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Should I Tell My Doctor About Hemorrhoids?

Like most people, you may think that your doctor is too busy to talk about hemorrhoids. They probably don't know much about treatment options for hemorrhoids either. But in fact, the opposite is true: doctors want their patients to come to them with any questions or concerns about their condition. Not only does this help them catch anything else wrong before it gets worse, but it makes sure that both patient and doctor are on the same page when it comes to preventing severe health conditions.

What are Hemorrhoids?

Hemorrhoids are swollen veins in the lower rectum or anus. This is caused by straining during bowel movements or putting pressure on the area due to pregnancy, obesity, chronic constipation, or poor dietary habits. Symptoms of hemorrhoids include burning sensation, itching, and bleeding.

Doctor's Advice: "I think it's essential for people to tell their doctors if they have hemorrhoid symptoms," said Karen Weintraub, MD, an ob-gyn at New York-Presbyterian Hospital/Columbia University Medical Center. "If people don't mention it to their doctors, then there may be underlying cancer that goes untreated because it's discovered."

Do I need to see a doctor about my hemorrhoids?

Yes. Not only do you need to tell your doctor if you have hemorrhoid symptoms, but it's also essential for them to know what medications you are taking, how often, and for how long. That includes over-the-counter remedies too. For example, a commonly used pain reliever called diclofenac may make bleeding worse in some patients who already have an increased risk of getting blood clots from another medication they take called warfarin. The combination can increase the chances of deep vein thrombosis, which is dangerous because it can cause a pulmonary embolism.

Doctor's Advice: "If people have been taking ibuprofen or aspirin - anything like that - it's crucial to tell their doctor," said Weintraub. "If they haven't been, and if they don't have any other risk factors for clots, then I probably wouldn't worry about it."

What is the Treatment for Hemorrhoids?

The treatment for hemorrhoids depends on how bad they are: the degree of discomfort and bleeding is different in everyone. There are several ways to treat them, including over-the-counter medications like suppositories, creams, or pads. Some patients opt for an in-office procedure called a rubber band ligation, which involves placing a band around the base of hemorrhoid to cut off circulation. For this procedure, you will need local anesthesia.

Doctor's Advice: "If people have very mild symptoms, then I usually recommend that they try an over-the-counter medication first," said Weintraub. "I think it's important for people to know what works for them."

Treatment options are done individually, so if you are not sure which would work best, check with your doctor. In some cases, surgery may be necessary, and overall, this should be something discussed with your physician. More severe cases of hemorrhoids seen in the office can include infrared coagulation, where a special probe is used to seal off the hemorrhoidal artery or rubber band ligation (mentioned above).

What is the prognosis?

The prognosis is good. Hemorrhoids, in most cases, are a temporary condition and can be managed with medication or lifestyle changes.

Doctor's Advice: "I usually recommend that people try a diet that's high in fiber," said Weintraub. "That can decrease the risk of constipation, which is really what increases the pressure in the rectum."

In severe cases where surgery is necessary, this should be discussed with your doctor to determine if they have any additional advice for you regarding treatment following surgery or if there are any other concerns about subsequent care.

What will happen without proper treatment?

The symptoms may worsen over time, increasing the likelihood of severe conditions like anemia, malnutrition, and rectal prolapse.

Doctor's Advice: "Some studies have linked chronic constipation to cardiovascular disease, so it is important for us not only to manage symptoms but also prevent long-term problems like hemorrhoids," said Weintraub.

Hemorrhoid symptoms can be managed with over-the-counter remedies or lifestyle changes. If these don't work, your doctor may recommend treatments, including medications or surgery, depending on the severity of your case. These topics should all be discussed with your doctor during an office visit to determine what would be best for you as an individual. The prognosis is typically good, and most patients find relief after receiving proper treatment.

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