Thomas P. Sokol, MD received his medical degree from the University of Health Sciences/The Chicago Medical School in 1980. He went on to his general surgical residency at Harbor/UCLA Medical Center and then to the Carle Clinic/ University of Illinois for Fellowship Training in Colon and Rectal Surgery.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
There are several nonoperative treatments for internal hemorrhoids. All of them
have the same effect. These procedures cause inflammation in the hemorrhoidal
cushions, which then produces scarring. The scarring causes the cushions to
shrink and attach to the underlying muscle of the anal canal. This prevents the
cushions from being pulled down into the anal canal. These treatments do not
require anesthesia since they do not cause pain. (The treated area contains only
visceral nerves.)
Sclerotherapy: Sclerotherapy
is one of the oldest forms of treatment. During sclerotherapy, a liquid (phenol
or quinine urea) is injected into the base of
the hemorrhoid. Inflammation sets in, and ultimately scarring takes place. Pain
may occur after sclerotherapy but usually subsides by the following day.
Symptoms of hemorrhoids frequently return after several years and may require
further treatment.
Rubber band ligation: The
principle of ligation with rubber bands is to encircle the base of the
hemorrhoidal anal cushion with a tight rubber band. The tissue cut off by the
rubber band dies and is replaced by an ulcer that heals with scarring. It can be
used with first-, second-, and third-degree hemorrhoids and may be more
effective than sclerotherapy. Symptoms frequently recur several years later but
usually can be treated with further ligation. The recurrence of
symptoms may be less with ligation than with sclerotherapy.
The most common complication of ligation is pain, which
may occur slightly more often than with sclerotherapy, but it tends to be mild.
Bleeding one or two weeks after ligation occurs occasionally and can be severe.
Bacterial infection
may begin in the tissues surrounding the anal canal (cellulitis). Rarely, the
infection spreads to the tissues within the pelvis and results in an abscess, or
the infection may enter the bloodstream (sepsis). Infectious complications
may be more common in patients who have defective immune systems, for example, from
AIDS, cancer,
chemotherapy, or severe
diabetes.
Heat coagulation: There are several treatments that use heat to kill
hemorrhoidal tissue and promote inflammation and scarring, including bipolar
diathermy, direct-current electrotherapy, and infrared photocoagulation. Such
procedures kill the tissues in and around the hemorrhoids and cause scar tissue
to form. They are used with first-, second-, and third-degree hemorrhoids. Pain
is frequent, though probably less frequent than with ligation, and bleeding
occasionally occurs. Sclerotherapy, ligation, and heat coagulation are all good
options for the treatment of hemorrhoids.
Cryotherapy: Cryotherapy uses
cold temperatures to obliterate the veins and
cause inflammation and scarring. It is more time consuming, associated with more
posttreatment pain, and is less effective than other treatments. Therefore, this
procedure is not commonly used.
Rectal bleeding (hematochezia) refers to the passage of bright red blood from the anus. Rectal bleeding may be moderate to severe and most bleeding comes from the colon, rectum, or anus. Common causes include anal fissures, hemorrhoids, diverticulitis, and more.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
There are many symptoms involved in the 1st, 2nd and 3rd trimesters of pregnancy. The first early pregnancy symptom is typically a missed period, but others include breast swelling and tenderness, nausea and sometimes vomiting, fatigue and bloating. Second trimester symptoms include backache, weight gain, itching, and possible stretch marks. Third trimester symptoms are additional weight gain, heartburn, hemorrhoids, swelling of the ankles, fingers, and face, breast tenderness, and trouble sleeping. Read more to learn about recommended procedures and tests for each stage of a healthy pregnancy.
Constipation is defined medically as fewer than three stools per week and severe constipation as less than one stool per week. Constipation usually is caused by the slow movement of stool through the colon. There are many causes of constipation including medications, poor bowel habits, low fiber diets, abuse of laxatives, hormonal disorders, and diseases primarily of other parts of the body that also affect the colon.
A skin tag is a small benign growth of skin that projects from the surrounding skin. Skin tags can vary in appearance (smooth, irregular, flesh colored, dark pigment, raised). Skin tags generally do not cause symptoms unless repeatedly irritated. Treatment for skin tag varies depending on the location on the body.
Anal itching is the irritation of the skin at the exit of the rectum, known as the anus, accompanied by the desire to scratch. Causes include everything from irritating foods we eat, to certain disease and infections. Treatment options include local anesthetics, vasoconstrictors, protectants, astringents, antiseptics, keratolytics, analgesics, and corticosteroids. If condition persists, a doctor examination may be needed to identify an underlying cause.
An anal fissure is a small tear or cut in the skin lining of the anus. Pain and/or rectal bleeding during bowel movements are common symptoms of anal fissures. Treatment involves increasing liquid intake, using stool softeners and avoiding foods that may not be well-digested.
Laxatives for treatment of constipation include over-the-counter preparations such as bulk-forming laxatives, stool softeners, lubricant laxatives, stimulant laxatives, saline laxatives, enemas and suppositories. Some over-the-counter laxatives are not recommended for patients with specific diseases or conditions. Some laxatives may have negative adverse effects if taken over long periods of time.
Portal hypertension is most commonly caused by cirrhosis, a disease in which results from scarring of a liver injury. Other causes of portal hypertension include blood clots in the portal vein, blockages of the veins that carry the blood from teh liver to the heart, and a parasitic infection called schistosomiasis.
Pregnancy can bring challenges like weight gain, stretch marks, varicose veins, heartburn, constipation, hemorrhoids, problems sleeping, and wondering if it is safe to have sex while pregnant. Learn how to manage and move through these challenges during pregnancy.
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