Whether or not hemorrhoids are found, if there has been bleeding, the colon above the rectum needs to be examined to exclude important causes of bleeding other than hemorrhoids. Other serious causes include colorectal cancer or polyps or inflammatory bowel disease. This examination can be done by either flexible sigmoidoscopy or colonoscopy.
PITFALLS
- Do not assume that the rectal bleeding is secondary to hemorrhoids
- Exclude other causes of hemorrhoid-like symptoms that require a different treatment
- Rare cancers of the perianal area may masquerade as external hemorrhoids
General Measures for Hemorrhoid Treatment
It is believed generally that constipation and straining to have bowel movements promote hemorrhoids and that hard stools can traumatize existing hemorrhoids. It is recommended, therefore, that individuals with hemorrhoids soften their stools by increasing their fluid and fiber intake in their diets. This is recommended for all patients who have hemorrhoidal symptoms and can be the only treatment required for patients with first degree hemorrhoids.
Vasoconstrictors applied to the perianal area may reduce swelling, pain and itching due to their mild anesthetic effect.
Daflon is micronized purified flavonoid fraction (MPFF) associated with fiber supplement has been superior to fiber supplement alone and equivalent to rubber-band ligation plus fiber supplement in stopping anal bleeding due to hemorrhoids.
CARET Service Our One-Stop Careful Assessment & Rapid Effective Therapy Service
At our clinic, we offer a special CARET service. This ONE-STOP service enables us to offer your patient a flexible sigmoidoscopy or a colonoscopy (as required) and ligation of hemorrhoids as part of our specialist consultation. This service will provide immediate reassurance of the benign nature of the rectal bleeding with simultaneous hemorrhoid treatment.