Managing Painful Bowel Movements: Non-Surgical Options for Hemorrhoids

Pain during bowel movements?

Hello, Doctor: Since I gave birth on July 30, 1989, my pre-existing hemorrhoids have become more painful, making it extremely difficult to use the restroom.
I would like to seek treatment.
Aside from surgery, are there any other less painful procedures available, such as laser therapy or electrotherapy? If so, which hospital can I go to for the procedure?

Xiao Qiao, 20~29 year old female. Ask Date: 2000/11/16

Dr. Wang Qichao reply Surgery

First, it is important to determine what your issue is.
Hemorrhoids typically cause pain only when there is thrombosis or ulceration; otherwise, the pain may be due to other causes such as perianal infectious diseases, anal fissures, or even tumors.
Distinguishing between these conditions is usually not difficult, and you can consult a colorectal surgeon for an examination.
If it is indeed hemorrhoids as you mentioned, surgical intervention is usually the definitive treatment.
Laser surgery does not significantly reduce pain, and electrotherapy is used for tumor treatment, not within the scope of hemorrhoid management.

Reply Date: 2000/11/16

More Info

Managing painful bowel movements, particularly in the context of hemorrhoids, can be a challenging experience for many individuals. Hemorrhoids, which are swollen veins in the lower rectum and anus, can cause significant discomfort, especially during bowel movements. While surgical options are available, there are also several non-surgical treatments that can help alleviate pain and manage symptoms effectively.

Firstly, it’s important to understand that hemorrhoids can be classified into two types: internal and external. Internal hemorrhoids are located inside the rectum and are usually not visible, while external hemorrhoids are located under the skin around the anus and can be painful, especially when thrombosed (clotted). The pain associated with bowel movements often arises from the irritation and inflammation of these hemorrhoids.

Non-Surgical Treatment Options
1. Dietary Changes: One of the most effective ways to manage hemorrhoids is through dietary modifications. Increasing fiber intake can help soften stools and reduce straining during bowel movements. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Additionally, staying well-hydrated by drinking plenty of water can also aid in preventing constipation.

2. Topical Treatments: Over-the-counter creams and ointments can provide temporary relief from the pain and itching associated with hemorrhoids. These products often contain ingredients like hydrocortisone or witch hazel, which can help reduce inflammation and soothe the area.

3. Sitz Baths: Soaking in warm water for about 15-20 minutes several times a day can help relieve discomfort. This practice can promote blood flow to the area and help reduce swelling.

4. Pain Relief Medications: Non-prescription pain relievers such as acetaminophen or ibuprofen can help alleviate pain associated with bowel movements. However, it’s essential to follow the recommended dosages and consult with a healthcare provider if you have any underlying health conditions.

5. Minimally Invasive Procedures: If conservative measures fail to provide relief, there are several minimally invasive procedures that can be considered:
- Rubber Band Ligation: This procedure involves placing a small rubber band around the base of the hemorrhoid to cut off its blood supply, causing it to shrink and fall off.

- Sclerotherapy: A chemical solution is injected into the hemorrhoid tissue, causing it to shrink.

- Infrared Coagulation: This technique uses infrared light to coagulate the blood vessels supplying the hemorrhoid, leading to its shrinkage.

6. Laser Treatment: Laser therapy is another option that can be less painful than traditional surgery. It involves using a focused beam of light to remove or shrink hemorrhoidal tissue. This method is often associated with less bleeding and a quicker recovery time.

When to Consider Surgery
If non-surgical treatments do not provide adequate relief, surgical options may be necessary. Surgical procedures for hemorrhoids include hemorrhoidectomy (removal of hemorrhoids) and stapled hemorrhoidopexy (stapling the hemorrhoids back into place). These procedures are typically reserved for severe cases or when other treatments have failed.

Finding the Right Care
To explore these options, it is advisable to consult with a gastroenterologist or a colorectal surgeon. They can provide a thorough evaluation and recommend the most appropriate treatment based on the severity of your condition and your overall health. Many hospitals and clinics offer specialized services for the treatment of hemorrhoids, so it’s worth researching local facilities or asking for referrals from your primary care physician.

In conclusion, managing painful bowel movements due to hemorrhoids can often be achieved through non-surgical means. By making dietary changes, utilizing topical treatments, and considering minimally invasive procedures, many individuals can find relief without the need for surgery. However, it’s essential to consult with a healthcare professional to determine the best approach for your specific situation.

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