Category Archives: Hemorrhoids

Hemorrhoids 101 | Minnesota

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Believe it or not, everyone has had a normal hemorrhoidal tissue in their rectum and anus. It’s only when your hemorrhoidal veins enlarge and become varicose veins that they’re considered abnormal or diseased.

There are three types of hemorrhoids – internal, external, and mixed hemorrhoids that consist of both internal and external. External hemorrhoids are those that occur outside the anal verge and affect bowel cleansing after one’s bowel movement, causing skin irritation and itching. A thrombosed external hemorrhoid is usually very painful due to rupture of one’s varicose veins, which causes blood clots and is often accompanied with swelling and pain. These external hemorrhoids are typically treated with either an incision or removal of the clot, or with an external hemorrhoidectomy performed under local anesthesia.

Internal hemorrhoids are graded from I to IV based on the degree of prolapse. Grade I hemorrhoids bulge with defecation; grade II lesions also bulge with defecation, but then recede spontaneously. Grade III hemorrhoids require digital replacement after prolapsing, while grade IV hemorrhoids cannot be replaced once prolapsed. There are many treatment options for internal hemorrhoids that vary based on the severity of each case, including infrared coagulation, rubber band ligation and hemorrhoidectomy.

Infrared coagulation (IRC) is a fast and effective non-surgical solution for hemorrhoid treatment!

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A hemorrhoid is a common illness that numerous Minnesotans suffer from. Approximately three out of four people will develop hemorrhoids at some time in their lives. While many people associate hemorrhoid treatments with painful surgery, only a small percentage of hemorrhoid patients actually require hemorrhoidectomy. A fast and simple non-surgical office procedure has taken the fear out of hemorrhoid treatments. The majority of hemorrhoid patients are good candidates for non-surgical Infrared coagulation (IRC) treatments.

What is Infrared Coagulation (IRC)?
IRC is a FDA approved office procedure that uses infrared light to treat symptomatic internal hemorrhoids, and it takes just a couple of minutes for each treatment. IRC is a safe, fast, and effective solution for hemorrhoids. Therefore, IRC has quickly become the most widely used office procedure for hemorrhoid clinics and is preferred over other methods because it is fast, effective, well-tolerated by patients, and rarely has complications.

A small light probe contacts the area above the hemorrhoid complex under direct view, exposing the tissue to a burst of infrared light for about 1.5 second. This coagulates the veins above the hemorrhoid, causing it to shrink.
With IRC, hemorrhoid doctor can effectively coagulate the insensitive area right above the hemorrhoids and destroy these small veins. In this way, the sensitive and painful area is avoided, and IRC becomes a very tolerable treatment.

IRC offers major advantages to patients over previous hemorrhoid treatment methods:

• Fast, simple, and safe solution
• No anesthesia required
• No special preparation needed
• No recovery time after treatment
• Clinically proven results
• Covered by all major insurance companies

Who are the Best Candidates for Infrared Coagulation (IRC)?
Infrared coagulation can be used to treat the early stages of hemorrhoids, and it is most effective in grade 1-2 hemorrhoids.

How is Infrared Coagulation Procedure Performed?
Before IRC procedure is performed, Dr. Shu gently inserts the anoscope (a very short, 3-4 inch rigid metal tube), then uses a handheld device that creates an intense beam of infrared light to touch the mucosa above the hemorrhoids, exposing the hemorrhoid tissue to a quick pulse of infrared light. The heat from the infrared light burns 4-5 spots in the targeted area, coagulating the vein above the hemorrhoids.

The resulting scar tissue cuts off the blood supply to the hemorrhoid venous complex. This causes the hemorrhoid complex to shrink and die. It may take a few weeks for all the hemorrhoids to shrink completely. Moreover, the scar tissue acts to hold nearby hemorrhoid veins in place so they don’t bulge into the anal canal easily and become hemorrhoids as you age.

Each IRC treatment only takes a couple of minutes. You may need as many as four separate treatment sessions every two weeks to cover all the areas where hemorrhoids appear, but this depends on each individual case and how extensive your hemorrhoids are.

What is the Recovery Time of Infrared Coagulation Procedure?
After the IRC procedure, you may feel mild discomfort in the anus and the urge to have a bowel movement sometimes. You are able to resume normal everyday activities immediately afterward. Typically, there are no post-treatment effects. However, there may be slight spot bleeding a few days later, but heavy rectal bleeding is extremely rare. Avoid heavy straining, lifting, and aspirin. If you notice significant rectal bleeding, you should call your doctor’s office.

You may use Tylenol as needed and take a warm sitz bath daily to relieve discomfort. A stool softener, fiber, and water will help ease your bowel movement while you heal.

The Easy Hemorrhoid Care™ (EHC) – a New and Elevated level of Care Delivery System for Hemorrhoid Treatment | Minnesota

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One Stop Medical Center invites you to experience an elevated level of care for your hemorrhoid treatments, with Minnesota’s first ever Easy Hemorrhoid Care™ Experience.

For nearly 20 years, Dr.Steven Shu has been providing exceptional hemorrhoid care utilizing the state-of-the-art medical techniques and technology available. Now he and his team offer Easy Hemorrhoid Care™ , a new care delivery system for hemorrhoid treatment with minimal invasive procedures, including Infrared Coagulation (IRC), rubber band ligation, and modified hemorrhoidectomy. It is an efficient system that requires only one trip. We provide patients a new experience in hemorrhoid care, from procedure through recovery. These advancements reduce discomfort, time, decrease the chance of complication and reduce the total recovery time.

For the first time in Minnesota, a personalized approach to meet your specific hemorrhoid care requirements is now available! The Easy Hemorrhoid Care™ Experience has been designed to take the stress and worry out of your hemorrhoid treatment. This package provides the most comfortable and seamless hemorrhoid care experience possible, with enhanced, customized hemorrhoid care, saving you precious time in your busy schedule.

Benefits of the Easy Hemorrhoid Care™ (EHC)
In the standard hemorrhoid care, the patients with hemorrhoids require multiple office visits with Infrared Coagulation and/or rubber banding ligation for their internal hemorrhoid treatments, followed by external hemorrhoidectomy and/or excision of anal hemorrhoids. It is a long process, but it is usually covered by your medical insurance.

The Easy Hemorrhoid Care™ (EHC) is a specially designed hemorrhoid care delivery system that aims to shorten the whole process of hemorrhoid treatment, to reduce discomfort, the chance of complications, and total recovery time. Patients are given Botox during the procedure to relax anal sphincter muscles, reducing post procedural pain. It is an efficient system that requires only one trip where you receive premium medical care, but it is not covered by your insurance.

To learn more about our Easy Hemorrhoid Care™ Experience in One Stop Medical Center, please contact us by calling at 952-922-2151 or email at info@shuMD.com.

The Common Causes of Minor Rectal Bleeding | Minneapolis & St Paul

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Minor rectal bleeding is one of the common symptoms that the Minnesotan patients seek for the medical care. It refers to the passage of small amount of bright red and fresh blood from the rectum and anus, which may appear on the surface of stool, on the toilet paper or in the toilet bowl.

This blog mainly discusses on the conditions with minor rectal bleeding that occurs intermittently. Rectal bleeding can be caused by various conditions, but even the slightest amount of bleeding should be taken seriously. Common causes of minor bleeding are internal hemorrhoids, ruptured thrombosed external hemorrhoids, fissures, fistula, diverticulosis, colon cancer, colitis, and polyps. Patients of older age or with significant family history of bowel disease or cancer should consider further examination. In addition, patients who were previously treated for rectal bleeding but continued to experience bleeding must be further examined.

The source of minor rectal bleeding is determined by history, physical examination and endoscopies. In the initial office visit, your doctor may inspect the anus visually to look for anal warts, anal fissures, cancer or external hemorrhoids, and followed by the digital examination with a gloved, lubricated finger and then anoscopy to look for abnormalities and sources of bleeding in the lower rectum and anal canal. If indicated, your doctor may also perform endoscopies, either sigmoidoscopy or colonoscopy.

Anoscopy is a rectal exam with a very short (3 to 4 inch) rigid metal tube to examine the lower rectum and anal canal, it is very useful when your doctor suspects hemorrhoids, anal fissures and other anorectal diseases.

A flexible sigmoidoscopy is to uses a short (24 inches) and flexible tube with a camera to examine the lower colon and rectum.

Colonoscopy is a test that examines the lining of the entire colon for abnormal growths, such as polyps or cancer. A long tube is passed into your bowel, and a light on the end allows the examiner to see the inside of the bowel. If anything abnormal is found, a small biopsy will be done, and polyps or growths can be removed.

The management of minor rectal bleeding mainly focuses on the treatments of the underlying diseases.

Treatment of External Thrombosed hemorrhoids | Minneapolis & St Paul

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External hemorrhoids occur outside the anal verge. Thrombosed external hemorrhoids occur if varicose veins rupture and blood clots develop. It is often accompanied by swelling with a bluish-purplish discoloration and severe incapacitating pain.

The symptoms may improve in some patients with conservative nonsurgical treatment – the anal care I coined includes stool softeners, increased dietary fiber, increased fluid intake, warm Sitz baths, and analgesia. For most patients, surgical excision is often more effective and efficient in treating thrombosed external hemorrhoids. Surgical excision is an office-based procedure performed under local anesthesia. This safe office procedure offers low complication and recurrence rates and high levels of patient satisfaction.

Procedure
After cleaning the anal area with an antiseptic, lidocaine with epinephrine is locally injected in the surgical area. The thrombosed hemorrhoid is unroofed by making an elliptical incision in the hemorrhoid, then the blood clots are removed, and the procedure is finished for a simple case. Simply draining the clot usually relieves the pain immediately, but it may not work well if multiple thromboses exist as it can also lead to recurrence, so it is better for patients with multiple thromboses to completely excise the thrombosed hemorrhoids. The external hemorrhoidectomy may be performed, then the hemorrhoidal tissue with blood clots is removed together, and the bleeding in the wound is stopped with a cautery. The wound in the anal area is covered with sterile gauze.

Postoperative Care
The patient will be instructed to do anal care measures, including warm Sitz baths three times a day for 15-30 minutes at a time. Acetaminophen or ibuprofen should be used for pain control. The patient should remain well hydrated and take a stool softener to keep stool soft.

Complications
Common complications of thrombosed external hemorrhoid excision include pain, bleeding, infection and delayed healing. A perianal skin tag could develop in some patients. Stricture and incontinence are extremely rare complications.

Why can’t Single Treatment Modality Fix All Hemorrhoids? | Minnesota

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Hemorrhoids diseases include internal hemorrhoids, external hemorrhoids, anal tags, thrombosis of hemorrhoids and mixed hemorrhoids. Internal hemorrhoids are graded from I to IV based on the degree of prolapse. Besides causing anal itching, pain, bleeding and prolapse, hemorrhoids could cause other complications, such as thrombosis, anemia, and infection. Moreover, many hemorrhoid patients have a comorbidity of anal fissure, fistula, or anal warts. Because no single treatment modality can fix all hemorrhoids, a true hemorrhoid clinic will offer multiple treatment modalities and options to meet a patient’s needs and provide complete care.

If you are treated with single modality for your hemorrhoids, regardless of the severity, type of hemorrhoids, and associated anorectal conditions, it leads to poor results because of poor quality care.

No single treatment modality can fix all hemorrhoids or get rid of anorectal symptoms. Specialized hemorrhoid clinics should be able to offer multiple treatment modalities with cutting edge technologies to cure hemorrhoids and associated diseases.

Internal hemorrhoid Grade 1
Very early hemorrhoids can often be effectively dealt with by dietary and lifestyle changes. The lifestyle changes should also be part of the treatment plan for more advanced hemorrhoids.

Internal hemorrhoid Grade 1-2
Infrared coagulation (IRC) is a non-surgical treatment that is fast, well tolerated, and remarkably complication-free. The infrared light quickly coagulates the vessels that provide the hemorrhoid with blood, causing the hemorrhoids to shrink and recede.

Internal hemorrhoid Grade 3
Rubber band ligation is widely used for the treatment of more advanced (more prolapsed) internal hemorrhoids where the prolapsed hemorrhoidal tissue is pulled into a double-sleeved cylinder to allow the placement of rubber bands around the tissue. Over time, the ligated tissue dies off. Rubber band ligation downgrades the hemorrhoids to grade 1 or 2, so some patients may need to do Infra-Red Coagulation (IRC) treatments after Rubber band ligation.

Internal hemorrhoid Grade 4
A hemorrhoidectomy surgically removes the tissue that causes bleeding or protrusion. It is done in a doctor’s office, surgical center, or hospital under anesthesia and may require a period of inactivity.

External hemorrhoidal tags (anal tags)
Small and asymptomatic tags don’t need any treatment. If symptomatic, anal tags can easily be removed in the office using a local anesthetic and a radiofrequency device.

Thrombosed external hemorrhoids
These hemorrhoids are typically treated with either incision to remove the clot or with external hemorrhoidectomy. Simply draining the clot usually relieves the pain immediately, but it may not work well if multiple thromboses exist as it can also lead to recurrence, so it is better for patients with multiple thromboses to completely excise the thrombosed hemorrhoids.

External hemorrhoids
Small and asymptomatic external hemorrhoids don’t need any treatment, however most patients will have an intermittent flare up. Eventually patients may need surgery (external hemorrhoidectomy) if you have large external hemorrhoids and/or persistent symptomatic external hemorrhoids.

Rubber band ligation for the Treatments of Internal Hemorrhoids | Minnesota

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Rubber band ligation is one of the most common outpatient treatments available for the Minnesotan patients with internal hemorrhoids. It is a better option for patients with prolapsed hemorrhoids. A number of prospective studies have found rubber band ligation to be a simple, safe, and effective method for treating symptomatic second- and third-degree internal hemorrhoids as an office procedure with significant improvement in quality of life. This procedure is almost never appropriate if there is insufficient tissue to be pulled inside the band ligator drum, such as grade 1 or mild grade 2 hemorrhoids, and it should not be done with the most severe (grade 4) hemorrhoids, either.

Rubber band ligation is an office procedure in which the prolapsed hemorrhoid tissue is tied off at its base with rubber bands, cutting off the blood flow to the hemorrhoidal mass. It is contraindicated in the patients using anticoagulants and other anorectal diseases, such as local infection, acute thrombosis and chronic anal fissure.

The process involves a doctor inserting an anoscope into the anus and identifying and grasping the prolapsed hemorrhoid with an instrument to place a rubber band around its base. With the rubber band in place, the hemorrhoid shrinks and recedes, dying off in a few days or a week. The reduced volume of venous tissue with the scar formation prevents hemorrhoid tissue from bulging into the anal canal. The procedure is usually done in a doctor’s office and only takes a couple of minutes. Treatment is limited to one to two hemorrhoids each office visit, and additional areas may be treated at two week intervals.

What to expect after the rubber band ligation treatment:

After the banding procedure, most patients don’t feel much discomfort; some may feel tightness and mild pain or feel as if you need to have bowel movement. People respond differently to this procedure. Most patients are able to return to regular activities (but avoid heavy lifting) almost immediately. Others may need a few hours or a day of rest. If you feel some pain after banding, you may use Tylenol or Ibuprofen as needed and take a lot of Sitz baths for 15-30 minutes at a time to relieve discomfort.

Some patients may have slight rectal bleeding after a week, when the rubber band falls off. The bleeding usually stops by itself; however, if you notice significant rectal bleeding, then you should call your doctor’s office. It is also very important to make sure that your stool is soft by taking stool softeners containing fiber and drink more fluids.

Infrared Coagulation (IRC) for Hemorrhoids | Minnesota

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Infrared coagulation (IRC) is a medical procedure used to mainly treat grade 1 to grade 2 internal hemorrhoids. This treatment is also used as an adjunctive treatment in conjunction with banding therapy or surgery for more severe hemorrhoids such as grade 3 and 4. During the procedure, the doctor uses an IRC device that creates an intense beam of infrared light. Heat created by the infrared light destroys vein complex and causes scar tissue, which cuts off blood supply to the hemorrhoid. Over the several weeks following the IRC treatments, the hemorrhoid shrinks and a scar formed in the lining of the anal canal, which holds nearby veins in place to prevent their prolapse.

Only one area of internal hemorrhoids can be treated at a time. Hemorrhoids patients typically get four IRC treatments at two week intervals.

Infrared coagulation is usually done in a doctor’s office in Minnesota. You may briefly feel heat and some stinging pain during the procedure, which lasts only 1-2 seconds in each touching.

What To Expect After Treatment:

Intermittent rectal bleeding could occur at any time within 14 days after the IRC procedure. Bleeding is usually minimal and mild, and resolves by itself after the treated areas heal.

  • You may use mild pain relievers such as Tylenol and sit in a shallow tub of warm water (sitz bath) for 15 to 30 minutes at a time to relieve discomfort.
  • To reduce the risk of bleeding, avoid taking aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) for a week both before and after the infrared coagulation.
  • You take stool softeners that contain fiber to ensure smooth bowel movements and avoid strain.

    • One Stop Medical Center in Minnesota offers comprehensive hemorrhoid care, please call 952-922-2151 if you need a consultation.

    Manangement of Anal Skin Tags | Minnesota

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    Have you been using too much toilet paper because of pesky anal tags? Hemorrhoidal skin tags are flaps of skin or flesh found around the anus. They often form as a result of an existing hemorrhoid. Hemorrhoids occur when veins in the anorectal areas become swollen and inflamed.

    Anal skin tags often occur if an individual heals the thrombosed external hemorrhoids at home without surgery, the thrombosed hemorrhoids may leave behind skin tags. Anal skin tags may also form because of non-hemorrhoid causes, such as anal fissure, surgery, or infection, etc. Despite the fact that people often confuse them with cancerous growths, skin tags are benign and present no serious health concerns.

    Hemorrhoidal skin tags often don’t cause significant rectal symptoms, but they often affect the cleansing after bowel movement. If feces become trapped beneath the skin tags, it can cause irritation and lead to itching and further inflammation. Skin tags can also cause pain when it flairs up or if there’s another underlying rectal problem.

    Patients suffering discomfort or itching due to hemorrhoidal skin tags can treat the condition with the following:

    • Thorough cleaning of the affected area after bowel movement. May use gentle cleansers, such as witch hazel or aloe vera extract.
    • Do a Sitz bath with warm water.
    • May use OTC hemorrhoid cream to reduce irritation and swelling.
    • If the skin tags frequently cause symptoms, individuals may consider having them removed surgically.
    • Most patients who have anal tags often have hemorrhoids, too, they should consider complete care by treating internal hemorrhoids before removal of anal tags or at the same time.

    Excision of anal tags:
    Anal tags can easily be removed in the office using local anesthetic. The procedure takes less than 10 minutes and patients are safe to drive immediately afterwards. There may be mild postoperative pain and discomfort with bowel movement in the first week. The patients are typically able to go back to work next day although the whole healing process may take a few weeks.

    Why Single Treatment Modality can’t Fix All Hemorrhoids

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    There are three types of hemorrhoids – internal, external, and mixed hemorrhoids that consist of both internal and external. Internal hemorrhoids are graded from I to IV based on the degree of prolapse. Because no single treatment modality can fix all hemorrhoids, a true hemorrhoid clinic will offer multiple treatment modalities and options to meet a patient’s needs.

    Years ago, an IRC-only hemorrhoid clinic at France Avenue closed its business because a family physician treated every hemorrhoid patient with the single modality – Infra-red coagulation (IRC), regardless of the severity, type of hemorrhoids, and associated anorectal conditions. Poor quality care leads to poor results.

    Many patients with more advanced hemorrhoids need banding, and even the surgical excision of anal tags and external hemorrhoids. Many hemorrhoid patients have a comorbidity of anal fissure, fistula or anal warts, and need further management with special expertise for these associated medical problems.

    Most hemorrhoid patients have the symptom of rectal bleeding; a high quality hemorrhoid clinic should offer colonoscopy to rule out colon cancer and other colon diseases.

    No single treatment modality can fix all hemorrhoids or get rid of anorectal symptoms. Specialized hemorrhoid clinic should be able to offer multiple treatment modalities with cutting edge technologies to cure hemorrhoids and associated diseases.

    One Stop Medical center provides premier one stop hemorrhoid care. Regardless of how severe your hemorrhoids are, what kind hemorrhoids, or any associated anorectal diseases, we are able to find a solution for you. Supported by an outstanding medical team and equipped with cutting edge technology, our state-of-the-art accredited surgical center sets the standard for patient safety and high quality medical care.