemorrhoids and your symptoms are not improving with fiber supplements, an increase in water intake, over-the-counter pain relievers, or a warm bath, then schedule an appointment,” Dr. Charabaty-Pishvaian says.

In most cases, you can see a general practitioner or your family physician about your hemorrhoid symptoms. If complications arise, you may be referred to a specialist, such as a gastroenterologist or a proctologist.

Different Types of Hemorrhoids

There are two types of hemorrhoids: external and internal. External hemorrhoids arise from the anal canal, while internal hemorrhoids arise from the rectum, immediately above the anal canal. According to Cuckoo Choudhary, MD, associate professor of gastroenterology at Thomas Jefferson University in Philadelphia, one type is not worse than the other, but both can cause problems. “It all depends on the size and degree of the hemorrhoid,” Dr. Choudhary says. “Untreated internal hemorrhoids can cause bleeding. External hemorrhoids can cause thrombosis [blood clotting], which gives way to severe pain from hemorrhoidal strangulation.”

If you know you have hemorrhoids and you have acute and severe anal pain, it could be a sign of thrombosed hemorrhoids.

Know When to See Your Doctor

Though the annoyance of hemorrhoids can be reason enough to call your doctor, use this checklist to know when a visit is a must:

  • If you’re experiencing any type of rectal bleeding
  • If the hemorrhoids are causing you pain or discomfort
  • If the problems persist despite trying over-the-counter hemorrhoid creams or other remedies
  • If you’re passing stools that look maroon in color or tarry in color, a sign of bleeding

If you experience a large amount of rectal bleeding that is accompanied by dizziness or faintness, be sure to seek emergency medical care immediately.

Though hemorrhoids are thought of as a minor health problem, you shouldn’t let that notion keep you from getting them examined. The ultimate goal is hemorrhoid relief, and for many people, that means an office visit.

Read more: Hemorrhoids: What to Know

When to See a Doctor for Hemorrhoids Symptoms

It’s not unusual to hear jokes about hemorrhoids, a condition marked by swollen veins in the anus and lower rectum. But if you’re one of the millions of people who have hemorrhoids, particularly severe hemorrhoids, you know they’re not funny. Also called piles, they affect about 1 in 20 people in the United States, and about half of people over age 50 have hemorrhoids. They can be internal (inside your anus or rectum) or external. But are hemorrhoids dangerous and how long do they last? Here is some information to help you learn more about this common infliction.

Common Causes of Hemorrhoids

Hemorrhoids are caused by pressure in the lower rectum or anus or trauma to the area. This blocks or slows down blood flow from your rectal area and causes the veins to bulge and push out. Hemorrhoids can be caused by:

  • Straining while moving your bowels

  • Chronic constipation or diarrhea

  • Pregnancy

  • Obesity

  • Sitting for extended periods

  • Eating a low-fiber diet

  • Frequent heavy lifting

  • Anal intercourse

  • Anal infections

Hemorrhoids are also more obvious as we age because the connective tissue that holds internal hemorrhoids inside the rectum may weaken, allowing the veins to bulge (prolapse) through the anus.

Hemorrhoid Treatment at Home

Hemorrhoid symptoms can be quite uncomfortable but there are several treatments you can do at home that may help relieve the pain and discomfort.

  • Take a warm bath or sitz bath for 10 to 15 minutes after each bowel movement.

  • Clean around your anal area gently each day with warm water.

  • Do not use alcohol-based or perfumed cleaning wipes around your anus. These cause drying and irritation.

  • Moisten toilet tissue before using it to clean after a bowel movement.

  • Apply cold compresses to your anus.

  • Use stool softeners.

  • Take over-the-counter pain relievers, including acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen or naproxen.

You may help prevent hemorrhoids from forming or from worsening with some lifestyle changes as well. They include:

  • Don’t strain while moving your bowels.

  • Limit the amount of time sitting on the toilet.

  • Increase fiber in your diet. Fiber helps give stool bulk so it can be moved through your intestines, and it also helps water remain in the stool so it doesn’t get too dry and difficult to pass.

  • Increase fluid intake. Drink 6 to 8 glasses of water and other liquids to help keep your stool soft.

  • Exercise regularly. This will help regulate and stimulate your bowels.

  • Apply topical ointments. Over-the-counter creams and suppositories can help relieve pain and reduce swelling.

When to See a Doctor for Hemorrhoids

How long do hemorrhoids last? The answer to this is variable. Treatment for small hemorrhoids may work within a few days, while larger hemorrhoids may last much longer. Most hemorrhoids can be managed at home but if the pain or bleeding is severe; you are soiling yourself with stool; the hemorrhoids keep returning; or you are experiencing pain, bleeding and itching from the hemorrhoids after a week, consider seeing your doctor for assessment and treatment.

Although not common, if you experience dizziness, fainting, or large amounts of bleeding from your rectum, this is an emergency and you should seek medical help immediately.

Who to See for Hemorrhoids

In most cases, your family doctor or primary care physician can help you manage hemorrhoids. However, if the hemorrhoids are severe, you may need to see a hemorrhoid doctor, such as a colorectal surgeon or a gastroenterologist. These providers can provide more advanced hemorrhoid treatment, such as:

  • Rubber band ligation: A surgeon places a special medical-grade rubber band round the base of the hemorrhoid to cut off blood circulation. Within a week, the end of the hemorrhoid shrivels and falls off, leaving behind scar tissue.

  • Hemorrhoidectomy: This is an out-patient surgical procedure to remove the hemorrhoids.

  • Hemorrhoid stapling: Used primarily for internal hemorrhoids, this procedure uses a stapling tool that removes tissue.

  • Sclerotherapy: This involves an injection of a chemical solution directly into the hemorrhoid to shrink it.

  • Infrared photocoagulation: Used only for internal hemorrhoids, this procedure directs an infrared light towards the hemorrhoid tissue to cause scars, which block blood flow to the hemorrhoids.

  • Electrocoagulation: Similar to infrared photocoagulation, this procedure uses electric current to cause scar tissue.

Some people may be embarrassed to speak with their doctor about hemorrhoids, but the condition is so common that your doctor won’t be surprised if you bring it up. There’s no need to live with the pain and discomfort of hemorrhoids. Prompt treatment will allow you to live your life more comfortably.

Treatment of Hemorrhoids | NIDDK

How can I treat my hemorrhoids?

You can most often treat your hemorrhoids at home by

  • eating foods that are high in fiber
  • taking a stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel)
  • drinking water or other nonalcoholic liquids each day as recommended by your health care professional
  • not straining during bowel movements
  • not sitting on the toilet for long periods of time
  • taking over-the-counter pain relievers such as acetaminophen, ibuprofen, naproxen, or aspirin
  • sitting in a tub of warm water, called a sitz bath, several times a day to help relieve pain

Applying over-the-counter hemorrhoid creams or ointments or using suppositories—a medicine you insert into your rectum—may relieve mild pain, swelling, and itching of external hemorrhoids. Most often, doctors recommend using over-the-counter products for 1 week. You should follow up with your doctor if the products

  • do not relieve your symptoms after 1 week
  • cause side effects such dry skin around your anus or a rash

Most prolapsed internal hemorrhoids go away without at-home treatment. However, severely prolapsed or bleeding internal hemorrhoids may need medical treatment.

How do doctors treat hemorrhoids?

Doctors treat hemorrhoids with procedures during an office visit or in an outpatient center or a hospital.

Office treatments include the following:

  • Rubber band ligation. Rubber band ligation is a procedure that doctors use to treat bleeding or prolapsing internal hemorrhoids. A doctor places a special rubber band around the base of the hemorrhoid. The band cuts off the blood supply. The banded part of the hemorrhoid shrivels and falls off, most often within a week. Scar tissue forms in the remaining part of the hemorrhoid, often shrinking the hemorrhoid. Only a doctor should perform this procedure—you should never try this treatment yourself.
  • Sclerotherapy. A doctor injects a solution into an internal hemorrhoid, which causes scar tissue to form. The scar tissue cuts off the blood supply, often shrinking the hemorrhoid.
  • Infrared photocoagulation. A doctor uses a tool that directs infrared light at an internal hemorrhoid. Heat created by the infrared light causes scar tissue to form, which cuts off the blood supply, often shrinking the hemorrhoid.
  • Electrocoagulation. A doctor uses a tool that sends an electric current into an internal hemorrhoid. The electric current causes scar tissue to form, which cuts off the blood supply, often shrinking the hemorrhoid.

Outpatient center or hospital treatments include the following:

  • Hemorrhoidectomy. A doctor, most often a surgeon, may perform a hemorrhoidectomy to remove large external hemorrhoids and prolapsing internal hemorrhoids that do not respond to other treatments. Your doctor will give you anesthesia for this treatment.
  • Hemorrhoid stapling. A doctor, most often a surgeon, may use a special stapling tool to remove internal hemorrhoid tissue and pull a prolapsing internal hemorrhoid back into the anus. Your doctor will give you anesthesia for this treatment.

Sometimes complications of hemorrhoids also require treatment.

Seek care right away

You should seek medical care right away if you have severe anal pain and bleeding from your rectum, particularly with discomfort or pain in your abdomen, diarrhea, or fever.

How can I prevent hemorrhoids?

You can help prevent hemorrhoids by

  • eating foods that are high in fiber
  • drinking water or other nonalcoholic liquids each day as recommended by your health care professional
  • not straining during bowel movements
  • not sitting on the toilet for long periods of time
  • avoiding regular heavy lifting

This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.

4 Procedures for Hemorrhoid Removal Performed By A Doctor

If you have hemorrhoids and at-home treatments to shrink them or ease the pain haven’t worked, your doctor may be able to help.

Several procedures can be done in a doctor’s office, and each has advantages and disadvantages.

Rubber-Band Ligation (Banding)

Your doctor will take a tiny rubber band (only a few millimeters wide) and put it over the base of an internal hemorrhoid to cut off the flow of blood. The hemorrhoid usually shrinks and falls off (along with the band) in about a week.

If you have several hemorrhoids, you may need to have this done every few weeks. This treatment can be painful and cause bleeding. More rarely, it also may cause blood clots or infections.

Hemorrhoids treated this way are less likely to come back than with other treatments.


Your doctor will give you a shot that puts chemicals into the hemorrhoid tissue. These chemicals also cut off blood flow to the hemorrhoids and shrink them. You may need to have this done every few weeks until they go away completely.

You may feel mild pain or pressure after, but infections are rare. With this treatment, the hemorrhoids often come back in a few years.

Infrared Coagulation

With this treatment, your doctor focuses an infrared light on a hemorrhoid, and the heat causes scar tissue to form and blood flow to the hemorrhoid to be cut off.

Generally, coagulation treatments have few side effects and cause very little pain. However, hemorrhoids are more likely to come back with these treatments than with banding.


This is similar to infrared coagulation, except instead of an infrared light, your doctor uses heat from an electric current to create scar tissue and cut off the hemorrhoid’s blood supply.

Hemorrhoidal Artery Ligation and Recto Anal Repair (HAL-RAR)

Hemorrhoidal Artery Ligation and Recto Anal Repair (HAL-RAR) is a new procedure in which a miniature Doppler sensor is inserted in the anus to detect the arteries supplying blood to hemorrhoids. The surgeon can pinpoint the arteries supplying the hemorrhoids and can tie them off to cut the blood supply. The hemorrhoids are reduced almost immediately and within weeks, are no longer noticeable. The procedure is effective and virtually painless, but it is not simple.

Hemorrhoids – Gastroenterology Specialists of Frederick


More Fiber
If the doctor finds hemorrhoids, you may be advised to change your diet to include more fiber. Eat more fresh fruits, leafy vegetables, and whole-grain breads and cereals (especially bran). Drinking six to eight glasses of fluid (not alcohol) each day will also help. Your doctor may recommend that you use a supplement that provides fiber and softens the stool or a stool softener. Softer stools make it easier to empty the bowels and lessen pressure on the veins.

Your doctor might also recommend cold packs, tub bath, warm soaks (sitz bath) or bed rest.

Good Hygiene
Good hygiene is also important. Bathe the anus gently after each bowel movement using soft, moist toilet paper (or a commercial moist pad). Avoid a lot of wiping. If necessary, you can even use a bath or shower as an alternative to wiping. After bathing, dry the anus gently with a soft cloth or towel.

To protect against irritation, cleanse the anus gently and apply zinc oxide paste (or powder) to the area. Medicated suppositories or creams are available at the drug store. Any of these home treatments may relieve the symptoms and no other treatment may be needed. If symptoms persist, see your doctor.

Procedural Treatments

In some cases, internal hemorrhoids that have fallen outside of the anus (prolapsed) or that bleed too much must be removed. Your gastroenterologist may be able to treat them during an outpatient visit to the office or to the hospital. A number of methods can be used to remove or reduce the number of hemorrhoids:

Surgical treatment: Cutting out the hemorrhoids (hemorrhoidectomy) is sometimes recommended, but carries a painful recovery.
Endoscopic: Endoscopic methods include the use of freezing, electrical or laser heat, or infrared light to destroy the hemorrhoidal tissue.
Band ligation: The gastroenterologist or surgeon may use a technique in which a rubber band is put around the base of the hemorrhoid. The band cuts off circulation, and the hemorrhoid withers away within a few days. This technique is used only for internal hemorrhoids.
Sclerotherapy: In this procedure a chemical is injected around the vein to shrink the hemorrhoid.


  • Pass your bowel movements as soon as possible after the urge occurs.
  • Avoid straining.
  • Be active. Move around, walk and exercise to help move the stools through your body.
  • Stay regular by eating enough fiber and drinking enough fluid. Most Americans only take in 13 grams of fiber in their daily diet, half of what is recommended. Adding fiber to your diet helps to produce stools that are softer and easier to pass.

Hemorrhoids usually do not pose a danger to your health. In most cases, hemorrhoid symptoms will go away naturally within a few days. Rarely, chronic bleeding from hemorrhoids may lead to anemia.

Modified and reprinted from the American Gastroenterological Association.

Choosing A Doctor To Treat Your Hemorrhoids

If you suffer from hemorrhoids, the good news is that lower grade hemorrhoids can resolve on their own with at-home treatments. But what if they get to the point where you need to see a doctor to treat them? How do you choose where to go and what doctor is right for you?

Here’s what you should know about finding the right doctor for you:

Ask For Referrals

To start, ask for referrals to specialists! This is an important step in choosing a doctor, as your primary care physician may not be able to treat hemorrhoids on their own. Doctors will often refer to specialists on their own, but if they don’t make sure you mention it.

In order for insurance to cover the cost of the examination and procedure at a specialist, a referral is needed.

The Right Doctor For The Right Procedure

It’s also important that you search your insurance’s website for doctors that are within your network. This will help prevent out-of-network charges and other out-of-pocket fees. When you have a list of doctors, it’s a good idea to meet with them to determine if they are right for you and your needs.

It’s a good idea to ask friends and family if they have had experience with these doctors to get an idea of their experience as well as research the doctor’s license and any potential complaints against them.

Depending on the severity of the hemorrhoids, the doctor you pick depends on their specialty:


A gastroenterologist can diagnose hemorrhoids and provide non-surgical treatments like hemorrhoid banding. If your hemorrhoid is severe enough to warrant surgery, they will refer you to a doctor that can, like a colorectal surgeon or a general surgeon.

Like a gastroenterologist, a colorectal specialist will be able to diagnose you with hemorrhoid and provide treatment options. The only difference is that a colorectal specialist is able to provide surgical treatments if deemed necessary.

General Surgeon & Colorectal Specialist

A general surgeon and a colorectal specialist (or surgeon) can perform surgeries on hemorrhoids if they are severe enough in the form of a hemorrhoidectomy. Hemorrhoids may require surgery when they don’t respond to non-surgical treatments or if it prolapses.

These doctors can perform hemorrhoid surgery and send you home that day after a brief observation and discussing aftercare to you and a trusted family member.

The Right Doctor Will Listen & Answer Your Questions

A doctor should listen to your questions and concerns and answer them in a way you understand. They will also help you understand your treatment options and feel comfortable discussing the problem.

After treatment, your doctor should thoroughly go over aftercare and how you can treat yourself at home to lessen symptoms and heal.

They Use The Right Equipment

Hemorrhoid treatment should not be painful, even if it is a non-surgical treatment like banding. That’s why you should ask your doctor what equipment they use like the Nexus System, which is a fast, safe, and non-disruptive treatment option for low-grade hemorrhoids.

Everything You Need to Know About Hemorrhoids with Dr Michael Valente

Podcast Transcript

Scott Steele: Butts and Guts, a Cleveland Clinic podcast exploring your digestive and surgical health from end to end. Welcome back to another episode of Butts and Guts. I’m your host Scott Steele, Chairman of colorectal surgery here at Cleveland Clinic in beautiful Cleveland, Ohio. I’m very pleased to have one of my staff members here and a good friend, Dr. Michael Valente. Michael is an assistant professor of surgery at Cleveland Clinic Lerner College of Medicine. Mike’s also our program director for our illustrious fellowship in colorectal surgery. Mike welcome to Butts and Guts.

Michael Valente: Thank you, Dr. Steele it’s a pleasure to be here.

Scott Steele: So tell listeners a little bit about your background; how did it come to the point where you’re from, where you trained, that you wind up at Cleveland Clinic.

Michael Valente: So I actually grew up in Cleveland, Ohio. I’m a born and raised here.

Scott Steele: West Side? East Side?

Michael Valente: Born at Marymount Hospital; lived on the west side for most of my life and I live in Brecksville, Ohio. 

Scott Steele: Where’d you train? 

Michael Valente: I trained for general surgery at Akron City Hospital down in Akron, Ohio, and then did my colorectal fellowship down in Columbus, Ohio.

Scott Steele: So Mike, we’re going to talk today about something that is all too common. Over 1 million visits to the doctor in the United States alone every year and that’s hemorrhoids. So let’s start out at a 10,000-foot level, what’s a hemorrhoid?

Michael Valente: That’s a good question, Dr. Steele. Hemorrhoids are actually part of our normal anatomy. Every single person listening to this podcast has hemorrhoids whether you know it or not. Most of the time you don’t even know that you have them; they’re part of our normal anatomy. And really what they are is a conglomeration of blood vessels that sit in the anus, so they’re there for a normal function.

Scott Steele: And what type of function do people have that hemorrhoids would be able to do?

Michael Valente: Hemorrhoids, in their normal resting state, fill with blood and they help actually keep some continence or control of our gas, our bowel movements, under normal circumstances.

Scott Steele: So I get a lot of people that will go online and they’ll have some anal rectum complaints, and one of the very first things that come up is hemorrhoids. And one of the first things that you’ll see is external hemorrhoids versus internal hemorrhoids. What’s the difference between the two?

Michael Valente: Internal hemorrhoids are as the name states – inside. They’re internal, so those are usually cushions of blood vessels that are not able to be seen by the naked eye; they’re inside. And internal hemorrhoids usually are a cause of rectal bleeding. They can cause pain sometimes if they swell and bulge, or prolapse. External hemorrhoids are usually what we could see from the outside. Those are also referred to as sometimes skin tags, and sometimes external hemorrhoids can be quite painful if they become what we call thrombosed external hemorrhoids.

Scott Steele: So Mike, you said a little bit ago that every single person, and I know it’s going to be a lot of listeners out there that would disagree that they have hemorrhoids, but you know you brought up a good point that they serve to act as little ball valves together so that you don’t have seepage. They’re your last little line of defense in the war to preserve continence. But one of the things is that patients get them removed. So if they’re normal and everybody has them, I don’t understand this. Why would somebody need to have their hemorrhoids removed?

Michael Valente: That’s a great question and I discuss this with patients every week. When hemorrhoids become problematic or troublesome they, they become what we call hemorrhoidal disease and, and that’s when these normal hemorrhoids that do serve a function become abnormal. And what I mean by that is they overfill with blood, or they become lax or loose, and they prolapse or herniate. And really the hemorrhoids at this stage are causing more problems then they’re doing good. And what I mean by that is they may bleed, which is one of the most common problems with hemorrhoids that we see. They can cause pain with the prolapse, quite debilitating pain sometimes. They secrete mucus and they may cause trouble with keeping hygienic down there as well. So when it reaches that point where they become so troublesome, that’s when we recommend some sort of intervention.

Scott Steele: Let’s take a step back and we’ll go back up to the symptoms that patients go. You mentioned that patients can have bleeding; is the bleeding associated with hemorrhoid any different from other sources of bleeding along the G.I. tract?

Michael Valente: Yes and no. Most hemorrhoidal bleeding occurs with bowel movement or during the active defecation, and a lot of times that bleeding is a bright red in nature, and it usually may drip into the toilet, but usually associated with the act of having a bowel movement. Other causes of gastrointestinal bleeding can be more severe, more volume, if you will, and maybe associate with other conditions that are more serious.

Scott Steele: Are there some hints that you might say, hey, this is hemorrhoid bleeding versus some more benign disorders that are in the anal rectal region, that you would say this is associated with another diagnosis?

Michael Valente: When we usually talk about hemorrhoid bleeding, it’s what we would call a painless bleeding most often, as opposed to bleeding that occurs with a bowel movement that may cause severe sharp pain that would point us toward something called an anal fissure.

Scott Steele: If we’re going to talk about the symptoms that patients get, when should they go and see the doctor?

Michael Valente: That’s a great question. When the patient is having rectal bleeding, we do recommend that they do come to see us because it very well may be just hemorrhoids. But you need to have a trained professional colorectal surgeon, if you will, or even your family doctor, really investigate that, because even though the hemorrhoids do bleed, and it’s a major cause of anal or rectal bleeding, there could be other causes that we must rule out first.

Scott Steele: So if I go to the doctor, with or without hemorrhoids or suspicion of hemorrhoids, what can I expect at that doctor visit?

Michael Valente: At the colorectal surgeon’s office, for example, a very detailed history asking a lot of questions about type of bleeding, when it’s occurring. And then after a good conversation about maybe leading us towards a diagnosis, a good examination in the office is compulsory. And what I mean is usually that consists of a rectal examination and sometimes the use of what we call an anoscope, a small device that usually has a light on it to evaluate the most distal part of the rectum and anal canal.

Scott Steele: Mike, are hemorrhoids cancer or can they turn into cancer?

Michael Valente: No, hemorrhoids are not cancer. Hemorrhoids do not turn into cancer. But what I want to emphasize is many patients have been told they have hemorrhoids, or potentially just chalk up their symptoms to “hemorrhoids,” and they may be missing a more serious diagnosis like rectal cancer or anal cancer.

Scott Steele: Is that common that it be cancer or is it more common that it’s going to be hemorrhoids?

Michael Valente: It’s most common that it’s going to be hemorrhoids. But we don’t ever want to take any chances.

Scott Steele: Yeah, absolutely. So what causes hemorrhoids?

Michael Valente: Many things – multifactorial, we like to say. I tell a lot of my patients sometimes hemorrhoids are just the act of one’s ageing process, where the hemorrhoids, themselves, are getting loose, and they tend to have the effects of gravity like other body parts may as well. We do see hemorrhoids in very young people as well. And I think one of the most common causes of hemorrhoids is a lack of a good diet and exercise. What I mean by that is people who don’t have a good dietary intake of fiber tend to be constipated tend to spend a lot of time on the toilet, a lot of times straining on the toilet to get a bowel movement to come out, and those definitely precipitate hemorrhoidal disease.

Scott Steele: Let’s focus in a little bit about treatment or even first prevention of hemorrhoids.  You mentioned fiber, how much fiber is the average Western diet type person taking?

Michael Valente: Yeah, the average Western diet is extremely low in fiber. I have patients tell me all the time “I eat very well, I have salads, and I have oatmeal for breakfast, and I have lots of fruits and vegetables. And that may be true, but the average American or Western civilized countries maybe get 10 to 15 grams of fiber in the best of circumstances. What we recommend, as the Society of Colorectal Surgeons, is between 25 and 35 grams per day.  And the normal western diet really can’t achieve that goal, and that’s where we get into having supplemental fiber as part of one’s daily routine.

Scott Steele: There’s a lot of supplemental fibers out there, and it’s difficult if I’m a patient, I’m looking at this grocery store aisle full of fiber and I’m thinking where do I start? What do I choose? Where do I go?

Michael Valente: Over the last several years, I’ve made a note to try several ones out to see so I could tell my patients what works best or what works best for them and, and it’s really what works best for your individualize routine. I recommend, and most of us do, the powdered fiber supplements that tend to work the best. And the key ingredient is what we call psyllium in most of the fiber products. And the question goes back to, will it work right away? It does not. It’s a slow gradual process where you need to start with a very low dose and work your way up, and every patient is going to have their kind of sweet spot amount that they need each day or every other day to get the right effect. Because if one takes too much fiber too quickly, the patient will have some side effects of bloating, gas and potentially too much bowel movement. And we want to avoid that, so we start slow and kind of work our way up.

Scott Steele: I think it’s also important that patients understand that with any fiber product out there you need to make sure you take enough water in there because, for sure, dehydration can cause symptoms. Mike, you said something a little bit earlier about having good bowel habits and good bowel regimens, and that potentially having poor bowel regimens and bowel habits can lead over time to exacerbation of hemorrhoids. What does that mean having good bowel habits?

Michael Valente: The first thing I want every listener to do is leave your phone outside of the bathroom. Don’t take the newspaper, your book, or your iPhone, or any other device in there with you. The bathroom is meant for one reason and one reason only, and that’s to have a proper bowel movement. And what that means is if you have a proper diet with good fiber and enough water intake, your bowel movements should be a very short occurrence. You should be able to sit down on the toilet with minimal straining, if any, and within a few minutes you should be done going to the bathroom. Anything more than five to 10 minutes – I mean, five minutes really should be the maximum time you spend in the bathroom.

Scott Steele: So we talked a little bit about prevention with good bowel regimen, and fiber being the mainstay of that. Let’s focus a little bit more on a couple of myths. I take a lot of enriched bread or I take a bunch of oil flaxseed oil. Is that fiber? 

Michael Valente: No.

Scott Steele: And if I’m somebody who doesn’t want to take the pills or the gummy bears or the powders. What foods are pretty good in fiber that you can be able to take? 

Michael Valente: Certain breads definitely have a lot of fiber in them, but these are more the whole grains. White the bread has the least amount of fiber you’re going to have in there. Those are things you should avoid. Obviously, oatmeal and other refined grains are quite beneficial as well.

Scott Steele: Let’s say that they don’t have somebody that is responding to prevention, and they got hemorrhoids. They’ve gone to the doctor. Are there some therapies that can be done that are short of having an excision that patients could undergo?

Michael Valente: Absolutely. Honestly, in my practice, over 90 percent of my patients who receive some treatment do not have surgery, and we generally perform various office-based procedures that work quite well.

Scott Steele: One of the ones that I read about was banding. Tell me a little about who gets banded and how does that happen and where does it occur?

Michael Valente: Hemorrhoid rubber band ligation is a technique that’s very well tolerated and used widely throughout the world, actually. Patients who have bleeding hemorrhoids – these are for internal hemorrhoids, only the bleeding internal hemorrhoids or internal hemorrhoids that may have some prolapse where they aren’t stuck on the outside. So bleeding hemorrhoids and prolapsing hemorrhoids are very well treated with hemorrhoid banding. Hemorrhoid banding takes place after a proper office-based examination, and people always ask me, “Do I need to take off work? Is this going to be very painful?” And it’s really not painful; it’s more of a pressure sensation. And what that hemorrhoid band does is causes the hemorrhoid to lose its blood flow and allows that hemorrhoid to actually fall off several days later, in the toilet usually, you don’t even notice it. And what that does is it cuts down the size of the hemorrhoid, causes some scarring, and prevents it from bleeding or prolapsing again.

Scott Steele: So the band itself is what we use in order to take up that extra tissue. The band is placed around kind of the neck of that extra tissue and then over the next few days it’ll fall off, you won’t even know it’s there. So do you get all the hemorrhoids with just one band?

Michael Valente: We don’t. Every once in a while there may be one particular hemorrhoid area that’s causing a major problem, where that one band may do the trick. But usually this is a procedure that requires repeat banding in the office setting, which is once again very well tolerated. And I tell my patients it’s not going to potentially cure your hemorrhoids – the hemorrhoids are still there in other areas, and more of them may form in the future, especially if poor bowel movement habits are undertaken still. It’s not uncommon that I’ll have the patient go back two, three weeks after the first hemorrhoid banding to do another one. And then potentially another one after that to do the trick.

Scott Steele: Are there any side effects to the banding?

Michael Valente: Hemorrhoid banding is very safe. There are some side effects that we do talk about during the procedure. And all my patients go home with an instruction sheet to look out for. The biggest thing that can happen in our practice is that if a patient says, “I’m on a blood thinner,” we usually have them stop that. But once you resume that blood thinner, like even aspirin, there could be some severe bleeding that occurs afterwards which you need to seek medical attention.

Scott Steele: So in general, they are very well tolerated; occasionally you’re going to feel a dull ache. A lot of patients out there will get on the internet and read various things, and they may read about a severe infection that can occur with banding. But it’s important to know that this is extremely rare, and most of the physicians that use banding have maybe never even seen it associated with banding. But it is something that you might read about, but it’s important to put it in perspective.  So banding is for internal hemorrhoids only.

Michael Valente: Yes.

Scott Steele: The kind that may prolapse out and the kind that typically bleed, or the kind that you may not even know is there and just causing you to have problems. You don’t do banding on external hemorrhoids. What are some other office-based procedures that can be done for hemorrhoids?

Michael Valente: Another less popular treatment is sclerotherapy, and sclerotherapy works actually very well. Sclerotherapy is the injection of a caustic agent into the hemorrhoid pedicle itself to cause scarring of the hemorrhoid to stop it from bleeding. Sclerotherapy really works well in patients who are on some sort of anti-platelet or anticoagulation medicine where they really can’t come off of that. And we like to use sclerotherapy in those situations to help with the hemorrhoids. Some practitioners routinely use sclerotherapy with banding in combination. But I would say the vast majority of my patients will get a banding, maybe a sclerotherapy if they can’t come off their blood thinner.

Scott Steele: If you really think about hemorrhoid therapy, in broad terms, we’re either talking about trying to get rid of them or trying to fix by the anus, and that’s where the sclerotherapy works a little bit better on. So we’ll kind of skip over some of the infrared coagulation that people may have, or sclerotherapy. There are all sorts of things that people might have that are more office-based procedures, but the mainstay of therapy for internal hemorrhoids is to have them banded. But then the next thing is for those who fail the medical therapy, or are not candidates for some of the office-based type procedures, and go onto surgery. Surgery typically involves two different types of lumps – the removal of them or this ligation that I hear about. Let’s start with the ligation first.

Michael Valente: Sure.

Scott Steele: What is ligation of hemorrhoids?

Michael Valente: Ligation of hemorrhoids is a procedure where you’re essentially tying off the hemorrhoid mass with suture material, usually, and that is usually meant for patients without much external hemorrhoid disease, where they really have prolapse or bleeding hemorrhoids that are quite large or really fail banding therapy.

Scott Steele: And is that for internal or external hemorrhoids?

Michael Valente: Those are for internal hemorrhoids.

Scott Steele: If somebody’s got a large degree of external hemorrhoids, probably, they’re not going to need to have something in conjunction with the ligation of that.

Michael Valente: Correct.

Scott Steele: OK. Now in terms of the excision or cutting out of the hemorrhoids, there are also two different things in terms of that. We talk about the stapler that’s used or we also talk about the good old-fashioned excision. Mike, when do you decide to use these and what is the difference between the two?

Michael Valente: Probably in the last 15 years a newer procedure called the stapled hemorrhoidopexy, or hemorrhoid surgery, was implemented. I’ll be honest, I don’t do that procedure myself. It’s something that I think is decreasing in occurrence throughout America. I think that procedure can be performed well with certain types of hemorrhoids. But in my practice I prefer the excisional hemorrhoidectomy if we’re going to go to surgery, to do hemorrhoid surgery. The excision is the way to go.

Scott Steele: What does that involve?  I’m going to go in for hemorrhoidectomy, what can I expect and what are you actually doing in there after I go to sleep?

Michael Valente: So after you go to sleep we take the internal and external hemorrhoid and I prefer using a good old-fashioned scalpel. We cut out the hemorrhoid all the way down to its base, get all the blood vessel on the disease tissue out – that includes both the internal and the external part – and then we sew them up with suture material. And that usually is at least two, sometimes three, different columns of hemorrhoid tissue. That’s under general anesthesia or some sort of anesthetic in the operating.

Scott Steele: Do you remove all of the hemorrhoid tissue?

Michael Valente: Generally speaking we don’t. We remove the vast majority of the problematic hemorrhoid tissue, but we definitely have to leave some hemorrhoid tissue behind. It does have a function. We really can’t take out the entire circumference of the anal hemorrhoids because that would lead to certain complications.

Scott Steele: If I was a patient that is going to plan on having a hemorrhoidectomy, or is having one that’s coming up or thinking about it, what’s the postop like after the hemorrhoid surgery?

Michael Valente: It’s very painful. It’s a painful operation. I think patients, overall, tolerate it extremely well. But I think that first week, and I tell my patients you’re not going to like me very much, that first week potentially you’re going to wonder why you had this done. But really with proper pain control, multimodal pain treatment with ibuprofen, sometimes also narcotics. That first week is a very tolerable, and after a couple weeks you really start feeling really well and you’re really happy that you had it done.

Scott Steele: I appreciate your full honesty, and in reality, I try to tell the patients that again this is something that it’s a sensitive part of your body, there’s no way getting around it. We’ll do our best to control your pain through a lot of different mechanisms, and by and large most patients do very well. But it is a sensitive area. And the other important aspect is that that area of your body can swell, and it does take a couple of weeks to completely heal all the way in. So you have your hemorrhoidectomy, you get better with that in time, can hemorrhoids recur?

Michael Valente: They can.

Scott Steele: And how often does that occur?

Michael Valente: I would say in my experience not that often to the type of situation where you would need another surgery. Every once in a while if I do a good hemorrhoid surgery, a few years later I may have to put a rubber band ligation back on for another smaller area. But, generally speaking, if it’s done properly by a well-trained surgeon you should do very well.

Scott Steele: So Mike, some last take home points about hemorrhoids.

Michael Valente: Number one, everyone has them; don’t be alarmed by the fact that you have them. Number two, proper dietary factors – drinking at least two liters of water a day, about 64 ounces, is extremely important to help prevent this. Please get off the toilet as soon as possible. Any time you have symptoms of rectal bleeding, please don’t just chalk it up to saying that you have hemorrhoids without seeing a trained professional to make sure you don’t have some other condition that needs to be taken care of.

Scott Steele: So we’re going to end with the four quick hitters. Your favorite sport?

Michael Valente: American football.

Scott Steele: Favorite meal?

Michael Valente: Anything my mother makes.

Scott Steele: What’s the last book that you read?

Michael Valente: The Sun Also Rises by Ernest Hemingway.

Scott Steele: And you’re a native Clevelander. So tell me, what do you like about here in Cleveland?

Michael Valente: I love the weather, Scott.

Scott Steele: That sounds good. To learn more please download our free hemorrhoids treatment guide at clevelandclinic.org/hemorrhoids. To make an appointment with a Cleveland Clinic specialist please call 216.444.7000. Mike, thanks so much for joining us here on Butts and Guts.

Michael Valente: Thanks for having me, Scott.

Scott Steele: That wraps things up here at Cleveland Clinic. Until next time, thanks for listening to Butts and Guts.

90,000 If you have hemorrhoids, which doctor will help you?

Hemorrhoids are a fairly common disease among adult men and women, especially sedentary work contributes to it. The problem is so delicate that many are embarrassed to go to the clinic with it, to find out which doctor they need to make an appointment with. However, this is a wrong behavior: if hemorrhoids are left untreated, they become chronic. An exacerbation of the disease is caused by the transfer of heavy objects, the period of pregnancy, and malnutrition.If hemorrhoids are not treated, then the problem will have to be eliminated with the help of surgical operations. Therefore, we recommend that at the initial manifestations of hemorrhoids, contact a specialist – a proctologist or coloproctologist.

Which doctor treats hemorrhoids?

Hemorrhoids are a pathology of the lowest part of digestion – the rectum. Proctologists are engaged in the diagnosis and treatment of this part of the organ. According to the modern classification of specialties – coloproctologist.These specialists deal with all problems related to the colon, anus and perineum. Hemorrhoids are diagnosed by an increase in the nodes, they will be detected by a gynecologist who performs a routine examination of women and a urologist when examining men. Also, the surgeon who examines them as part of the medical board at the military registration and enlistment office can inform the young men about the first signs of the disease. If symptoms are found, then the patient is referred to a narrower specialist – a coloproctologist, it is explained that a professional approach is important in treating the disease.

Most district-level hospitals have a proctologist on staff. If it is not there, then you can make an appointment with the surgeon, since proctology is one of the areas of surgery, therefore such a doctor has a sufficient knowledge base and practice in this area. A surgeon in a district hospital (polyclinic) conducts outpatient appointments free of charge. In addition, you can go to a private medical clinic, in such institutions there are enough coloproctologists. To get to a good specialist, you should inquire about the clinic’s license, find out the doctor’s experience and category, read reviews about him.When making an appointment, it is necessary to clarify what is included in the examination, the doctor may additionally prescribe an instrumental examination (sigmoidoscopy, anoscopy), which are paid separately. It is important to clarify this not only from a financial point of view, but also for proper preparation for research.

In the case when there is bleeding from the anus, the pain is very strong, then you need to call an ambulance. This complication can be caused by a pinching of the node or thrombosis. If medical assistance is not provided in a timely manner, it will lead to necrosis (tissue necrosis).

Proctologists and coloproctologists

The exact name of medical specialties is approved by the List of the Ministry of Health. In state institutions, when applying for a job, they strictly monitor that the name of the specialty exactly corresponds to the legislation. Previously, doctors who were involved in the treatment of hemorrhoids were called “proctologists”. Since 2014 they have been called “coloproctologists”. This is due to the fact that the field of study of pathology was slightly “expanded” – to the entire large intestine.

Depending on the place of work and the characteristics of the medical profile, coloproctologists can be:

  1. Therapists. In this case, the coloproctologist deals with the therapeutic (drug) treatment of the disease, as well as the treatment of Crohn’s disease, colitis, elimination of infections and parasites that have settled in the intestines.
  2. Surgeons. Coloproctologists of this direction practice minimally invasive methods of treating hemorrhoids, and also perform operations to remove tumors, hemorrhoidal cones, polyps using special endoscopic devices.

A coloproctologist-therapist for the treatment of hemorrhoids prescribes medications, prescribes drugs for oral and local use, and prescribes a diet that must be followed. Doctors of this specialization usually work in outpatient clinics and receive outpatient appointments.

A coloproctologist-surgeon is a doctor who is consulted in cases when treatment with various home methods has not yielded results, hemorrhoids have passed into an advanced stage, complications have appeared (a crack on the intestinal wall), bleeding begins, prolapse or infringement of hemorrhoids occurs.All this requires surgical intervention.

Both types of coloproctologists have enough knowledge and experience to diagnose hemorrhoids, determine the stage of the disease, and choose an effective method of treatment. At the reception, the doctor finds out how long ago the signs of the disease appeared, what provoked it and led to an exacerbation. At the consultation, a specialist necessarily examines the anus, palpates the lower rectum, performs anoscopy, sigmoidoscopy.If necessary, such studies as irrigoscopy or colonoscopy are additionally prescribed.

On the basis of research, complaints and analyzes, an individual treatment regimen for the patient is selected, taking into account the age and the presence of other diseases. The therapeutic process and its effectiveness are monitored. For the I-III stages of the disease, treatment is carried out using mini-surgery (sclerotherapy for external hemorrhoids, the imposition of latex rings, ligation of blood vessels).Also, laser irradiation, cryotherapy, thermal coagulation can be used for treatment. After the procedures, the proctologist must prescribe a therapy that will prevent the development of exacerbations and maintain a positive treatment result. To do this, the doctor explains to the patient the peculiarities of nutrition, hygiene, and regimen.

Duties of a coloproctologist surgeon

A coloproctologist-surgeon not only treats hemorrhoids, but also deals with the elimination of intestinal pathologies due to injuries, congenital diseases.

The doctor provides emergency or routine care in the presence of:

  • hemorrhoids with complications;
  • 90,021 rectal fissures;

    90,021 intestinal polyps;

    90,021 paraproctitis;

    90,021 cysts and tumors.

The task of the doctor is to choose an effective method of treatment, taking into account the results of diagnostics and the general health of the patient. The choice of the method of surgical intervention is based on the ratio of the level of risk and predicting the development of the disease.The coloproctologist explains to the patient the methods of preparation for surgery, removes structures, removes cracks, restores intestinal functionality. After the operation, a diet, dressings, local procedures, and medication are prescribed.

The duties of a doctor of this specialization, in addition to admitting patients, include maintaining documentation, analyzing the effectiveness of his work, and improving his qualifications every 5 years. During the retraining courses, the doctor gains knowledge about new therapeutic advances and drugs, the possibilities of innovative diagnostic equipment.

Preparation for inspection

It is better to plan a trip to the coloproctologist on your day off, since you need to carefully prepare for the examination. Before taking it, it is advisable to cleanse the intestines.

The day before visiting the doctor, you need to exclude from the diet food that provokes gas formation:

  • milk;
  • 90,021 legumes;

  • all types of cabbage;
  • fatty fish and meat dishes;
  • 90,021 sweet products;

    90,021 carbonated water, strong coffee and tea;

  • pickles;
  • any alcohol, including beer.

You should refrain from smoking. The night before, you need to do 2 cleansing enemas, in the morning one more. If the classic version of the enema is poorly tolerated, then rectal suppositories based on glycerin, Mikrolax microclysters are suitable. They provide bowel cleansing within 20 minutes. You should go to the doctor on an empty stomach in case he prescribes a blood test.

How painful is the examination?

The doctor performs an examination taking into account the patient’s condition, his excitement.Therefore, he talks to the patient and tries to conduct the examination slowly and accurately. The palpation procedure is quite unpleasant, but for the most part it does not cause pain. If there is a blackened hemorrhoidal node outside, then the examination is not performed, its removal is immediately assigned.

Why is it important to see a doctor?

Hemorrhoids is a disease that causes discomfort and complicates a person’s life, work due to the following signs:

  • pain during bowel movements;
  • 90,021 bleeding;

    90,021 itching, erosion, irritation, weeping skin around the anus;

  • Sensation as if there is something foreign in the anal canal.

If you do not start to treat hemorrhoids, then this leads to the appearance of cracks and ruptures, and inflammatory processes. Due to stagnation of blood, blood clots form, which impair tissue nutrition, leading to necrosis. This provokes severe pain and general intoxication. If the thrombus is not removed in time together with the node, then bleeding occurs. It is joined by a bacterial infection that spreads to the rectal tissue. This is fraught with sepsis, damage to neighboring organs.

Due to the shyness in the diagnosis and treatment, hemorrhoids quickly turn into a neglected state with complications.The longer you do not seek medical help, the more difficult it is to treat the disease, the risk of complications increases, and the need for urgent surgery. A timely visit to the doctor allows you to stabilize the condition, prevent the transition of hemorrhoids to the painful 4th stage.

Which doctor should I go to for the treatment of hemorrhoids?

Despite the fact that hemorrhoids are perhaps one of the most common diseases of the rectum, it is not customary to talk about it out loud.False bashfulness and delicacy makes a person not only hide his own suffering, but also hesitate to even just find out: which doctor treats hemorrhoids? But there is no point in being ashamed. After all, the sooner you go to the doctor you need, the sooner and more surely you will get a satisfactory solution to the problem.

By the way, in most medical institutions (and, of course, our specialized international network of clinics is no exception!) This disease is treated by a coloproctologist (or, as most people are more accustomed to, by a proctologist).It is to this doctor that you need to go with hemorrhoids.

When to see a doctor?

Of course, any physician will tell you that the disease is easier to cure in its earliest stages. Therefore, as soon as you begin to notice the symptoms of hemorrhoids in yourself, then you immediately need to undergo an examination. And it would be best to immediately consult a doctor who specializes in the treatment of hemorrhoids and other diseases of the rectum.

It is quite possible, by the way, that the examination by the proctologist will please you and the doctor will say that you have no hemorrhoids.And there is, for example, a simple inflammation that can be cured in just a couple of weeks.

But if, nevertheless, you are diagnosed with this unpleasant disease in every sense, then it is also important not to start the problem by starting qualified treatment as early as possible. Do not bring the disease to a chronic stage!

Acute or chronic stage of the disease

Both acute and chronic stages of the disease have a fairly similar clinical picture.The only difference is that the chronic form includes periods of relapse and prolonged remission, moreover, a patient who has been suffering from hemorrhoids for a long time knows firsthand which doctor to contact. Starting rapidly, the acute manifestation of the disease has the following symptoms:

  • Profuse bleeding after stool.
  • A pulling sensation in the anus, sometimes accompanied by the illusion of a foreign body being there.
  • Discomfort and pain when trying to defecate, sitting or walking for a long time.
  • Burning in the anal area.
  • Swelling of the mucous tissues of the anus.

Any of the signs listed above is a serious reason to seek medical help for a diagnosis.

What awaits you at the proctologist’s appointment?

The diagnostic activities that await you in the doctor’s office are hardly pleasant. However, determining hemorrhoids, what doctor can do without palpation of the anus, which helps to find the inflamed nodes?

A specialist can also get a visible picture of the disease using anoscopy – a procedure for examining the rectum using a special mirror instrument.

The most complete and informative method for diagnosing hemorrhoids for the attending physician was and remains sigmoidoscopy. A special tube with a lighting element expands the rectal opening by supplying air, then, using magnifying optics, allows you to examine the rectal mucosa.

Only after collecting the primary history and obtaining the results of the above studies, the doctor prescribes treatment for hemorrhoids, taking into account the individual characteristics of the patient’s body.

Only a doctor can cure hemorrhoids!

Admirers of self-medication, as well as those who hope that hemorrhoids will resolve on their own, should remember that without qualified therapy, the disease will continue to progress and, most likely, will become chronic.

Some patients with hemorrhoids, when deciding which doctor to go to, choose all kinds of traditional healers who can relieve pain without eliminating the cause of the problem.During the time spent on pseudo-treatment, the disease reaches the last, fourth stage, in which the loss of nodes occurs at any, even the weakest, physical stress, and sharp unbearable pain becomes a constant companion of the patient.

In order to prevent this from happening, treat yourself only in high-class clinics with certified proctologists, behind whose backs a classical medical education, vast experience and colossal capabilities of modern medicine.

And in order to choose the best clinic and find which doctor will best cope with your hemorrhoids – of course, you should listen to the reviews of other patients and entrust your health only to well-established medical institutions. There is no doubt that the network of clinics “URO-PRO” is one of those!

Order a call ← Our specialists can call you back at a convenient time for you. The call is free!

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90,000 Frequently asked questions to the proctologist

What are hemorrhoids?

Hemorrhoids – expansion and overflow of blood in the cavernous (spongy) bodies of the rectum and anal canal, which are a normal anatomical formation.Accordingly, they speak of hemorrhoids only when the cavernous bodies increase and begin to make themselves felt.

What are external and internal hemorrhoids, and is hemorrhoid always manifested by the presence of formations on the skin around the anus?

Hemorrhoids can be located both outside (external hemorrhoids) and inside the rectum (internal hemorrhoids), which are not visible from the outside.

How are hemorrhoids manifested?

The main manifestations of hemorrhoids are bleeding and prolapse of hemorrhoids.Pain for chronic hemorrhoids is not typical – in this case we are talking either about acute hemorrhoids, or about other diseases of the rectum. By the way, not always the release of blood from the rectum and the loss of any formations indicate hemorrhoids. This diagnosis can be reliably made only by a proctologist after examination. Hemorrhoids can mask other and often more serious diseases of the rectum.

Why does hemorrhoids occur and how to prevent the development of hemorrhoids?

One of the main factors in the development of hemorrhoids is heredity.Therefore, if your parents suffered from hemorrhoids, then with a certain degree of probability we can say that hemorrhoids can occur in you. Often hemorrhoids are combined with varicose veins of the lower extremities and flat feet, which is a consequence of congenital weakness of the connective tissue, which is the skeleton of the veins. In addition, food addictions (spicy food abuse), excessive alcohol consumption, a sedentary lifestyle, and a long stay in the same position (the work of a salesman, hairdresser, manager, etc.) are risk factors.), intense physical activity, persons suffering from constipation. Often, the first manifestations of hemorrhoids refer to the period of pregnancy. Accordingly, the elimination of risk factors for the development of hemorrhoids from your life can prevent the development of hemorrhoids.

What are the complications of hemorrhoids?

Typical complications of hemorrhoids are hemorrhoidal thrombosis with pain syndrome and hemorrhoidal bleeding. Contrary to popular belief, hemorrhoids never develop into cancer (but can mask its presence).

Can hemorrhoids go away on their own?

Hemorrhoids do not tend to shrink, but rather increases over time. Drug treatment slows down its progression, and in the case of acute hemorrhoids, only reduces or eliminates its symptoms.

When and how should hemorrhoids be treated?

Correct and adequate treatment of hemorrhoids is prescribed only by a doctor. The symptoms of hemorrhoids are very varied and the treatment is accordingly different.In addition, the symptomatology you personally have may be due to other proctological diseases. Treatment depends on the stage and nature of the disease. In addition to medical and surgical treatment, outpatient minimally invasive techniques are currently used, such as photocoagulation, sclerotherapy, ligation (application of latex rings) of hemorrhoids. Their use allows you to achieve a cure in a short time with minimal risk of complications. Abroad, only 25% of patients with hemorrhoids undergo surgical treatment, and 75% undergo minimally invasive treatment of hemorrhoids.

What ointments are most effective for the treatment of hemorrhoids?

Symptoms of hemorrhoids are very diverse, and the applied ointments have a narrowly targeted effect on certain symptoms of hemorrhoids. Therefore, only a proctologist can choose an effective treatment for hemorrhoids. In addition, it has been proven that topical forms of drugs (suppositories and ointments) do not have a therapeutic effect on hemorrhoids, reducing only their manifestations. Therefore, the complex of treatment of hemorrhoids must include tablet forms of venotonic drugs.

Can hemorrhoids turn into cancer?

Hemorrhoids never get angry. However, this does not exclude the simultaneous existence of rectal cancer.

Is it possible to get rid of hemorrhoids without surgery?

You can. Currently, there is a wide arsenal of so-called minimally invasive non-surgical outpatient methods for treating hemorrhoids. Their advantage is simplicity, painlessness and ease of procedures for the patient.The patient remains in the usual rhythm of life. However, their use is most effective in the early stages of hemorrhoids. In advanced cases, an operation is indispensable.

Who is a coloproctologist?

In accordance with the modern nomenclature of medical specialties, the proctologist was renamed as a coloproctologist, since in addition to diseases of the rectum (in Greek – proctos), his competence also began to include diseases of the colon (in Greek – colon).

How often should I see my proctologist?

Naturally, the earlier the patient turns up, the easier and more effective his treatment.In addition, there are formidable diseases of the rectum, outwardly manifesting nothing. Therefore, the optimum for preventive visits to a proctologist is once a year or at least once every five years. For patients over 50 years old, patients whose parents suffered from proctological diseases, it is mandatory to visit a proctologist once a year.

What preparation is required before visiting a proctologist?

If you are concerned about intense pain in the rectum or anus, then preparation before the visit is not required.In other cases, 2 cleansing enemas are required the night before and the morning of the visit. There is an alternative option – micro enema with the ready-to-use Microlax preparation in the morning of the day of the visit. Preparation is necessary for a full examination and, if necessary, rectoscopy – examination of the rectum with an apparatus to a depth of 30 cm.

How necessary and painful is rectoscopy?

The method is absolutely necessary for the majority of proctological patients, for the diagnosis of possible latent diseases of the rectum, the only diagnostic method of which is rectoscopy, which allows you to examine the intestine with the eye and detail the pathological process.The method is painless, moreover, the appearance of pain during the study is an indication to terminate the procedure.

Treatment of hemorrhoids – Prices for procedures and diagnostics in Moscow

Consider the existing methods of treating hemorrhoids, one of the most common diseases of the rectum (according to statistics, about 10% of the adult population of the planet suffers from it).

Today, various hemorrhoid clinics offer more and more innovations. Updates are associated with the fact that, firstly, the classification of the disease has been finally formed.Now hemorrhoids are divided into acute and chronic; the latter is further classified into four stages. The disease in the acute phase is characterized by transience, the occurrence of complications (acute pain, the appearance of blood clots, bleeding). On the contrary, chronic can last for years. At the same time, the symptoms are less vivid, which forces people to come to the clinic when the dropping out nodes can no longer be corrected.

Secondly, new methods of hemorrhoid treatment have appeared in proctology clinics. Non-surgical, minimally invasive methods of therapy are used at a certain stage of the disease, allowing a guaranteed successful result.

In acute hemorrhoids, as well as in the early stages of chronic hemorrhoids, it is advisable to carry out conservative (non-surgical) treatment, including non-drug and medicinal methods. At this stage, the therapeutic course aims to stop the pain syndrome, stop the inflammatory process, restore normal blood circulation and digestion.

Conservative treatment of hemorrhoids is general and local. General treatment involves the use of medications to tone the veins, improve blood flow.For the local treatment of hemorrhoids, various ointments, suppositories, baths are used to relieve symptoms such as itching, pain, and healing cracks. At the same time, special dietary meals are prescribed. The diet of a patient undergoing treatment at the clinic should consist of fresh fruits and vegetables, wholemeal flour products, and bran. Spicy, spicy dishes and alcohol will have to be excluded from the menu. Also, a person is given certain recommendations on the mode of work, rest, nutrition, physical activity.

Minimally invasive (or less traumatic) methods of surgical treatment are used for chronic disease of 1/2/3 stage, in case of improvement in acute hemorrhoids.There are many such methods. Which is best suited for the patient, the doctor chooses individually.

Infrared coagulation. The heat generated by infrared rays removes (coagulates) hemorrhoids. Such treatment in the clinic by infrared coagulation is the most effective technique, characterized by speed, painlessness, and no need for a rehabilitation period. You can return to your usual schedule the next day or after a day.

Ligation (ligation) of knots with latex rings. A special latex ring is placed on the base of the hemorrhoid (leg), causing it to die off (approximately 3 weeks after the medical manipulation). The procedure itself is painless, but the dying off of the node can cause some discomfort, however, this method of treatment does not require any hospitalization or long-term preoperative preparation.

Sclerotherapy. Requires the professionalism of a doctor. A special substance is injected into the base of the node (feeding leg) with a thin needle, which leads to hardening (formation of connective tissue) of the vessel, as a result of which the node decreases, and subsequently completely disappears.

Cryotherapy. The assembly is removed by exposure to low temperature (eg, liquid nitrogen).

Laser therapy. Secures (coagulates) the hemorrhoid in the rectal wall using a laser.

Electrocoagulation. Elimination of hemorrhoids by means of electric current. The method is similar to the procedure and effect of infrared coagulation.

Finally, the third treatment option is classic surgery . It involves excision of the nodes, ligation of their vascular legs.Classic surgery for the treatment of hemorrhoids in the clinic is performed under general anesthesia, regardless of the stage of the disease. After the operation, the patient spends several days in the hospital under the supervision of a surgeon. However, science does not stand still here either.

Recently, hardware methods of hemorrhoidectomy have been used, when with the help of a special device the inner layer of the rectum is simultaneously cut off together with the nodes, and immediately the integrity of the mucous membrane is restored with the help of special clips.The method is convenient for both the doctor and the operating surgeon. It allows you to reduce the time of surgery, the duration of anesthesia. As a result, the period of postoperative rehabilitation is reduced.

Thus, today there are a great variety of methods for treating hemorrhoids. Each of them has strict indications that only a competent doctor can determine. There is only one universal rule: the earlier a disease is diagnosed, the easier it is to cure it.

The best operation is the one that doesn’t need to be done.Therefore, if any alarming symptoms occur, suggesting a rectal disease, it is necessary to urgently consult a doctor for the treatment of hemorrhoids. Clinic “Doctor 2000” invites you for examination at a convenient time for you.

Experienced candidates and doctors of medical sciences are at your service.

Hemorrhoid treatment in Kazan without surgery


You can choose a method of treatment that is comfortable for you:

Traditional Complex

Each appointment of a doctor – proctologist and each procedure are paid separately.

Everything is included: all the necessary procedures, tests, medicines, consultations.

You don’t need to pay anything extra.

Repeated consultation with a proctologist 990 p .

Ligation (sclerosing, coagulation) of one hemorrhoid 5 990 rub.

Everything is included: all the necessary procedures, tests, medicines, consultations.

You don’t need to pay anything extra. The course of treatment for hemorrhoids 1 tbsp. 29 900 RUB

Any convenient payment methods, including installments 0% .

The cost of the course of treatment is determined at the initial examination, after the diagnosis has been established.


5 years for the results of hemorrhoids treatment.

In case of relapse, we treat for free.

Reasons for the development of hemorrhoids

Sedentary work and sedentary lifestyle

Increased physical activity

Pregnancy and childbirth in women

Improper diet and bad habits

Stool disorders (both constipation and diarrhea)

Manifestations of hemorrhoids

It is strongly recommended to consult a coloproctologist if you have the following symptoms:

Pain in the anus during / after a bowel movement or constant.A sharp increase in preexisting pain

Discharge of blood, mucus, or pus from the anus

Prolapse or protrusion of hemorrhoids

Itching and burning, discomfort (often throbbing) in the anus

Hemorrhoid Treatment

Folk remedies, ointments and candles will not help get rid of hemorrhoids. They can only temporarily relieve symptoms.The cause of hemorrhoids – an enlarged hemorrhoid or several nodes – cannot be eliminated in this way. Stool disorders, an error in diet, physical activity will inevitably lead to a new exacerbation, usually more pronounced than the previous one.

The minimally invasive methods of treatment used in our clinic allow us to effectively help our patients without surgery. The treatment does not change your usual lifestyle, does not affect your ability to work, does not require hospitalization and long-term recovery.

Ligation with very strong latex rings (STORZ, Germany)

Infrared coagulation of enlarged nodes (INFRARED, USA)

Sclerotherapy of hemorrhoids

In case of relapse after minimally invasive treatment or in advanced stages of chronic hemorrhoids, when minimally invasive methods are not effective, doctors of the specialized clinic “Golden Glow” can apply classical surgical methods of treating hemorrhoids.After that, for medical reasons, a sick leave will be issued, which will allow you to recover faster after surgical manipulation.

Important information. Classic, surgical methods of hemorrhoid treatment are more laborious and require a longer recovery. However, when using them, relapses occur much less often and a more stable therapeutic effect is achieved.

Preparation for the appointment of a proctologist

In order for the doctor to be able to make a full examination and establish the correct diagnosis, a simple preparation is required:

On the eve and on the day of the visit to the doctor, exclude gas-forming foods (carbonated drinks, legumes, cabbage and fermentation products) from the diet.

No later than two hours before taking, cleanse the intestines with an enema or pharmaceutical preparations designed to cleanse the rectum.

If the condition of the problem area is such that it does not allow a complete cleaning of the intestines (sharp pain, cramps, bleeding), do not try to do it . Try to carry out a bowel movement naturally, perform hygiene procedures with cool water and come to the doctor’s office.After making a preliminary diagnosis, the doctor will try to alleviate your condition and will make a full examination when it will not cause severe pain.

Visit to the doctor

We do our best to make the examination as comfortable as possible:

All manipulations are carried out only after anesthesia (pain relief).

The examination is carried out in disposable shorts, only the problem area remains open.

The doctor will delicately examine the rectum and the adjacent area of ​​the sigmoid colon. The enlarged image will be displayed on the monitor of the video recorder.

After the diagnosis is made, taking into account all comorbidities and conditions, a suitable method of treatment will be proposed, which can be started immediately on the day of treatment.

Doctors of the medical center “GOLDEN LIGHT”

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To make an appointment with a doctor, call +7 (843) 202-10-20 or apply online using the form below.The administrator will contact you from 8.00 to 20.00 and offer a convenient time for you.

Hemorrhoid treatment in Izhevsk prices

At the Doktorius clinic, a comfortable examination and non-surgical treatment can be completed in just 1 visit! Without fear and pain!

In order to know about the state of your body, it would be good to have a clear idea of ​​all its signals. This will help prevent many of the complications of the disease.

For example, about hemorrhoids: what are the causes of its occurrence, what methods it is treated with and whether it is possible to protect oneself from it, because this disease occurs quite often.

People who are familiar with hemorrhoids firsthand also assess it as an unpleasant disease in all respects, which will not “dissolve” by any ointments and suppositories.

No. Procedure name

Cost, rub)

1 Initial doctor’s consultation and examination, incl.h .:

  • digital examination of the rectum;

Hardware diagnostics:

  • anascopy,
  • video rectoromanoscopy,
  • bacterioscopic analysis of the perianal area;
  • Colonoscopy FREE * (March 1-15, 2020).

During treatment, all repeated appointments with a proctologist, complete blood count, hepatitis B and C, blood test for HIV and syphilis, biopsy are FREE.

* When undergoing treatment in the department of proctology.

50% DISCOUNT from 1 to 15
March 2020

2 Initial doctor’s consultation with prescribing treatment for pregnant women


Get rid of hemorrhoids immediately!

The main thing to remember is that a timely visit to a proctologist will allow you to treat quickly and painlessly.As soon as you feel discomfort and other unpleasant and painful sensations in the anus, DO NOT BE HESITATED – this is an extra fear! Make an appointment with a proctologist and treat hemorrhoids without surgery.

How is the examination carried out by the proctologist?

For patients in the medical center “Doctorius” there are comfortable conditions for proctological examination, examination takes place on a couch in a comfortable and comfortable position on the side with the use of an anesthetic gel.

Early non-surgical treatment can be completed in just 1 visit!

Remember that our doctors will help you in difficult moments of illness.For convenience, Doctorius employs male and female proctologists.


  • pain;
  • discharge of blood from the anus;
  • 90,021 prolapse of nodes from the anus or sensation of bumps in the anus;

    90,021 discomfort and burning;

    90,021 itching;

    90,021 flatulence and defecation disorders;

  • oozing and other dirty discharge from the anus;

Contact a proctologist on time and get rid of an unpleasant disease in all manifestations.

Our advantages:

  • Receptions are conducted by experienced proctologists with over 10 years of experience
  • The patient is examined in a comfortable and comfortable position lying on his side wearing a special disposable medical clothing set, using an anesthetic gel to minimize discomfort
  • During the examination, the examination results are transmitted on the monitor for clarity to the patient
  • Thanks to modern minimally invasive techniques, the treatment of hemorrhoids, anal fissures passes without pain, without hospitalization, without interrupting the usual way of life
  • For each patient, the most appropriate method of treatment is selected individually, taking into account the existing diseases
  • Treatment is possible in one day, depending on the stage of the disease
  • Free follow-up appointments for treatment
  • After completed treatment, after half a year consultation is free
  • For convenience, male and female proctologists conduct appointments.


During the initial examination, the doctor-proctologist of the clinic “Doctorius” will listen carefully to you and collect the necessary anamnesis. He will conduct a complete proctological examination: when the patient is placed on a couch in a comfortable and comfortable position on his side, using an anesthetic gel.

The examination includes: palpation of the rectum and instrumental diagnostics – anoscopy and video sigmoidoscopy.

The entire examination takes no more than 40 minutes, after which the doctor makes a diagnosis and selects a comprehensive and effective treatment.

Treatment methods

Hemorrhoids is a disease of the rectum caused by the presence of hemorrhoids. And the task of treatment is to rid a person of hemorrhoids.

Medical Center “Doctorius” provides comprehensive treatment of the disease.

Doctors proctologists “Doctorius” use modern minimally invasive methods of treatment, allowing you to do without surgery and long-term rehabilitation.

The Department of Proctology “Doctorius” has in its arsenal everything necessary for effective treatment, which is safe and comfortable for our patients.

Minimally invasive treatments include:

The required method of treatment is selected by the doctor proctologist based on the stage of the disease and concomitant pathologies in the patient.

We offer gentle treatments for women immediately after childbirth.


The development of hemorrhoidal disease is facilitated by such reasons as:

  • Strong straining during bowel movements;
  • 90,021 hard stools and persistent constipation;

  • frequent diarrhea;
  • 90,021 pregnancy and childbirth;

  • bad habits, alcohol;
  • prolonged sitting position;
  • heavy physical activity, overexertion;
  • unbalanced, unhealthy diet.

After hemorrhoid treatment

Nutrition is of no small importance in rehabilitation after surgery, and is also the prevention of postoperative complications. At the first time after the operation, it is necessary to balance the diet to ensure timely and easy bowel movement.

  • On the first day, it is recommended to take only liquid food for stool retention for 1-2 days.
  • Then you should eat 3-4 times a day, while it is advisable to cook or bake protein foods.It is recommended to eat at least a pound of vegetables and fruits rich in fiber per day. Perfect: lettuce, cabbage, mainly cauliflower, beets, carrots and pumpkin, as well as bananas, apples, plums, apricots, prunes, dried apricots. Spicy foods should be discarded. For constipation, laxatives are recommended.
  • It is necessary to provide the body with a sufficient amount of fluid – at least 2 liters of water per day.
  • Consumption of alcohol is categorically contraindicated.

During the rehabilitation period, it is necessary to take special care of the cleanliness of the perianal area, avoid physical activity, and do not strain during bowel movements.

Hemorrhoids – treatment of hemorrhoids without surgery

If you are faced with with such an unpleasant disease as hemorrhoids or suspect its presence, do not delay a visit to the doctor .

In the proctology department of the Medline Surgut clinic coloproctologists have been successfully treating patients for a long time, and most importantly, they use minimally invasive technologies that make it possible to do without surgery and sick leave .

Treatment takes place quickly, comfortably, without pain or constraint . The entire staff of the clinic is not only professionals in their field, but also tactful, delicate people.

Causes of hemorrhoids:

  • bowel disorders
  • sedentary work and sedentary lifestyle
  • pregnancy and childbirth
  • strenuous physical work or sports involving weight lifting
  • Frequent consumption of spicy food and alcohol
  • inflammatory processes in the pelvic area
  • heredity

Hemorrhoids: symptoms and signs

  • aching pain, pain when defecating, walking or sitting
  • heaviness and discomfort, feeling of a foreign object in the anus
  • itching and burning
  • mucus excretion
  • bloating and rumbling
  • bleeding
  • prolapse of hemorrhoids and the appearance of seals in the anus

Pay attention! It is important to see a doctor on time.The symptoms of hemorrhoids are not always pronounced and sometimes begin with small, subtle signals. Do not wait for obvious signs to appear, consult a proctologist. With self-medication with folk remedies and suppositories, the disease can worsen or go into a chronic stage. Remember that hemorrhoids do not go away on their own, and an advanced disease is much more difficult to treat.

Make an appointment with a proctologist by phone 99-30-30 or online.
In matters of health, there can be no constraints!

How is hemorrhoids treated at Medline Surgut?

To diagnose hemorrhoids at the initial consultation , the proctologist conducts a visual examination, finger examination, anoscopy and sigmoidoscopy (painless instrumental examinations).

It is possible in most cases to start treatment of hemorrhoids at the Medline Surgut clinic already at the first appointment . And in 80% of cases successful cure of is achieved with the help of minimally invasive technologies without pain, surgery and sick leave.

Our proctologists not only use the most modern minimally invasive treatment technologies, but also take a comprehensive approach to solving problem , giving recommendations on changing the diet, daily regimen and eliminating factors affecting the onset of the disease.It is important for us not only to cure , but also to do so, so that the disease does not come back again .

Latex ligation is a method of treating hemorrhoids without surgery.

Latex ligation is a popular European technique for the treatment of hemorrhoids, which has a number of advantages over traditional methods of treatment:

  • does not require long preparation and recovery period
  • performed quickly and painlessly
  • allows to avoid surgery in 80% of cases

How is the latex ligation procedure going?

Latex ligation procedure is performed using an anoscope and a special apparatus – ligator .Before the procedure, a little preparation for cleansing the intestines is required. No anesthesia required, the procedure is quick and painless . Using a vacuum, the ligator sucks in the internal hemorrhoid and puts a latex ring over it. The ring squeezes the connective tissue at the base of the node, depriving the tissue of nutrition. As a result, after a few days the hemorrhoid dies off and is rejected.

Ligation with latex rings is effective at stages 2-3 of the disease.

Infrared coagulation – minimally invasive method for hemorrhoid treatment

Infrared coagulator acts on the leg of the hemorrhoid with an infrared heat wave, “sealing” the vessels. As a rule, it is prescribed at stages 1-2 of the disease, and also gives excellent results in complex treatment in combination with other methods.

Treatment of acute hemorrhoids with drugs

In acute hemorrhoids, the conservative method is preferred.Medicines are also used in complex treatment.