Hemorrhoids

Hemorrhoids are swollen and dilated veins in the anus and lower rectum similar to varicose veins. The most common cause of hemorrhoids is chronic constipation or occupations that involve standing for long periods of time. When the dilated veins are present in the lower rectum they are called internal hemorrhoids and when they are present outside and around the anus they are called external hemorrhoids. Hemorrhoids commonly present with painless rectal bleeding, chronic itching and irritation in the perianal region and sometimes with incontinence. Treatment of hemorrhoids depends upon the grade of the hemorrhoids. Early grade 1 and grade 2 hemorrhoids can be managed by dietary modifications, avoiding constipation and local application of creams or gels to prevent irritation and decreased swelling. More advanced grade 3 and prolapsed grade 4 hemorrhoids may need operative intervention in the form of hemorrhoidectomies.

Dr. Raghavan specializes in open hemorrhoidectomies for symptomatic grade 3 and 4 hemorrhoids whereby the entire column is excised under general anesthesia. Although it is a painful procedure the chance of recurrence is much less common and patients experience a significant improvement in symptoms within 2 weeks after surgery. Strongly recommended is the use of Sitz baths in the postoperative period to decrease swelling and enhance healing. Early symptomatic grade 1 and grade 2 hemorrhoids can also be treated by a less invasive procedure called banding that can be done in an office setting with minimal to mild discomfort.