Hemorrhoids: When to See a Specialist and Treatment Options

Have hemorrhoids together?

Hello, doctor.
I was really nervous and shy when you examined me that day.
You recommended that I see a colorectal specialist, but I forgot the details of my condition that you mentioned.
Could you please repeat it? I'm considering whether to visit the colorectal clinic or just use the ointment you prescribed.
My sister is pregnant and has noticed blood when she has a bowel movement.
The gynecologist in Beigang also prescribed her an ointment.
She wants to know if it will gradually go away.
Besides exercising more and drinking water, is there anything else she should pay attention to?

huanzhe, 30~39 year old female. Ask Date: 2012/12/22

Dr. Lin Wenbin reply Obstetrics and Gynecology

First, apply the hemorrhoid ointment prescribed by your doctor, and then return for a follow-up examination.
Drinking plenty of water and taking warm sitz baths can help improve your hemorrhoids.
Detailed discussions about your condition are easier to have during the outpatient visit.

Reply Date: 2012/12/22

More Info

Hemorrhoids, commonly known as piles, are swollen veins in the lower rectum and anus that can cause discomfort, pain, and bleeding. They are a prevalent condition, particularly among pregnant women and individuals who experience chronic constipation or straining during bowel movements. Understanding when to see a specialist and the available treatment options is crucial for effective management.

When to See a Specialist
1. Persistent Symptoms: If you experience ongoing pain, bleeding, or discomfort that does not improve with over-the-counter treatments or lifestyle changes, it is essential to consult a specialist. Persistent bleeding, especially if it is bright red, can indicate more serious conditions that require medical attention.

2. Severe Pain: If the pain becomes unbearable or if you notice a lump around the anus that is painful, it could indicate a thrombosed hemorrhoid, which may require surgical intervention.

3. Changes in Bowel Habits: Any significant changes in your bowel habits, such as diarrhea or constipation, should be evaluated by a healthcare provider to rule out other gastrointestinal issues.

4. Pregnancy-Related Concerns: Pregnant women often experience hemorrhoids due to increased pressure on the pelvic veins. If symptoms worsen or if there is significant bleeding, it is advisable to seek medical advice.

Treatment Options
1. Conservative Management: Many cases of hemorrhoids can be managed with lifestyle changes and over-the-counter treatments. This includes:
- Dietary Changes: Increasing fiber intake through fruits, vegetables, and whole grains can help soften stools and reduce straining.

- Hydration: Drinking plenty of water is crucial to prevent constipation.

- Exercise: Regular physical activity can improve bowel function and reduce pressure on the veins.

2. Topical Treatments: Over-the-counter creams and ointments can provide relief from itching and discomfort. These may contain hydrocortisone or witch hazel, which can help reduce inflammation.

3. Sitz Baths: Soaking the affected area in warm water for 10-15 minutes several times a day can alleviate discomfort and promote healing.

4. Medical Procedures: If conservative measures fail, a specialist may recommend procedures such as:
- Rubber Band Ligation: This involves placing a 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 to shrink it.

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

- Surgery: In severe cases, surgical removal of hemorrhoids (hemorrhoidectomy) may be necessary.

Conclusion
If you are experiencing symptoms of hemorrhoids, it is essential to monitor your condition closely. While many cases can be managed with lifestyle changes and topical treatments, do not hesitate to seek medical advice if symptoms persist or worsen. A specialist, such as a colorectal surgeon, can provide a thorough evaluation and recommend appropriate treatment options tailored to your specific situation.
In the case of your sister, if her symptoms are mild and she has been prescribed a topical treatment, she may find relief with conservative measures. However, if she experiences significant bleeding or pain, it would be wise for her to consult a healthcare provider for further evaluation.

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