Find a Hemorrhoids Doctor: Diagnosis and Treatment Options

Hemorrhoids, also known as piles, are a common condition that can cause pain, itching, and bleeding in the anal area. While many cases can be managed with home remedies, it’s important to know when to seek professional help from a Hemorrhoids Doctor. This article will guide you through the diagnosis and treatment options available, helping you understand when and why seeing a specialist is crucial for effective relief.

Diagnosing Hemorrhoids: When to See a Hemorrhoids Doctor

If you suspect you have hemorrhoids, a primary care provider can often diagnose and treat them. In some cases, they might refer you to a specialist, also known as a hemorrhoids doctor, for further evaluation. This specialist could be a gastroenterologist (a doctor specializing in the digestive system) or a colorectal surgeon.

The diagnosis process typically starts with a physical exam. Your hemorrhoids doctor will consider your symptoms and medical history. Here’s what you can expect during a typical examination:

Visual Examination: External hemorrhoids are often visible to the naked eye. The doctor will visually inspect the anal area for any signs of external hemorrhoids.
Digital Rectal Exam (DRE): For internal hemorrhoids, which are not visible externally, a digital rectal exam is usually performed. The doctor will gently insert a gloved, lubricated finger into your rectum to feel for any abnormalities, including internal hemorrhoids or other issues.
Visual Inspection with Instruments: Since internal hemorrhoids are often soft and might not be felt during a DRE, your hemorrhoids doctor may use specialized instruments for a more thorough visual exam. These tools include:
- Anoscope: A short, rigid, tube-like instrument inserted into the anus and rectum to visualize the anal canal.
- Proctoscope: Similar to an anoscope but slightly longer, allowing for a view of the rectum.
- Sigmoidoscope: A longer, flexible, lighted tube that allows the doctor to examine the lower part of the colon and rectum (sigmoid colon).

In some situations, your hemorrhoids doctor might recommend a colonoscopy. This comprehensive examination of the entire colon is usually suggested if:

Your symptoms indicate a possibility of other digestive system diseases.
You have risk factors for colorectal cancer, such as family history or age.
You are middle-aged or older and haven’t had a recent colonoscopy for routine screening.

Treatment Options Your Hemorrhoids Doctor May Recommend

Treatment for hemorrhoids varies depending on the severity of your symptoms. A hemorrhoids doctor can provide a range of treatments, from simple home care advice to minimally invasive or surgical procedures.

Home Remedies and Over-the-Counter Treatments

For mild to moderate hemorrhoid symptoms, your hemorrhoids doctor might initially recommend home remedies and over-the-counter (OTC) treatments. These can often effectively relieve pain, swelling, and inflammation.

High-Fiber Diet: Increasing your intake of dietary fiber is crucial. Fiber softens stools and adds bulk, reducing straining during bowel movements. A hemorrhoids doctor will likely advise a gradual increase in fiber intake to avoid gas and bloating.
Topical Medications: OTC hemorrhoid creams, ointments, suppositories, and pads are readily available. These often contain ingredients like hydrocortisone, witch hazel, or numbing agents like lidocaine to relieve itching and pain. Your hemorrhoids doctor can advise on appropriate products.
Sitz Baths: Soaking the anal area in warm water for 10-15 minutes, two to three times daily, can provide significant relief. A sitz bath, which fits over your toilet seat, makes this easier.
Oral Pain Relievers: Over-the-counter pain medications like acetaminophen (Tylenol), ibuprofen (Advil, Motrin IB), or aspirin can temporarily alleviate pain and discomfort.

If symptoms persist beyond a week with home treatments, or if you experience severe pain or bleeding, it’s essential to consult your hemorrhoids doctor again for further evaluation and treatment.

Medical Treatments for Hemorrhoids

When home remedies are insufficient, or for more severe hemorrhoids, your hemorrhoids doctor can offer various medical treatments.

Prescription Medications: For more persistent discomfort, your doctor may prescribe stronger creams, ointments, or suppositories. These might contain higher concentrations of hydrocortisone or other active ingredients. It’s important to follow your doctor’s instructions on duration of use, especially with steroid-based creams.
External Hemorrhoid Thrombectomy: If a painful blood clot (thrombosis) forms in an external hemorrhoid, your hemorrhoids doctor can perform a thrombectomy. This minor in-office procedure involves removing the clot and the hemorrhoid, providing immediate pain relief. It is most effective when performed within 72 hours of clot formation.

Minimally Invasive Procedures for Hemorrhoids

For persistent bleeding or painful hemorrhoids, a hemorrhoids doctor can perform minimally invasive procedures. These are typically done in an outpatient setting and often don’t require anesthesia.

Rubber Band Ligation: This is a common and effective procedure. The doctor places one or two small rubber bands at the base of an internal hemorrhoid. This cuts off blood supply, causing the hemorrhoid to shrink and fall off within a week. While generally safe, it can cause some discomfort and bleeding a few days after the procedure.

Rubber band ligation procedure performed by a hemorrhoids doctor.

Sclerotherapy: In this procedure, the hemorrhoids doctor injects a chemical solution into the hemorrhoid tissue. This solution causes the hemorrhoid to shrink. Sclerotherapy is generally painless but may be less effective than rubber band ligation for larger hemorrhoids.
Coagulation (Infrared, Laser, or Bipolar): These techniques use heat or light to cause small, bleeding internal hemorrhoids to harden and shrivel. Coagulation methods are generally well-tolerated with minimal discomfort and side effects.

Surgical Procedures for Hemorrhoids

Surgery is usually reserved for a smaller percentage of patients with hemorrhoids, typically when other treatments have failed or for very large hemorrhoids. Your hemorrhoids doctor, especially a colorectal surgeon, may recommend one of the following surgical options:

Hemorrhoidectomy (Hemorrhoid Removal): This is the most effective surgical treatment for severe or recurring hemorrhoids. The surgeon removes the excess tissue causing the bleeding. Different techniques can be used, and anesthesia options range from local with sedation to spinal or general anesthesia. Hemorrhoidectomy offers the highest success rate in eliminating hemorrhoids but can involve a more painful recovery period compared to other procedures.
Stapled Hemorrhoidopexy (Hemorrhoid Stapling): Primarily used for internal hemorrhoids, stapling blocks blood flow to the hemorrhoidal tissue. It generally involves less post-operative pain and quicker recovery than hemorrhoidectomy. However, it may carry a slightly higher risk of hemorrhoid recurrence or rectal prolapse compared to hemorrhoidectomy.

Choosing the best treatment approach requires a discussion with your hemorrhoids doctor to weigh the benefits and risks of each option based on your individual situation.

Preparing for Your Appointment with a Hemorrhoids Doctor

If you are scheduling an appointment with a hemorrhoids doctor, preparation can make your visit more effective.

What You Can Do:

Pre-Appointment Restrictions: When you book your appointment, ask if there are any specific preparations needed, such as dietary restrictions or bowel prep.
Symptom List: Write down your symptoms, including when they started and how often they occur.
Medical History: Note down key personal information, including your typical bowel habits, diet (especially fiber intake), and any other medical conditions.
Medication List: List all medications, vitamins, and supplements you are currently taking, including dosages.
Questions for Your Doctor: Prepare a list of questions to ask. Examples include:
- What is the likely cause of my symptoms?
- Is my condition temporary or chronic?
- What are my treatment options?
- Should I consider surgery?
- What self-care measures can help?
- How do my other medical conditions affect my hemorrhoids?

What to Expect from Your Doctor:

Your hemorrhoids doctor will ask you questions to understand your condition better. Be ready to answer questions such as:

How severe are your symptoms?
What are your typical bowel habits?
How much fiber is in your diet?
What makes your symptoms better or worse?
Is there a family history of hemorrhoids or colorectal cancer?
Have you noticed blood in your stools or on toilet paper?

In the Meantime:

While waiting for your appointment, you can take steps to soften your stools by increasing fiber intake through fruits, vegetables, and whole grains. Drinking plenty of water (6-8 glasses a day) and considering a fiber supplement can also help ease symptoms.

Seeking timely advice and treatment from a hemorrhoids doctor is crucial for managing hemorrhoids effectively and improving your quality of life. Don’t hesitate to reach out to a healthcare professional if you are experiencing symptoms.