Are Hemorrhoids Easily Treatable?

• What are hemorrhoids?
• Symptoms to look out for
• How hemorrhoids are diagnosed
• Treatment options for hemorrhoids 
• International Medical Services at Samitivej

Hemorrhoids are the most common causes of rectal bleeding. They can occur from sitting in the toilet for long periods of time, forcing bowel movements, straining during a physical activity, heavy lifting, obesity, low-fiber diet or even from pregnancy.

Also referred to as piles, they are caused when the blood vessels in and around the anus become swollen or inflamed. These can develop in a cluster or in several distinct areas.

1. Internal hemorrhoids: These develop on the inside of the rectum and usually involve swollen blood vessels that are generally invisible on the outside. A colonoscopy is normally required to diagnose them. Such hemorrhoids are classified into the following 4 stages according to their size (from smallest to largest):

Stage 1: These hemorrhoids are tiny and do not protrude from the rectum, although they may cause bleeding during or after a bowel movement.
Stage 2: These hemorrhoids expand, protruding from the anus during bowel movements, and return to their original position completion of the bowel movement. They cause more frequent bleeding with the blood often bright red in color.
Stage 3: These hemorrhoids are large and protrude from the anus during bowel movements, and fail to return to their original position without being pushed back in by the patient. These hemorrhoids lead to frequent bleeding and significant irritation.
Stage 4: At this stage, the hemorrhoids are quite large, protruding from the anus at all times, with the distinct possibility of severe pain.

2. External hemorrhoids: This type of hemorrhoid develops on the outside of the anus due to swelling of the blood vessels located in this region. They are visible, can be felt by hand, and tend to become more painful when inflamed.

It is quite common for patients to experience both internal and external hemorrhoids simultaneously.

A white mucus being passed with dark, bloody stools

• Anemic episodes
• Frequent bowel movements or being unable to pass stools properly
• A constant pain in the anus
• Alternating between bouts of constipation and diarrhea
• A continuous reduction in stool size
• Sudden weight loss
• A family history of colon cancer

Should you experience any of the above symptoms that do not improve but instead deteriorate, it is highly recommended that you seek medical diagnosis at your earliest opportunity because symptoms of hemorrhoids and tumors are so similar to those associated with colon cancer. This will ensure that any disorder can be identified at the outset, thereby giving any subsequent treatment a much higher chance of success.

For consultation, you can have a live chat, or schedule an online appointment with our specialists via Samitivej Virtual Hospital. CLICK HERE

A gastroenterologist and a colorectal can diagnose hemorrhoids however a gastroenterologist can only provide non-surgical treatments. If your hemorrhoids requires surgical treatment, then it will be performed by a colorectal surgeon or a general surgeon. 

Samitivej’s skilled and highly specialized doctors and surgeons who perform hemorrhoid treatments have over 20 years experience, stay up-to-date with the latest research and practice, and use the latest, most appropriate internationally recognized treatments.

A doctor can usually see the external hemorrhoids however, internal hemorrhoids might require anal canal and rectum examination for anything unusual. For accurate diagnosis and treatment, or if the doctor suspects another health condition based on your symptoms, they may perform a colonoscopy, which allows complete viewing of your intestine. 

After a thorough diagnosis, your doctor will recommend the most effective, yet non-invasive treatment options for our patient’s specific condition explaining the pros and cons of each. In order to assist our doctors in providing our patients with the best possible treatment, at Samitivej we supply them with state-of-the-art surgical equipment, clean and private facilities, and specialized techniques.

Treatment depends entirely on the type and severity of each case

1. Non-surgical treatment can be used for treating stage 1 and 2 hemorrhoids. There are many non-surgical techniques that can be used, as follows:
Suppository medication: may be prescribed as it can ease symptoms associated with internal hemorrhoids.
Injections: into the affected region can reduce their size but should be carried out every 2–4 weeks for best results.
Rubber band ligation: can be applied to the tip of the hemorrhoids, starving them of blood supply until they fall off. However, such a method of treatment must only be carried out under the supervision of a trained specialist because there is a risk of infection and other associated side effects.

2. Surgical treatment: Suitable for treatment of stage 3 and 4 internal hemorrhoids.
Traditional hemorrhoid surgery: can be used to remove large and problematic hemorrhoids. This method involves cutting into the blood vessels without damaging the anus at all. Patients can still regulate their bowel movements after surgery, and this method offers more long-term benefits than other treatments. There is also a low rate of recurrence when carried out by a specialist surgeon. It is a suitable form of treatment for those suffering with large external or internal hemorrhoids that have begun protruding directly from the rectum.
Stapled hemorrhoidopexy using a PPH stapler: is only suitable for treating smaller-sized internal hemorrhoids. However, owing to the fact that most hemorrhoid sufferers tend to have both internal and external hemorrhoids, the use of this device is not widespread. Surgeons must be extremely careful when performing this procedure because if the incision is too low and some external tissue is removed, it can lead to issues due to the permanently misplaced metal ring.
Laser hemorrhoid: surgery can be used to treat less severe cases of hemorrhoids whereby the protruding tissue is small. It involves focusing a laser beam onto the affected blood vessels to break them down gradually. It is relatively effective, but there is a high chance that the hemorrhoids may return in the long run.
Doppler guided hemorrhoid artery ligation with recto-anal repair: may only be used to treat smaller internal hemorrhoids. This treatment relies on ultrasound scans used to pinpoint the location of each vein supplying blood to the hemorrhoid. This then allows the stitching of that vein to take place in order to cut off the blood supply. There is a risk of the hemorrhoids returning in the long-term due to the prevalence of blood vessels or due to the body replacing the destroyed veins.

Samitivej Hospitals encourage and focus on early diagnosis and detection, so we can prevent rather than cure. And, when a patient does require treatment, they trust us to provide the most effective treatment solution.

We are truly humbled and honored to have received 4 Prestigious Awards in 2020

• Treatment Plan Consultation with a doctor via online video-call (second opinion)
• Treatment Planning if you have medical records or a price estimate from another hospital
• Cost Planning by our Appraisals Team with price guarantee (only for procedure packages without complications)
• Check Initial Coverage Eligibility with Thai and international insurance companies (only for insurance companies in contract with the Hospital)

You can consult our specialist online to find out about the treatment options most suitable for your condition via Samitivej Virtual Hospital. To schedule an appointment or for more information CLICK HERE.