A hemorrhoid is a cushion of blood vessels in the lining of the anal canal. All people have hemorrhoids; we are all born with hemorrhoids. Not everyone, however, has hemorrhoid causing symptoms. When these hemorrhoids become enlarged, you may have painless rectal bleeding. Swelling of hemorrhoids may cause them to prolapse (slide out) during a bowel movement.

Your physician will determine if your hemorrhoids require one of the following treatments:

Barron Ligatures (Rubber Bands):
A rubber band is put around the hemorrhoid, causing it to wither and fall off over a 5 to 10-day period.

Injection of Hemorrhoids:
A liquid is injected into the hemorrhoid, stopping the bleeding and preventing it from protruding.

These treatments are only used for internal hemorrhoids. They would be extremely painful if used for external hemorrhoids.

Symptoms and Care:
You may feel mild to moderate pain, a dull ache, or essentially nothing for the first 36 to 48 hours. A sense of urgency to have a bowel movement is normal after these treatments. If discomfort is mild, take over-the-counter medications such as Tylenol® or Advil®. Do not take aspirin or products containing aspirin because they promote bleeding. Taking warm baths for 15 to 20 minutes will help relieve your discomfort. If your pain is severe, call the office and speak with the nurse. Generally it takes two to four treatments, three to six weeks apart, to treat the prolapsing internal hemorrhoids. Usually only one area, or occasionally two, is treated at a time. Remember that bleeding and prolapse will probably persist until all the hemorrhoids and prolapsing tissue have been treated.

Diet:
After your treatment, it is important to keep your bowel movements soft and regular. Eat foods high in fiber and drink plenty of water (8 to 10 glasses a day). Continue the fiber supplement recommended by your doctor. Caffeine contributes to constipation so limit your consumption of coffee, tea, colas, and chocolate.

Activity:
You may continue your normal physical activities. You will be able to drive your car, walk up stairs, and do normal exercise immediately.

If you need a refill for a pain medication prescription, you must call your doctor during normal business hours. Our policy is that we do not refill pain medication prescriptions after hours or on weekends because your chart is not available. The doctor on call is not allowed to refill your prescription.

If any of the following problems occur, please call our office and speak with a nurse who will help you with your problem or have the doctor call you.

• Pain that does not gradually lessen in three days
• Increasing pain several days after treatment
• Tender swelling in the anal area
• Fever or chills
• Difficulty urinating
• Constipation (no bowel movement for three days)
• Diarrhea (more than three watery stools within 24 hours)
• Increased bleeding (more than one cupful)
• Three to four large bloody bowel movements within three hours
• Drainage of pus from the rectum

If your own doctor is unavailable, the doctor on call is available 24 hours a day, every day of the year. After hours, call any of our offices and the answering service will locate one of our doctors on call. In an emergency try to contact us for advice before you go to the hospital. A telephone call may save you a lot of time, discomfort and expense.