| About
Hemorrhoids
Hemorrhoids
are swollen veins in the lower rectum or anus. By age 50, about
half of the population will have experienced this sometimes painful
condition, which results from an increase in pressure inside the
veins of the rectum. Common causes include constipation, pregnancy,
childbirth, obesity, heavy lifting, sitting for long periods and
diarrhea.
There are two types of hemorrhoids based on location. Internal hemorrhoids
occur inside the lower rectum and often can’t be seen or felt.
As this form is typically painless, the only symptoms you may notice
are small amounts of bright red blood (on your toilet paper or inside
the toilet bowl) or a feeling of fullness following a bowel movement.
Occasionally, internal hemorrhoids can push through the anal opening.
This is known as a prolapsed, or protruding, hemorrhoid. Sometimes
these swollen veins remain prolapsed temporarily; in other cases,
they become permanent. If the hemorrhoid remains outside the anus,
it can cause pain, itching, bleeding and the formation of excess
skin (skin tags).
External hemorrhoids occur as bulges or lumps around the anus. Because
of the sensitive nerve fibers in this area, these enlarged veins
are often painful, especially when sitting. They also may bleed
and itch. Should blood pool in an external hemorrhoid, a blood clot
referred to as a thrombosed hemorrhoid may develop and cause severe
pain.
The less common of the two forms, external hemorrhoids are often
incorrectly self-diagnosed because many people mistake internal
hemorrhoids – or the skin tags they can produce – for
external hemorrhoids. Always consult a physician to determine whether
you have the internal or external type.
Home remedies such as creams, suppositories and warm baths may offer
temporary relief from the symptoms of hemorrhoids. But for many
people, hemorrhoids don’t go away. Instead, they can get progressively
worse over time, growing in both size and number. Some chronic sufferers
develop hemorrhoids in as many as three locations.
Fortunately, you don’t have to put up with recurring flare-ups
and increasing pain. You can seek professional medical treatment
now, and end your discomfort for good.
New Procedure- CRH O’Regan System™
At
Dr laurence Entsuah office, we use the patented, CRH O’Regan
System™, considered the “gold standard” treatment.
This highly effective (99.1%), minimally invasive procedure is performed
in our offices in less than a minute. If there are multiple hemorrhoids,
we treat them one at a time in separate visits.
During the brief and painless procedure, our physician specialist
places a small rubber band around the tissue just above the hemorrhoid
where there are few pain-sensitive nerve endings. Unlike traditional
banding techniques that use a metal-toothed clamp to grasp the tissue,
we use a gentle suction device, reducing the risk of pain and bleeding.
Our banding procedure works by cutting off the blood supply to the
hemorrhoid. This causes the hemorrhoid to shrink and fall off, typically
within a day or so. You probably won’t even notice when this
happens or be able to spot the rubber band in the toilet. Once the
hemorrhoid is gone, the wound usually heals in a week or two.
During the first 24 hours, some patients may experience a feeling
of fullness or a dull ache in the rectum. This can typically be
relieved with an over-the-counter pain medication. A remarkable
99.8% of patients treated with our method have no post-procedure
pain, however.
In fact, thanks to design improvements, our procedure has a ten-fold
reduction in complications compared to traditional banding.
For one, our instruments are smaller, affording greater comfort
for patients and better visibility for physicians. Unlike other
devices, they are also single use and 100% disposable.
In most cases, banding can take place during your first appointment.
After all, once you know what the problem is, why wait to get relief?
WHAT
TO EXPECT
The
first appointment will consist of, at a minimum, a consultation
with a physician. During diagnosis, we may perform a digital exam
as well as a sigmoidoscopy, a visual examination of the lower bowel
using a lighted tube connected to an eyepiece.
If the diagnosis is hemorrhoids, treatment can start immediately.
In the event of multiple hemorrhoids, often the largest, most symptomatic
hemorrhoid is banded first. Additional appointments are then scheduled
to treat the remaining hemorrhoids at two week intervals with a
final check-up and optional colorectal cancer screening three weeks
later.
Sometimes patients have both an anal fissure and hemorrhoids. If
this applies to you, our protocol is to treat the anal fissure first.
Then, once that problem is resolved, we can proceed with the hemorrhoid
removal procedure. Treating these conditions one at a time is important
for determining which symptoms relate to which problems.
After
Care
Following
hemorrhoid banding, we recommend that you rest at home for the remainder
of the day and resume full activity the next day. You can have normal
bowel movements during this time, but you may want to soak in a
sitz bath (a warm tub with a tablespoon of table salt added) or
use to a bidet for a gentler cleansing of the anal opening.
Soon
you’ll be feeling much better, but you’ll need to make
some changes to prevent future problems. Straining due to constipation
should be diligently avoided, so be sure to drink seven or eight
glasses of water (around 50 ounces) a day and add two tablespoons
of natural oat or wheat bran to your diet. (Metamucil, Benefibre,
flax or other soluble fiber may be helpful as well.)
We also recommend that you not sit longer than two minutes on the
toilet. If you can’t have a bowel movement in that time, come
back later. This two-minute rule can help keep you from straining
during bowel movements without realizing it. Finally, when traveling
by air, stay hydrated, avoid alcohol, eat fiber and walk around
when you can.
TREATMENT
COMPARISON
The
CRH O’Regan System is appropriate for an estimated 90% of
hemorrhoid patients. Only the most severe cases require surgery
(hemorroidectomy), which is just one more reason not to delay treatment.
If you wait too long – and your hemorrhoids grow too large
– your non-surgical options decrease.
The chief complaint about conventional rubber banding – which
demonstrates superior long-term efficacy over other non-surgical
methods – has been pain in 4-29% of cases. In contrast, only
0.2% of patients treated with our advanced technique experience
post-procedure pain. Our method is also faster, more accurate and
has virtually no downtime.
Over the years, a number of new treatments have been devised for
hemorrhoids, but none has outperformed the CRH O’Regan System.
Among them are infrared photocoagulation, or the use of lasers to
burn the hemorrhoid tissue, and stapled hemorroidectomy, a surgical
variation that uses a circular stapler device to life and remove
the hemorrhoid.
FREQUENTLY
ASKED QUESTIONS
What
are hemorrhoids?
Hemorrhoids
are swollen veins located in the lower rectum or anus. There are
two types of hemorrhoids: internal and external. Depending on the
location, symptoms may include pain, inflammation, itching, and
a feeling of fullness following a bowel movement. Additionally,
there may be bright red blood covering the stool, on the toilet
tissue or in the toilet bowl.
What causes hemorrhoids?
Hemorrhoids
result from an increase in pressure in the veins of the rectum.
This may be caused by constipation, pregnancy, childbirth, obesity,
heavy lifting, long periods of sitting, or diarrhea. In Western
countries, constipation is associated with diets low in fiber and
high in fat.
Who gets hemorrhoids?
Hemorrhoids
affect both men and women. The incidence of hemorrhoids increases
after age 30, and by age 50, about half of the population will have
experienced the condition.
How does the procedure work?
A
small disposable syringe like device is used to attach a tiny rubber
band around the internal hemorrhoid – with the blood supply
cut off, the hemorrhoid dies and falls off.
Can you treat external hemorrhoids?
Yes.
Most hemorrhoidal symptoms are from dilated internal hemorrhoids
and or anal fissures. The banding of internal hemorrhoids usually
shrinks the external hemorrhoids as well and is highly effective
in relieving the symptoms of pain and bleeding. After banding is
completed there may be an external component or skin tag that persists,
but usually they do not cause much in the way of symptoms. An acute
thrombosis of an external hemorrhoid can be very painful. Our physicians
are fully trained and can perform office based procedures as required
to care for these external hemorrhoidal conditions.
How many bands are necessary?
There
are three sites where hemorrhoids form frequently, and it is not
uncommon for all three sites to require treatment. We generally
only band one hemorrhoid site at a time in separate visits, as multiple
bandings have been found to increase complications. Also, some extreme
large hemorrhoids may require additional banding sessions. Thus,
as many as six bands total may be used in severe cases, but one
to three is standard
Is it effective?
Yes
it is 99.1% effective, and the best thing is that it is non-surgical,
so there is no pain, medication or recovery time needed. Most of
our patients go back to work the same or next day.
How long will this take?
The
procedure takes about 60 seconds, but the entire visit is about
15-30 minutes.
Is the procedure covered by Insurance?
The procedure is covered by most insurance plans, including Medicare.
As insurance coverage varies, however, we would need to verify your
particular insurance. (the financial policy of your practice should
be inserted here)
Will it hurt?
No.
Thanks to our improved instrument and technique, band placement
is painless. You may experience a feeling of fullness or dull ache
in the rectum for the first 24 hours, but this can generally be
relieved by over-the-counter pain medication. A recent study of
our banding technique shows that 99.8% of patients experience no
post-procedure pain.
Will I have to miss work or other activities?
Your
first appointment in our office will probably be the longest, as
it involves a consultation, medical history and diagnosis. We suggest
you allot up to an hour. Subsequent treatment sessions will be shorter,
around 15-30 minutes total. After a hemorrhoid banding procedure,
we recommend that you rest the remainder of the day at home and
resume full activity the next day. However, many patients with office
jobs find they can return to work immediately following their appointment.
Will I need to do any preparation at home prior to the procedure?
No
prep is needed prior to the procedure.
Will I need a driver or can I drive home myself?
You will not need a driver, in fact most patients return to normal
activity immediately following the procedure.
Will the hemorrhoids come back after the treatment?
With
proper dietary changes the hemorrhoids should not return.
Who else offers the CRH O’Regan banding?
This
patented procedure is only available through a select few healthcare
providers who have been licensed and trained to offer the CRH O’Regan
System in their practice.
For
more information please visit http://www.crhsystem.com/ |
Digestive Medical Services, Inc.
