Internal hemorrhoids

You’ll be asked to lie or kneel on a table. Your health care provider then inserts an anoscope to view the anal canal. To treat the hemorrhoid, your provider will use 1 of the methods listed below. Because internal hemorrhoids don't have nerves that sense pain, you won’t have too much discomfort. You can often return to your normal routine the same day. If you have many hemorrhoids, you may need repeated treatments.

Banding

This treatment works well on internal hemorrhoids that protrude during bowel movements. The banding method is done by placing tight elastic bands around the base of the hemorrhoid. This cuts off blood supply to the hemorrhoid, causing it to fall off. This usually takes about a week. The area then heals within a few days.

Infrared coagulation

This procedure is done using a small probe that exposes the hemorrhoid to short bursts of infrared light. This seals off the blood vessel, causing it to shrink. Slight bleeding may happen for a few days. The area usually heals within a week or 2.

Electrocoagulation

An electric current is introduced into the internal hemorrhoid. The electric current causes scar tissue to form. This cuts off the blood supply, often shrinking the hemorrhoid.

Sclerotherapy

Sclerotherapy is done by injecting a chemical into the tissue around the hemorrhoid. The chemical causes the hemorrhoid to shrink within a few days. Bleeding usually stops in about 24 hours. This treatment is no longer done very often.

Thrombosed external hemorrhoids

Thrombosed external hemorrhoids are often very painful. That’s because the swollen hemorrhoid stretches the sensitive skin around it. To relieve the pain, your health care provider may remove the blood clot. This takes just a few minutes. You may need to rest for a few days before returning to work.

• Numbing the hemorrhoid. You’ll be asked to lie or kneel on a table. The hemorrhoid is then injected with a local anesthetic. This may cause some discomfort for a moment. But, within a short time, your provider will be able to remove the hemorrhoid without causing pain.

• Removing the hemorrhoid.A small incision is made to remove the blood clot. The hemorrhoid may also be removed. The skin is then either closed with stitches or left open to heal on its own. The area around the incision will likely be sore for a few days. But your pain should improve soon after the procedure.

  If the clot has been present for more than a few days, it may be hard to remove it with an incision. In this case, it will get better on its own with time and your provider will keep track of you.

Risks and possible complications

The risks and complications include:

• Infection.

• Bleeding.

• Trouble urinating. (This doesn't typically happen with thrombosed external hemorrhoids.)

• Narrowing of the anal canal. (This is very rare and doesn't happen with thrombosed external hemorrhoids.)

When to call your doctor

After your procedure, contact your health care provider or get medical care right away if you have:

• Increasing pain.

• Fever of 100.4°F (38°C) or higher, or as advised by your provider.

• Chills.

• Persistent bleeding.

• Trouble urinating.