Hemorrhoids and Anal Polyps: Your Surgical Options Explained

Internal and external hemorrhoids issues?

Hello Dr.
Ke, I am a patient with internal hemorrhoids who has been using suppositories.
Recently, I noticed a protrusion at the anal opening, and after sitting on the toilet for an extended period one day, I felt a part of the anal area swell (but it subsided shortly after I got up to take a shower).
I quickly went to the hospital for an examination, and the doctor indicated that the protrusion was not an internal hemorrhoid but an anal polyp.
He suggested that I undergo electrosurgical excision of the hemorrhoids along with the removal of the polyp.
However, the thought of being hospitalized for one night and having about two weeks of wound recovery makes me hesitant.
Before deciding on surgery, I would like to ask Dr.
Ke for his opinion on the following:
1.
If I choose to leave the polyp untreated, can I still undergo rubber band ligation for the internal hemorrhoids without needing to be hospitalized?
2.
Is the swelling at the anal opening after sitting on the toilet for too long a symptom of internal hemorrhoids pressing against the anus, as I suspect?
3.
The instructions for the suppository I am using, Yizhi Kang, state that if used continuously for six to eight weeks, it can reduce the hemorrhoids to just a layer of thick skin.
Is this information accurate?
I apologize for having so many questions, and I appreciate Dr.
Ke taking the time to respond.

Hemorrhoid Buddy, 20~29 year old female. Ask Date: 2016/10/02

Dr. Ke Fangxu reply Surgery

1.
If only anal polyps are being treated, local anesthesia is sufficient; however, if hemorrhoids need to be excised as well, hospitalization and discomfort are unavoidable.

2.
Yes, it is possible.

3.
Yes, therefore it is recommended to resolve bowel movements quickly; prolonged sitting will only lead to swelling and discomfort of the hemorrhoids.

4.
The effectiveness of topical ointments and suppositories is limited; they generally cannot achieve complete resolution of hemorrhoidal tissue.
To alleviate the symptoms of internal hemorrhoids, it is essential to focus on improving dietary habits and lifestyle.

Reply Date: 2016/10/02

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding hemorrhoids and anal polyps. It’s understandable to feel apprehensive about surgery, especially when it involves sensitive areas like the anal region. Let’s address your questions one by one.

1. Can I leave the polyp untreated and still use rubber band ligation for the hemorrhoids without hospitalization?
While rubber band ligation is a common and effective treatment for internal hemorrhoids, it is important to consider the presence of the anal polyp. If the polyp is left untreated, it may continue to grow or cause other complications. Rubber band ligation can be performed in an outpatient setting, meaning you wouldn’t need to stay overnight in the hospital. However, if the polyp is significant or symptomatic, it may be advisable to have it removed during the same procedure to avoid future issues. It’s essential to have a thorough discussion with your physician about the risks and benefits of treating both conditions simultaneously.

2. Is the swelling I experienced after sitting on the toilet for too long a symptom of internal hemorrhoids?
The swelling you noticed could indeed be related to internal hemorrhoids. When you sit for prolonged periods, increased pressure can lead to swelling or engorgement of the blood vessels in the anal area, which may cause temporary bulging. This is often a symptom of hemorrhoids, but it could also be related to other conditions, such as the polyp you mentioned. If the swelling subsides quickly after standing, it may indicate that it is related to the increased pressure from sitting. However, it’s crucial to have a healthcare provider evaluate any new or persistent symptoms to rule out other potential issues.

3. Is it true that using the medication I have can shrink hemorrhoids to just a layer of skin after six to eight weeks?
The claim that a topical medication can shrink hemorrhoids to just a layer of skin is somewhat optimistic. While certain medications, including topical treatments, can help reduce inflammation and alleviate symptoms associated with hemorrhoids, they may not completely eliminate them. The effectiveness of such treatments can vary from person to person. It’s important to follow the instructions provided with your medication and to monitor your symptoms. If you do not see improvement after the recommended duration, or if your symptoms worsen, it would be wise to consult your physician for further evaluation and potential alternative treatments.

In conclusion, while it’s understandable to be hesitant about surgery, it’s important to weigh the risks and benefits of leaving the polyp untreated versus having it removed. Discussing your options with your healthcare provider can help you make an informed decision that aligns with your health needs and concerns. Additionally, managing your hemorrhoids effectively is crucial to prevent further complications.
If you have any more questions or need further clarification, please don’t hesitate to reach out. Your health and comfort are of utmost importance.

Best regards,
Dr. Ko

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