The Colon & Rectal Clinic of Ft. Lauderdale

One reason people do not talk about hemorrhoid problems with their doctor is because they anticipate a painful, traditional hemorrhoid surgery.

A minimally invasive surgical approach now available in the United States, called Procedure for Prolapse and Hemorrhoids (PPH), may help patients recover from hemorrhoid surgery faster with less pain when compared to conventional hemorrhoidectomy procedures.


Overview of Hemorrhoids

Hemorrhoids are one of the most common ailments for men and women alike — affecting more than half the population at some point in their lives. Onset commonly occurs after the age of 30, but hemorrhoids are reported in people of all ages. More than 525,000 patients in the United States are treated annually for symptomatic hemorrhoids. 6 Of these, approximately 10–20 percent will require surgical treatment for their condition.

What is a Hemorrhoid?

Each of us has veins within the anus that tend to stretch under pressure, somewhat like varicose veins in the legs. It is believed these veins exist to protect and cushion the anal canal. When these veins swell, they are called "hemorrhoids." One set of veins is inside the rectum (internal hemorrhoids), and another is under the skin around the anus (external hemorrhoids).

Types of Hemorrhoids

Internal Hemorrhoids

Internal hemorrhoids usually are not painful, but may bleed. Sometimes, an internal hemorrhoid may stretch until it bulges outside the anus. This is called a prolapsed hemorrhoid. A prolapsed hemorrhoid may shrink back inside the rectum on its own over time, or it may be gently pushed back inside. If the prolapsed hemorrhoid cannot be pushed back inside, several hemorrhoid treatment options are available, including hemorrhoid surgery.

External Hemorrhoids

External hemorrhoids involve the veins around the anus. They can be itchy or painful and can sometimes crack and bleed. If a blood clot forms, one may feel a tender lump on the edge of the anus, and see bright red blood on toilet paper or in the toilet after a bowel movement.

Hemorrhoid Classification Chart

Classification Treatment Options
1stDegree - No rectal prolapse
  • Diet
  • Local & general drugs
2ndDegree - Rectal prolapse is spontaneously reducible
  • Banding [recurring banding may require Procedure for Prolapse and Hemorrhoids (PPH)]
3rdDegree - Rectal prolapse is manually reducible
  • Banding
  • Hemorrhoidectomy
  • Procedure for Prolapse and Hemorrhoids (PPH)
4thDegree - Rectal prolapse irreducible
  • Hemorrhoidectomy
  • Procedure for Prolapse and Hemorrhoids (PPH)

Hemorrhoids Prevalence and Diagnosis

Hemorrhoids can affect men and women alike; however, an individual may be more likely to get hemorrhoids as they age or if their parents had them. Pregnant women often get hemorrhoids because of the strain from carrying the baby and from giving birth. For most women, such hemorrhoids are a temporary problem. Obesity, straining during bowel movements, sitting too long on the toilet, or standing or lifting too much can make hemorrhoids worse. Constipation is often the main cause of hemorrhoids.

If an individual is struggling with anorectal issues, it is important to visit a physician to correctly identify the problem. The physical evaluation should include observation, palpation, and anoscopic examination

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