Hemorrhoids

WHAT YOU SHOULD KNOW:

Hemorrhoids are swollen blood vessels inside your rectum (internal hemorrhoids) or on your anus (external hemorrhoids). Sometimes a hemorrhoid may prolapse, which means it extends out of your anus. Signs and symptoms may include anal bleeding, pain, bulging tissue, inflammation, discharge, and itching.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Treatment for hemorrhoids may cause pain, infection, or incontinence (not able to control your urine or bowel movements). After a rubber band ligation, the band may slip out or cause a tear in skin tissue. Surgery may cause scarring or cause damage to the tissue in your anus or rectum. Sclerotherapy may cause liver problems. It may also make it hard for some men to have an erection. With all of these treatments, you may have bleeding that is hard to stop. Without treatment, your hemorrhoids may become bigger, more painful, or develop a blood clot.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Medicines:

You may be given the following medicines:

• Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.
  
  
• Hemorrhoid topical medicine: Topical medicine is medicine you apply on your skin. This may come as pads, creams, ointments, or lotions. This medicine may help decrease pain and swelling. It may also help prevent infection. Sometimes, this medicine may contain steroids. Steroids decrease swelling but can weaken the skin around your anus. Ask your caregiver how long you should use medicine with steroids.
  
  
• Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
  
  
  • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
    
    
  • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
  
  
• Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.

Tests:

You may have tests to help diagnose hemorrhoids and rule out other causes of anal bleeding, like cancer.

• Anorectal manometry: This test helps caregivers see if there are problems with how your anus and rectum are working. A small, flexible tube is put inside your anus into your rectum to check its pressure. Lubrication is put on the tube to make it easier to insert. This tool is used to see if there are problems with the muscles controlling your bowel movements.
  
  
• Anoscopy: This test lets caregivers look inside your anus and rectum. The anus is the opening where BM is passed from your body. The rectum is the last part of the intestine (bowel). During an anoscopy, a clear jelly-like lotion is put onto a short plastic or metal tube. The tube is then gently pushed into your anus and up the rectum. Your caregiver can also take samples of BM to be sent to a lab for tests. This may help caregivers find the cause of your problem.
  
  
• Barium enema: A barium enema is an x-ray of the colon. A tube is put into your anus, and a liquid called barium is put through the tube. Barium is used so that caregivers can see your colon better on the x-ray film.
  
  
• Colonoscopy: A colonoscopy is a test that is done to look at your colon. A tube with a light on the end will be put into your anus, and then moved forward into your colon.
  
  
• Endorectal ultrasound: This test uses sound waves to show pictures of the inside of your rectum. A small tube is placed into your rectum and pictures are seen on a monitor.
  
  
• Sigmoidoscopy: A sigmoidoscopy test looks for changes in your intestinal (bowel) wall that may be caused by a disease or condition. This test may also help find the cause of bleeding or pain. A long, thin tube with a tiny camera on the end is put through your anus into your rectum (rear-end). It also goes to the part of your intestine called the sigmoid. Caregivers will look for problems in your rectum and lower colon. A small amount of tissue may be taken from the intestine wall and sent for tests. Follow your caregiver's instructions for what to do before, during and after the test.

Treatment options:

Your caregiver may decide you need an office procedure to treat your hemorrhoids. These procedures may cause the hemorrhoids to shrink or to break off from the rectal wall entirely. For some procedures, your caregiver may use lubrication to insert a thin tube into your rectum. If your hemorrhoids are large, or do not get better with other treatments, you may need other surgery. Ask your caregiver for more information about different kinds of treatments.

• Outpatient surgery:
  
  
  • Photocoagulation: This procedure uses special light to help stop blood flow to your hemorrhoids. Without blood flow, your hemorrhoids will shrink.
    
    
  • Rubber band ligation: Your caregiver will place a rubber band around your hemorrhoids to stop blood flow. After a few days, the hemorrhoid tissues should die and fall off.
    
    
  • Sclerotherapy: A chemical will be given as a shot into your hemorrhoids to make them smaller.
  
  
• Inpatient surgery:
  
  
  • Stapled hemorrhoidopexy: This procedure staples your hemorrhoid to the wall of your rectum or anal canal. This cuts off the blood supply to your hemorrhoids. Stapled hemorrhoidopexy also tightens up the wall of you rectum or anal canal.
    
    
  • Hemorrhoidectomy : A hemorrhoidectomy is surgery to remove your hemorrhoids. In an open hemorrhoidectomy, the remaining blood vessels and tissue are left partially open to heal. In a closed hemorrhoidectomy, stitches are used to sew up the area where the hemorrhoids are removed.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Hemorrhoids (Inpatient Care)