Category Archives: hemorrhoidectomy

The Common Causes of Rectal Lumps | Minneapolis & St Paul

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A rectal lump is one of the common symptoms in the anorectal diseases in Minnesota. A rectal lump is a growth in the anal canal or rectal area. Rectal lumps vary in size and the degree to which they produce symptoms. Depending on the underlying cause, a rectal lump may or may not cause any pain.

Should you be worried about that bump you just discovered back there? A palpable mass in the anal area may or may not indicate cancer or hemorrhoids. Lumps can be caused by a variety of conditions including anal warts, hemorrhoids, polyps, fissures, or cancer.

  • Hemorrhoids are probably the most common reason for having a rectal lump in Minnesota. It can be caused by internal hemorrhoids, but more commonly by external hemorrhoids. If a rectal lump is related to internal hemorrhoids, it usually gets bigger and more prolapsed right after the bowel movement; it could be spontaneously reduced in the early stage of internal hemorrhoids. But it could be non-reducible in the late stage of hemorrhoids. It may be associated with other symptoms such as bleeding, itch or pain. The thrombosed external hemorrhoids are usually very painful if the varicose veins rupture and the blood clots develop.
  • Anal warts are caused by human papilloma virus (HPV). HPV infection is considered to be sexually transmitted diseases. Left untreated, anal warts can spread and increase the risk of cancer in the rectal and anal region.
  • Anal Fissure is a small cut or split in the anal lining often caused by a painful, hard bowel movement. Fissures are typically located anterior or posterior to the anus. Anal fissure is often associated with a lump called sentinel pile, accompanied by pain and bleeding.
  • Rectal Cancer. The rectum is the last six inches of the body’s digestive system, exiting through the anus. One cause of a rectal lump is rectal cancer. Symptoms that require doctor’s attention include blood in the stool, change in bowel habits, tired feeling, abdominal discomfort, change in appetite, or unexplained weight loss.
  • Anal cancer occurs in the anal canal, it is account for 2% of cancer in the gastrointestinal tract. An external or internal mass may be palpable. Anal or rectal cancer generally do not produce any pain; Some lesions are so soft that they are missed on palpation. Anal cancer can take several forms including ulcers, polyps or verrucous growths.
  • Anorectal abscesses are the result of infection of anal glands in the lining of the anal canal near the opening of the anus. The patient usually has the painful swollen lump if it is superficial abscess. The presence of an abscess warrants surgical incision and drainage as soon as possible. Just antibiotics would be ineffective at this stage in the infection.

If you feel a lump in the anal or rectal area, contact our hemorrhoid clinics in Edina to determine the cause and get treatment. You should seek immediate medical care if the associated symptoms are serious such as high fever, drainage of pus from a rectal lump, severe pain, or bloody stool.

Treatment of the Thrombosed Hemorrhoid on the Road | 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 under skin. It is often accompanied by swelling with a bluish-purplish discoloration and severe incapacitating pain.

I have an interesting story that happened while I visited China many years ago. I was invited to give a lecture on office procedures as a guest professor in Zhejiang University, China. After the academic exchange, I had a few days to myself, so I went to visit an old friend of mine (let’s call him Dave). We decided to go visit a new resort town a few hours away from the city. As we were talking in the hotel, he was looking a bit shifty on the couch, as if he was very uncomfortable. I asked him if he was having a problem, and he said he had a lot of pain because of his hemorrhoids. Thankfully, this being an area of my specialty, I was able to diagnose him with having a thrombosed hemorrhoid that needed immediate treatment. I told him that a thrombosed external hemorrhoid is the common complication of hemorrhoids.

Dave said he would go to the hospital, but he hesitated to go because of inconvenient medical care in China. He didn’t trust the doctors in the local small hospital, and he was indecisive in choosing a larger hospital. I told him that I had fixed countless thrombosed hemorrhoids, and that if I had the tools I needed, I could fix it for him in a flash. I went to a local hospital in the town and identified myself, the medical staff believed that I was a general surgeon at Shanghai Medical University thirty years ago and that currently I practice in the US. I asked if I could get the necessary gear to do the procedure. Amazingly, the staff in the local hospital were very helpful and generous, and I managed to return with latex gloves, a scalpel, syringes, a pack of gauze, and a bottle of Lidocaine. I got him down on the bed and we did the procedure right there in the hotel.

The procedure took only a few minutes. I gave 0.5 cc Lidocaine to numb the top of the thrombosed hemorrhoid, then sliced open the hemorrhoid with a scalpel and removed the clotted blood with a cotton-tipped applicator. Once the clot was gone, I cleaned up the area by packing large amounts of gauze. The relief was immediate and other than a little bleeding for a day or so, the problem was gone. He was asked to do the Sitz bath three times a day and keep his stool soft.

I told Dave if he had the chance to visit Minneapolis, I can do IRC treatments to treat the root cause of problem – internal hemorrhoids.

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.

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.