Hemorrhoids

Hemorrhoids are very common. As a reminder, initial steps for patients with hemorrhoid flare-ups (swelling, discomfort, bleeding) are:

1. Avoid constipation — prunes, miralax, other laxatives prn. 
2. Sitz baths tid. 
3. Preparation H or hydrocortisone suppositories (remember it’s ideal to not continue this past 1-2 weeks of treatment). 
4. Aloe wipes, tucks pads. 
5. Lidocaine ointment is an option.

If hemorrhoids are more complicated or persistent, they do warrant evaluation by surgeons with expertise in hemorrhoidal disease. We offer the full spectrum of treatments such as banding, Hemwell, and surgery. We can also do these at the time of colonoscopy as it is important to rule out colonic sources of bleeding such as cancers. Hemorrhoid emergencies are rare, but it is good to remember strangulated hemorrhoids are incarcerated prolapsed hemorrhoids with the appearance of ischemia — these are very painful, tender, and need urgent operation and antibiotics.