Hemorrhoids and IBS

Hemorrhoids. What can be even more embarrassing and more painful than having Irritable Bowel Syndrome? I even hesitate to write about it, since it is such an uncomfortable subject to discuss.

The source of many jokes, this disorder is unique to humans. Those of us with IBS may know all too well that if you have hemorrhoids, IBS only makes them worse! IBS may even be the cause of them because of the straining involved with constipation and the irritation caused by diarrhea. Sometimes, the pressure and bloating in the abdominal area that is often associated with IBS can cause or aggravate hemorrhoids.

More specific causes of will be discussed later, however, for right now, please know that you are not alone in your pain and embarrassment. Millions of Americans suffer with the same problem, and more than half of the population will develop them after age 30.

Many people suffer in silence for quite some time before talking to a doctor. So try not to feel so embarrassed when you talk with your doctor—it is likely he or she has seen many other patients with the same complaint.

There are two types of hemorrhoids, external and internal. If external lumps develop near the anus, they can become very painful if a blood clot forms within it. It may also bleed. Internal hemorrhoids develop within the anus. They may bleed and protrude during a bowel movement.

The cause of either of these is not known, but there are several contributing factors, such as aging, IBS, pregnancy, and heredity.

The first step in getting the proper treatment and pain relief is to see a colon and rectal specialist, which can be found at the American Society of Colon and Rectal Surgeons website. This specialist will certainly recommend adding more fiber to your diet, (which I caution, because of the irritation it can cause to IBS sufferers. See my take on Fiber and IBS). Most likely the reason you are at the doctor's office, is because the standard recommendations of eating more fiber, taking warm baths, and using Preparation H, have not sufficiently helped your condition. If this is the case, make sure you emphasize this to the physician, and be firm in letting he or she know that these methods have not given you the relief you so desperately need.

Many procedures to treat the problem can be done on an out patient basis or office visit. The following is an overview of the types of procedures the doctor may recommend.

Ligation – also called the “rubber band treatment”, this is a simple procedure that takes about 10 seconds! A small rubber band is placed at the base of the internal tissue. This cuts off the blood supply, causing it to fall off in a few days. There may be some discomfort and bleeding with this procedure, but most likely, there are no symptoms at all. The procedure may need to be repeated for full effect.

Injection and coagulation – this treatment method can be used when there is bleeding, but no external lumps. Injection therapy, also called sclerotherapy, involves injection of a hardening agent at the base of the hemorrhoid, causing the area to form scar tissue, which reduces blood flow to the area. With coagulation, a small probe exposes the area to infrared light for about a second. This will cause scar tissue, which will cut off the blood supply and then cause the tissue to shrink and die.

Both ligation and injection and coagulation procedures are relatively painless.

Stapling – this method uses a special device to staple and remove the internal tissue causing pain. It can be a more painful procedure than other methods of treatment.

Hemorrhoidectomy – this is surgery to completely remove the tissue, and, I've been told, is one of the most painful surgeries you could ever have. For that reason, it is reserved for the most severe cases, when other treatments have failed. It is done under anesthesia, and will require some downtime.

Again, please do not hesitate to get the help you need for the horrible pain and discomfort. Understandably, you may feel embarrassed, but remember that the doctors see cases just like yours every day. There is no reason to suffer in silence!


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