If you have bleeding from your anal area that is continuous and literally will not stop then you need to seek immediate medical advice. In contrast the normal problem with a hemorrhoid that won’t stop bleeding is that blood flows each time you pass a motion, scratch it, or even, from time-to-time, for no obvious reason at all. Note that though often described as swollen veins hemorrhoids are not actually veins at all. In fact, the blood is arterial and this is the reason the blood involved is so bright red.
In another article How to Naturally Treat Bleeding Hemorrhoids we look at conservative ways of treating bleeding hemorrhoids including dietary and life style factors along with natural products that reduce inflammation and bleeding. These treatments work in many if not most cases. However, occasionally the state of the hemorrhoid goes beyond the point that the more conservative and natural treatments, or even the use of strong medically prescribed hydrocortisone creams, are effective. Use of the latter must be only short-term due to potentially serious side effects.
There are sometimes alternative approaches to surgery though. In her ground-breaking book Hemorrhoid No More Jessica Wright explains how she had persistently bleeding and serious hemorrhoids with intensely embarrassing consequences. After unsuccessfully undergoing surgery (a Stapled Hemorrhoidopexy) she ultimately used a diet based holistic method to bring long-term relief.
This demonstrates the potential power of dietary and lifestyle changes to provide relief in some resistant cases where surgery may seem the only way forward. In some other cases particularly when the hemorrhoid reaches stage III or IV there may be highly specific physical reasons why surgery is essential. Let’s next consider some of the implications of when things get to this stage and what you should expect.
As first step when your physician refers you to a surgeon they will need to confirm that the problem really is hemorrhoids and not something else as many other diseases of the rectum have quite similar symptoms such as anal fissures and abscesses. To do this the specialist will examine your anus both outside and inside while you adopt a prone position on a specially equipped proctology table.
Following this an instrument called a flexible sigmoidoscope, which is a flexible tube with a light allows a view of the inside your rectum and colon, will be inserted. This procedure is painless and can detect inflamed tissue as well as problems such as ulcers, polyps, and abnormal growth. This may be an unenticing prospect but will be all in a day’s work for the man or women examining you.
Depending on the results of the investigations and the severity and character of the hemorrhoid there are a number of surgical treatments available to the surgeon. The most common of the by far is the Elastic Band Ligation (EBL). This is one of the considered a simple, safe and quick to perform procedure which is not as invasive as most other methods. This involves an elastic band tied around the hemorrhoid using a special device called a rubber band ligator. This starves it of blood and after seven to ten days it falls off leaving a small ulcer that heals naturally. If you have several hemorrhoids the surgeon may carry out the procedure during a single session while others prefer to ligate them individually over the course of a number of weeks.
This simple operation has an excellent chance of success with up to up to 85% of patients finding that their symptoms are relieved. After a few years some patients find their symptoms return though repeat of the procedure is normally successful in this case. Few patients (<5%) require a more invasive treatment such as a hemorrhoidectomy following rubber band ligation.
There are some other ways of achieving a similar effect including injecting chemicals into the hemorrhoid and electro-coagulation. The first of these methods tends to be painful and second time-consuming and they are less often used. Some surgeons also use lasers but the equipment is expensive and does not necessarily offer advantages over other methods. In some more serious cases a more conventional hemorrhoidectomy may be required in which the hemorrhoid removed by surgical incision. This is a more major procedure with greater associated pain than those described above but has a good chance of curing the problem permanently.
A Stapled Hemorrhoidoplexy is a relatively new procedure used to staple a prolapsed hemorrhoid back in position. This requires a very experienced surgeon but is quick and with very little pain. A specially developed stapling gun is used and it is sometimes possible to carry it out under a local anesthetic. The technique is not widely available.
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