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Hiding from hemorrhoids?

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It's a problem not many people like to talk about, in fact, some may try to hide from their hemorrhoids and avoid seeking professional help.

"You may want to die of embarrassment just talking about hemorrhoids, but it won't kill you," says Virtua surgeon Howard Winter, MD. Recognizing how awkward the subject can be, Dr. Winter takes careful measures to make patients comfortable. "I make a conscious effort to put the patient at ease as we talk about his medical history and symptoms," he says.

Dr. Winter, who specializes in colorectal surgery, explains that hemorrhoids are swollen veins inside the rectum or around the anus caused by constipation, the strain of pregnancy and delivery, age and family history. Patients often experience symptoms such as pain after a bowel movement, itching and bleeding. Dr. Winter adds: "It's the severity of the symptoms that helps determine the best treatment."

For patients with minor symptoms, treatment may not be necessary. "If hemorrhoid symptoms are mild, it's a problem that can be left alone or managed with over-the-counter medication," he says.

However, for patients with frequent pain and bleeding, or with hemorrhoids that protrude outside the anus, surgical intervention may be necessary. The majority of these patients can be treated with one of these minimally invasive techniques.

Rubberbanding: A band is placed around the base of the hemorrhoid. The band cuts off circulation, and the hemorrhoid disappears in a few days. The painless procedure allows a patient to return to work in a day.

Infrared coagulation: A wand is used to heat and destroy the blood supply in the hemorrhoid. The procedure is painless and recovery is quick.

Procedure for prolapse and hemorrhoids (PPH): PPH is a newer procedure for the treatment of advanced hemorrhoids that protrude through the anus. PPH lifts the tissue and restores it to its original position. This interrupts blood flow to the hemorrhoids, which then shrink within a few weeks. Dr. Winter adds: "PPH affects fewer nerve endings so patients have less pain and a shorter recovery than they would with a traditional hemorrhoid removal surgery. For some patients with advanced hemorrhoids, however, a hemorrhoidectomy may be the only treatment option."

"See a doctor when you suspect hemorrhoids," Dr. Winter adds. "The best treatment is early treatment."