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What doctor do you go to for hemorrhoids: Hemorrhoids – Diagnosis and treatment

4 Signs Your Hemorrhoids Warrant a Doctor’s Visit

Hemorrhoids are fairly common, especially among people ages 45 to 75. And most hemorrhoid symptoms, such as mild itching or mild pain, can usually be treated at home with over-the-counter remedies.

But there are times when a trip to the doctor is warranted — and many people do seek medical help, whether for more specific medication or, in some cases, simple hemorrhoid surgery. According to the latest statistics for digestive diseases from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), 1.1 million people received outpatient care for hemorrhoids in 2009, and 266,000 people were hospitalized for treatment in 2010. While severe complications of hemorrhoids are quite rare, it’s important to know when to see your doctor.

“Anytime you have bleeding, feel a lump in the anus, or have rectal pain, you should see a doctor to make sure you don’t have a more serious cause of the symptoms,” says Aline J. Charabaty-Pishvaian, MD, associate professor of medicine and director of the center for inflammatory bowel disease at MedStar Georgetown University Hospital in Washington, DC.

Even a less serious situation can prompt a call to your doctor. If you’ve been trying to treat hemorrhoids on your own, for instance, yet the hemorrhoid symptoms linger, a doctor visit makes sense.

“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.


How to Soar to Self-Care in 2020

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

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Hemorrhoid Symptoms and Diagnosis: Internal and External Hemorrhoids

Hemorrhoids occur when veins in the skin around the anus or in the lower rectum get swollen and inflamed. It’s not exactly clear what causes people to get hemorrhoids, but there are some common, accepted risk factors and conditions that lead to their development.

Aging can decrease muscle tone in the area, weakening the tissue and causing hemorrhoids to bulge, while obesity and pregnancy can increase the risk for hemorrhoids due to increased pressure on tissue in the area. (1)

Repeated straining to make a bowel movement, as well as constipation, are also associated with hemorrhoids.

Hemorrhoids are generally not dangerous or life-threatening, but they may be painful.

Common Hemorrhoid Symptoms to Watch For

The following signs and symptoms may indicate hemorrhoids:

  • Bright red blood on toilet paper, in stool, or in the toilet bowl after a bowel movement
  • Anal itching
  • Pain around the anus, especially while sitting
  • Pain during bowel movements
  • One or more hard, painful lumps around the anus

If you have any symptoms of hemorrhoids, try to avoid excessive straining, rubbing, or cleaning around the anus.

Doing these things can make any irritation and itching worse, and can sometimes lead to bleeding.

Internal Hemorrhoids vs. External Hemorrhoids

There are two main types of hemorrhoids:

Internal Hemorrhoids These hemorrhoids develop inside the lower rectum. Internal hemorrhoids usually don’t hurt, but they often bleed painlessly, resulting in bright red blood you might notice when you go to the bathroom and wipe.

Most of the time, internal hemorrhoids are not visible to the naked eye. But in some cases, internal hemorrhoids may protrude through the anus, which is known as becoming prolapsed. When this happens, they will usually shrink back inside the rectum on their own. Protruding hemorrhoids can become irritated and itchy, and patients may find it difficult to clean themselves after a bowel movement.

Internal hemorrhoids are categorized by how prolapsed they are, which helps determine how they should be treated.

Grade 1 hemorrhoids means there is no prolapse. A prolapse that goes back in by itself is categorized as grade 2. Prolapse that needs to be pushed back in by the patient is considered grade 3. Grade 4 is when the prolapse can’t be pushed back in. (2)

External Hemorrhoids These hemorrhoids develop under the skin around the outside of the anus. They can be itchy or painful, and may feel lumpy.

External hemorrhoids are called thrombosed hemorrhoids when a blood clot develops within the hemorrhoid. The increased pressure can be very painful, especially within the first 48 hours after it develops. (1)

Thrombosed hemorrhoids tend to be bluish in color due to the clot. Sometimes the blood clot will go away on its own, but because the clot has stretched the skin, it may result in an anal skin tag — excess skin left when the blood clot in a thrombosed hemorrhoid is absorbed by the body. Skin tags do not require removal, but if it’s particularly bothersome to a patient, excision is an option. (1)

If a thrombosed hemorrhoid has been present for longer than two days, the pain has often peaked and you might try home treatments while waiting for the clot to clear up on its own. When the clot first forms, it can be very painful; if you make it to your doctor’s office during this time, an in-office surgical procedure, involving local anesthesia and excision of the hemorrhoidal tissue, may be available. (2)

RELATED: 8 Myths You’ve Been Told About Hemorrhoids

How Hemorrhoids Are Diagnosed by Your Doctor

See your doctor if you think you might have hemorrhoids, especially if you notice bleeding from your anus or rectum, or have bloody stools. Your doctor will want to rule out more serious problems that can cause bleeding from the anus or rectum, such as cancer.

Hemorrhoid symptoms may also be similar to those of other anal and rectal problems, including anal fissures, abscesses, warts, and polyps.

Your doctor will ask about your medical history and will ask you to describe your symptoms. Questions about your eating habits, toilet habits, and enema and laxative use are likely to come up. (3)

Your doctor will also perform a physical exam to look for lumps or swelling, prolapsed internal hemorrhoids, external hemorrhoids, skin irritation, skin tags, and anal fissures, which are small tears in the anus that can result in itching and bleeding. (3) This will involve a visual examination of the area.

Your doctor may also perform a rectal exam to diagnose internal hemorrhoids, check the muscle tone of your anus, and check for blood in the stool. This is done with a gloved, lubricated finger (called a digital rectal examination) and a tool called an anoscope.

An anoscope is a type of endoscope — a hollow, lighted tube that is inserted a few inches into the anus to help the doctor see any problems inside the lining of the rectum. This procedure is performed in the doctor’s office and doesn’t require anesthesia. (3)

Your doctor may also recommend additional tests to rule out other causes of bleeding, especially if you are over age 40.

These tests may include:

Colonoscopy After you’re sedated with medicine, your doctor uses a thin, flexible tube called a colonoscope to look at the inner lining of your colon.

A colonoscopy can help discover ulcers, polyps, tumors, and other areas of inflammation or bleeding.

Sigmoidoscopy This procedure is similar to a colonoscopy, but it uses a shorter tube called a sigmoidoscope to examine the lining of the rectum and the sigmoid colon (the lower part of the colon).

Barium Enema X-ray This is a special type of X-ray of the colon and rectum in which your doctor inserts a liquid solution containing barium sulfate into the rectum. The solution helps highlight specific areas in the colon for your doctor to examine in the X-ray images.

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Additional reporting by Deborah Shapiro.

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If you have hemorrhoids which doctor will help you?

/ Home / Articles / First aid for hemorrhoids

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 you need to book a consultation with. However, this is wrong behavior: if hemorrhoids are not treated, they become chronic. The exacerbation of the disease is caused by the transfer of heavy objects, the period of pregnancy, and malnutrition. If you do not treat hemorrhoids, then you will have to eliminate the problem 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 is a pathology of the lowest part of digestion – the rectum. Proctologists are engaged in the diagnosis and treatment of this part of the body. According to the modern classification of specialties – coloproctologist. These specialists deal with all problems that are associated with the colon, anus and perineum. Hemorrhoids are diagnosed by an increase in nodes, they will be detected by a gynecologist who performs a routine examination of women and a urologist when examining men. Also, the young men can be informed about the first signs of the disease by a surgeon who examines them as part of a medical examination at the military registration and enlistment office. If symptoms are detected, then the patient is referred to a narrower specialist – a coloproctologist, they explain that a professional approach is important in treating the disease.

Most district-level hospitals have a proctologist on staff. If not, then you can make an appointment with a surgeon, since proctology is one of the areas of surgery, so such a doctor has a sufficient knowledge base and practice in this area. The surgeon in the district hospital (polyclinic) conducts an outpatient appointment free of charge. In addition, you can contact a private medical clinic, there are enough coloproctologists in such institutions. To get to a good specialist, you should ask if the clinic has a 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 in terms of finances, but also for proper preparation for the study.

In the case when there is bleeding from the anus, the pain is very strong, then you need to call an ambulance. Such a complication can be caused by infringement of the node or thrombosis. If medical care is not provided in time, this 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 matches the law. Previously, doctors who treated hemorrhoids were called “proctologists”. Since 2014 they have been referred to as “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 is engaged in 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 topical use, paints a diet that must be followed. Doctors of this specialization usually work in polyclinics, conduct outpatient appointments.

A coloproctologist-surgeon is a doctor who is consulted in cases where treatment with various home methods has not yielded results, hemorrhoids have entered an advanced stage, complications have appeared (a crack in 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 treatment method. At the appointment, the doctor finds out how long ago the signs of the disease appeared, what provoked it and led to an exacerbation. At the consultation, the specialist necessarily examines the anus, performs palpation of the lower rectum, performs anoscopy, sigmoidoscopy. If there is a need, then such studies as irrigoscopy or colonoscopy are additionally assigned.

Based on the study, complaints and analyzes, an individual treatment regimen for the patient is selected, taking into account the age and presence of other diseases. The therapeutic process and its effectiveness are monitored. For stages I-III of the disease, treatment is carried out with the help of minisurgery (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 result of treatment. To do this, the doctor explains to the patient the features of nutrition, hygiene, regimen.

Duties of a coloproctologist

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

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

  • hemorrhoids with complications;
  • rectal fissures;
  • intestinal polyps;
  • paraproctitis;
  • cysts and tumors.

The task of the doctor is to choose an effective method of treatment, taking into account the results of the diagnosis 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 the prediction of the development of the disease. The coloproctologist explains to the patient the methods of preparing for surgery, removes structures, eliminates cracks, and restores the functionality of the intestine. After the operation, a diet, dressings, local procedures, and medications are prescribed.

The duties of a doctor of this specialization, in addition to receiving patients, include maintaining documentation, analyzing the effectiveness of their work, and improving their qualifications every 5 years. During retraining courses, the doctor gains knowledge about new therapeutic achievements 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, because you need to carefully prepare for the examination. Before taking it is desirable to perform a bowel cleansing.

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

  • milk;
  • legumes;
  • all types of cabbage;
  • fatty fish and meat dishes;
  • sweet products;
  • sparkling 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, Microlax microclysters, are suitable. They provide bowel cleansing in 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 carefully. The palpation procedure is quite unpleasant, but for the most part it does not cause pain. If there is a hemorrhoidal blackened 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 life and work of a person due to such signs:

  • pain during defecation;
  • bleeding;
  • itching, erosion, irritation, weeping skin around the anus;
  • sensation as if there is something foreign in the anal canal.

If you do not start treating hemorrhoids, then this leads to the appearance of cracks and ruptures, inflammatory processes. Due to stagnation of blood, blood clots are formed, which worsen the nutrition of tissues, lead to necrosis. This provokes severe pain and general intoxication. If the thrombus is not removed in time along with the node, then bleeding occurs. It is joined by a bacterial infection that passes to the tissues of the rectum. This is fraught with sepsis, damage to neighboring organs.

Due to the shyness in the diagnosis and treatment, hemorrhoids quickly become neglected with complications. The longer you do not seek medical help, the more difficult it is to treat the disease, the risk of complications increases, 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 stage 4.

September 22, 2020

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90,000 which doctor to contact. Expert advice.

Each disease has its own symptoms and causes. Naturally, you can not do without a doctor who is engaged in the prevention of the disease and its treatment. Which specialist should I contact if hemorrhoids appear?

Proctologist deals with all problems related to disorders in the rectum. If symptoms of the disease occur, he conducts the necessary studies and then prescribes the appropriate treatment. Fortunately, this disease does not always require surgical intervention, especially if it is detected in the early stages of development.

What are hemorrhoids?

Hemorrhoids are inflammation and swelling of the veins in the lower rectum and anus. This is due to circulatory disorders or other adverse factors. Sometimes the walls of these blood vessels stretch so much that the veins swell, especially during the process of defecation. About half of adults have experienced symptoms of hemorrhoids at least once by their 50th birthday.

Hemorrhoids are divided into internal and external. Internal hemorrhoids develop inside the rectum, or directly near the anus. External hemorrhoids develop outside the anus. The most frequent and unpleasant is the external process due to severe pain and difficulty in sitting. Most types of hemorrhoids are fairly easy to treat. Meanwhile, it is considered one of the most common causes of rectal bleeding.

What are the symptoms of hemorrhoids?

Depending on the type of hemorrhoids, they can cause different symptoms. Some of them are pronounced, others are hard to notice right away. For example, internal hemorrhoids are so deep inside the rectum that you usually cannot see or feel them. It does not cause pain because there are few nerve endings inside the rectum. Symptoms of internal hemorrhoids include:

  • blood on feces, on toilet paper after wiping, or in the toilet bowl;
  • soft tissue protruding beyond the anus (prolapse).

It can cause pain and discomfort when you have a bowel movement. You may see prolapsed hemorrhoids as moist bumps that are pinker than the surrounding area. They usually return inside the rectum on their own. Even if they don’t, they can often be neatly put back into place.
External hemorrhoids are located under the skin around the anus, where there are many more nerves that are sensitive to pain. Because of this, it is easier to detect, and the symptoms of external hemorrhoids are more serious and bothersome. You will feel obvious discomfort when sitting and lying down, and you will also be more sensitive to any touch to the affected area. Symptoms of external hemorrhoids include:

  • bleeding
  • itching
  • swelling

A blood clot inside an inflamed vein can turn external hemorrhoids into a thrombosed form. Usually the color of the veins around the anus turns purple or blue, a serious inflammatory process occurs. This is called thrombosis or thrombosed hemorrhoids. You may notice symptoms such as:

  • severe pain
  • constant itching
  • bleeding

Although hemorrhoids are quite painful, they are not life-threatening and often go away on their own without treatment. The exception is thrombosis during inflammation, which can lead to blockage of the veins and the occurrence of anal bleeding. If the disease appears frequently, you may develop symptoms of anemia, such as weakness and pale skin due to blood loss. Be careful and always see a doctor if you experience severe discomfort, pain, or excessive bleeding.

What causes hemorrhoids?

Hemorrhoids are not only acquired problems with veins, but also bad heredity. You can improve your position if you moderate heavy lifting, watch your diet and physical activity. A sedentary lifestyle, snacking on sandwiches and not having enough liquids in the diet is harmful to the body. Mindfulness of your body will give you long-term health and can prevent the risk of relapse.

Obese people with thrombosis or varicose veins are at increased risk. You fall into this group during pregnancy, as during this period our organs and systems malfunction. The enlargement of the uterus does not contribute to the health of the colon, as it presses on it, as a result of which the intestines swell slightly. To prevent this, it is important to constantly monitor your diet and catch the slightest discomfort during bowel movements.

Contrary to popular belief, hemorrhoids do not arise from constant sitting, but from a standing lifestyle. When you stand, the muscles tense up too much and, without the opportunity to relax, can provoke inflammatory processes. Anal intercourse can provoke the development of hemorrhoids. Be attentive and careful, and if you feel discomfort, it is better to stop any interaction.

Hemorrhoids can be passed genetically from parent to child. If any of your relatives have vein problems or had hemorrhoids, you are at increased risk. True, this does not mean that the disease will manifest itself in you without fail, some may not experience any problems in their entire lives.

How are hemorrhoids diagnosed?

Diagnosis of hemorrhoids usually does not cause many problems. An experienced specialist can identify the disease in you just by conducting a visual examination. If it seems to him that the problem may be more serious and a simple examination is not enough, the doctor may palpate your colon by inserting a finger into the anus. This procedure is not too painful, but it helps to determine at what stage the inflammatory process inside the intestine is now.

In addition, sigmoidoscopy may be prescribed. It is needed for a detailed examination of your anus for damage or the presence of blood clots in the hemorrhoids. For this procedure, a very small fiber optic camera is placed inside the intestine. With it, the doctor can see the full scale of the problem and, if necessary, adjust the treatment.

What are the treatment options for hemorrhoids?

Hemorrhoids can be treated at home or in the doctor’s office. Often simple cases are treated at home by relieving pain and relieving inflammation. To alleviate the pain syndrome, warm baths are recommended in the evenings. The water should not be hot, somewhere around 40 degrees. It is recommended to take a bath for 10-15 minutes, you can add natural herbs to it, such as chamomile and calendula. Using a cold compress can also help reduce swelling in hemorrhoids.

Suppositories, ointments and creams based on plant extracts and medicines help relieve pain and reduce inflammation. A variety of candles for the treatment of hemorrhoids can be found in all pharmacies and online stores. They are convenient to use, so you can remove the first symptoms even while sitting at work.

Another long-term remedy for the prevention and treatment of hemorrhoids can be foods rich in fiber. You can use it in its pure form in order to improve digestion and facilitate the process of defecation. One of the most common dietary supplements is psyllium.

If prone to hemorrhoids, observe special hygiene rules. Washing your anus daily with warm water without the use of soap or other harsh parabens will help. Also, avoid using dry or rough toilet paper after a bowel movement, prefer cleansing or soft paper tissues.

Medical intervention

In case of advanced hemorrhoids or frequent recurrences that can lead to heavy bleeding, the doctor may recommend surgery. One of the procedures for the treatment of hemorrhoids is the ligation of inflamed nodes and deprivation of their blood circulation. Swelling and inflammation gradually subsides, and you return to normal faster. This procedure should be performed only by a qualified medical professional, so as not to cause even more harm to the body.

There are several other techniques for treating hemorrhoids, such as hemorrhoidectomy. For some of them, surgical intervention is performed with a scalpel, for others – with a laser or ultrasound. When removing the tissue of hemorrhoids, the supply vessels are either cauterized or sutured. This helps to eliminate the symptoms of the disease and prevent future recurrences. The procedure is performed under epidural anesthesia, which makes it as painless as possible.

Hemorrhoid Prevention

To prevent hemorrhoids from getting worse, try the following tips:

  1. Eat more fiber. This helps food pass through your body more easily. A good way to get it is to include plant foods in your diet: vegetables, fruits, whole grains, nuts, seeds, and legumes. Try to get 20 to 35 grams of dietary fiber per day.
  2. Use fiber supplements. Over-the-counter supplements can help soften stools if you don’t get enough fiber from food. Start with a small amount and gradually increase the dosage until the desired effect is achieved.
  3. Drink water. This may seem like very simple advice to you, but drinking enough water will help you avoid hard stools and constipation. You will be less tense during a bowel movement and will not provoke inflammation in the anus.
  4. Exercise. Physical activity, such as walking for half an hour every day, keeps your cardiovascular and digestive systems working.
  5. Don’t wait too long. Doctors recommend using the toilet as soon as you feel the urge. Too long retention of feces can adversely affect the condition of the anus and colon.