Causes of rectal bleeding in Minnesota

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Rectal bleeding refers to the passage of red blood from the rectum and anus, often mixed with stool and/or blood clots. The severity of rectal bleeding varies widely. Most rectal bleeding is mild and intermittent, but it also may be moderate or severe.

Rectal bleeding can be caused by various conditions, but even the slightest amount of bleeding should be taken seriously. Common causes of bleeding are internal hemorrhoid, ruptured thrombosed external hemorrhoids, fissures, diverticulosis, colon cancer, colitis, polyps and angiodysplasias. 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.

Many patients in the Minneapolis and St Paul areas think rectal bleeding is always caused by hemorrhoids. When these patients come to the doctor’s office because of rectal bleeding, they tend to say they have hemorrhoids. The notion that rectal bleeding is the same as hemorrhoids is dangerous, as this may lead to a delayed diagnosis and treatment. The truth is that rectal bleeding in some patients could be caused by colon cancer with or without hemorrhoids.

The source of rectal bleeding is determined by history, physical examination and blood tests, assisted with anoscopy, sigmoidoscopy, colonoscopy, radionuclide scans, and angiograms.

Treatment of rectal bleeding includes correcting the low blood volume and anemia, determining the site and cause of the bleeding, and stopping the bleeding.

The common Causes of Anal Itching|Minneapolis

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Anal itching is one of four common anorectal cardinal symptoms in the office visit in Minnesota, other symptoms are rectal pain, bleeding and bulging out. Anal itching may resolve spontaneously or with topical medications, but the initial relief of the itching does not necessarily mean the problem goes away. Continuous scratching or excessive cleaning of the anal area may further harm the sensitive tissues and worsen symptoms. The peri-anal dermatitis with or without yeast infection can complicate the problem. In addition, the area can be highly sensitive to perfumes, soaps, fabrics, dietary intake and superficial trauma. When chronic itching occurs, the perianal area becomes white with fine fissures.

Possible causes of anal itching include:

• Skin irritation: Moisture and friction can irritate the skin in the peri-anal area. Some products such as soap and toilet paper may also trigger irritation.
• Hemorrhoids: Anal itching can be a symptom of hemorrhoids.
• Digestive problems: Diarrhea or fecal leakage or mucus discharge can cause anal irritation and itching.
• Skin disease: Anal itching could be related to a specific skin disease, such as psoriasis or contact dermatitis
• Infections. STD, yeast infections, and the parasite may also involve the anus and can cause anal itching.
• Anal tumors: Rarely, a cause of anal itching.

Mild anal itching can be easily relieved with Sitz bath and topical OTC hemorrhoid cream. If Pruritic Ani with chronic itching occurs, cyclic urge to scratch must be broken. Treatments for intensive and cyclic anal itching include wearing mitten and taking antihistamine as a sedative prior to sleeping to prevent the patient from unconsciously scratching, or using a topical corticosteroid to alleviate the itching. Underlying disorders such as hemorrhoids or infections must be considered and treated when diagnosing and treating anal itching.

Hemorrhoid Banding in Minneapolis/St. Paul

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Rubber band ligation (RBL) is one of the common procedures to treat hemorrhoids in Minnesota. Hemorrhoid banding is an office procedure in which the prolapsed hemorrhoid tissue is tied off at its base with rubber bands. It works very well for prolapsed hemorrhoids, such as the advanced grade 2 and grade 3 hemorrhoids. It cannot be performed if there is not enough tissue to pull into the barrel in the banding device. Hemorrhoid banding treatment is almost never appropriate for grade 1 or mild grade 2 hemorrhoids (treated with IRC), or most severe (grade 4) hemorrhoids (treated with surgery).

The process involves a doctor inserting an anoscope into the anus and grasping the prolapsed hemorrhoid with a long clamp to place a rubber band around its base. With the rubber band in place, the hemorrhoid dies off in a few days or a week. The procedure is done in a doctor’s office and only a couple of minutes. Treatment is usually limited to 1 hemorrhoid each office visit and additional areas may be treated at 2 week intervals.

After the procedure, some patients may feel tightness, mild pain or have the feeling of bowel movement. Most patients in the Minneapolis and St Paul areas are able to return to regular activities (but avoid heavy lifting) almost immediately. If you feel some pain after banding, you may use Tylenol or Ibuprofen as needed and do a lot of sitz bath for 15-30 minutes at a time to relieve discomfort. Some patients may have slight rectal bleeding in a week. If you notice significant rectal bleeding, then you should call your doctor’s office.

Hemorrhoid Prevention in Minneapolis/St. Paul

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There are many ways to prevent the hemorrhoids for the patients in Minnesota. One of the best ways to avoid hemorrhoids or a flare up is to avoid constipation by keeping your stools soft. Eating a diet that is high in fiber such as fruits, vegetables, beans, and whole grains are recommended. Taking a fiber supplement every day, such as Citrucel or Metamucil, can help keep bowel movements regular. Drinking enough fluids is equally as important. Water is the best form of hydration (6-8 glasses daily). Daily exercise is also great to help the bowel move through your digestive system and prevent you from becoming constipated. Moderate activity of at least 30 minutes 3-4 times per week is recommended. Long time of sitting or standing should be avoided. Scheduling time each day for a bowel movement and keeping it a daily routine may help. The best time for a bowel movement is right before taking a shower, washing helps to reduce anal skin irritation after bowel movement. Another convenient option for people in the Minneapolis and St. Paul areas is to use IntelliSeat. Take your time and do not strain when having a bowel movement, because straining can aggravate hemorrhoids. Straining and holding your breath when trying to pass a stool creates greater pressure in the veins in the lower rectum. Lastly, once you feel the urge, it is important to go because if you wait to pass a bowel movement, the urge goes away and your stool could become dry and be harder to pass.

Thrombosed External Hemorrhoid in Minnesota

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Thrombosed external hemorrhoid is a common problem in Minnesota. It is usually a complication from the underlying disease – internal hemorrhoids. It occurs outside the anal verge when one or more varicose hemorrhoidal veins rupture and blood clots develop. Typical symptoms of thrombosed external hemorrhoid are sudden onset with severe rectal pain and tender bluish swelling in the anus. 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.

I have an interesting story that happened while I visited China a few years ago. My friend Dave developed the thrombosed external hemorrhoid in the hotel while he accompanied me to visit a new resort town after an academic exchange in China. 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 twenty years ago and that currently I practice in the US. Surprisingly, the staff in the local hospital was 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 Dave down on the bed and we did an incision and draining procedure right there in the hotel. The relief was immediate and other than a little bleeding for a day or so, the problem was solved.

If anyone in the Minneapolis and St Paul areas develops the sudden onset of severe rectal pain, please call us immediately. We will accommodate to your urgent medical needs and offer the same day care.

Infrared Coagulation (IRC) for Hemorrhoid Treatment | Minneapolis and St Paul

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Since its introduction 20 years ago, infrared coagulation has become the world’s leading office treatment for hemorrhoids. Dr. Shu has provided one stop hemorrhoid treatment in Minneapolis since 2002, and he has treated thousands of hemorrhoid patients in the Minneapolis and St Paul areas with the IRC technology. This non-surgical treatment is fast, well tolerated and remarkably complication-free. A small probe is placed on the hemorrhoid and a few short bursts of infrared light are applied. The infrared light quickly coagulates the vessels that provide the hemorrhoid with blood, causing the hemorrhoid to shrink and recede. Shrinkage of the hemorrhoidal tissue may take a few weeks.

There may be a quick sensation of pain during the short burst of infrared light but overall the IRC treatments are very tolerable and painless. There are no post-treatment effects in 99% of patients. Usually approximately 4 treatments are required. The IRC technology is very effective in treating grade 1 and grade 2 hemorrhoids. In general, the treated hemorrhoids do not reoccur. Patients return to a normal lifestyle right after the treatment on the same day. There may be slight spot bleeding a few days later and up to 2 weeks. Heavy straining or lifting should be avoided and aspirin should not be taken for a few days. A sensible diet, moderate exercise and proper bowel habits will help so no further hemorrhoids will form.

One Stop Medical Center also offers the banding and hemorrhoidectomy for the patients with the advanced hemorrhoids. If you have any questions about hemorrhoid treatment in the Minneapolis and St Paul areas, please call us at 952-922-2151.

Hemorrhoid Treatment History Part 2

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The word “Hemorrhoids” is probably derived from the combination of Latin “hæmorrhoida -ae” (haemo (blood), rhoidae (flowing) and the Greek “Haimorrhoos”. The original “a” has been dropped to give us “Hemorrhoids”.

In the 13th century, European surgeons such as Lanfranc of Milan, Guy de Chauliac, Henri de Mondeville and John of Ardene made great progress and development of the surgical techniques.

In the 19th and 20th centuries, many new surgical techniques were developed to treat the advanced hemorrhoids. In the meantime, several minimal invasive non-surgical modalities were invented to treat early stages of hemorrhoids.

1806; Using the modern era of endoscopy, Philip Bozzini, an Italian-German physician, used an aluminum tube to see the genitourinary tract. He then earned the title “The father of endoscopy”.

1835; St.Marks Hospital London was founded by Frederick Salmon providing modern hemorrhoids and fistula treatment.

1849; Introduction of anal dilation for hemorrhoids treatment.

1935; Doctors E.T.C. Milligan and C. Naughton Morgan in St.Marks Hospital London further studied the excision and ligation methods, which later became the gold standard in hemorrhoidectomy.

1950s;Ferguson modified the Milligan-Morgan procedure, and A.G. Parks’ developed his closed method surgical treatment.

1960s, Banding of larger hemorrhoids was introduced with rubber band ligation.

1970s; Non-surgical methods including cryotheraphy, diathermy, Infra-red and laser cauteries were developed for treatment.

1975; PH Lord developed his anal dilation hemorrhoid treatment method, whilst WHF Thompson postulated that hemorrhoids developed from anal cushions that are part of the normal anatomical structures.

1990s; Stapled Hemorrhoidopexy, also known as Procedure for Prolapse & Hemorrhoids (PPH) was first described by an Italian surgeon – Dr. Antonio Longo, and since then has been widely adopted to treat the grade 3 and 4 hemorrhoids. Moreover, the digitalized Infra-red coagulation (IRC) was getting popular for the treatment of early stage of hemorrhoids.

Hemorrhoid Treatment History Part 1 | Minneapolis

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As early as 2250 BC hemorrhoids have been recorded in literature to some extent. It would probably be safe to say that it is one of the oldest ailments known to people. The Egyptians were the first people who medically recorded the remedies for hemorrhoids. In 1700 BC Egyptian papyrus advised to use a poultice of dried acacia leaves with a linen bandage to heal protrusions and inflammations of venous tissue.

A well-known Greek physician named Hippocrates wrote about hemorrhoids in his book, On Hemorrhoids, describing it as bile or phlegm which is determined to be the veins in the rectum. He treated the anal protusions very crudely advocating pulling the tissue off with the finger tips, or pulling the veins upward, while someone puts a hot iron to the hemorrhoid and burns it off. The first recorded endoscopy (use of speculum to inspect the rectum) can also be credited to Hippocrates. In 400 BC, the Hippocratic also discussed a treatment similar to modern rubber band ligation: “And hemorrhoids in like manner you may treat by transfixing them with a needle and tying them with very thick and woolen thread, for application, and do not forment until they drop off, and always leave one behind; and when the patient recovers, let him be put on a course of Hellebore”.

Even the bible has records of hemorrhoids in the earliest times from the Old Testament Book of Samuel 5:9 Philistines, “punished with emerods” and Samuel 5:12, “People who moved the Ark to Ekron were punished with emerods”.

One of the earliest known hemorrhoid treatments was with the aloe vera plant. Dioscorides, a Roman physician started using that to treat inflamed hemorrhoids. Celsus (25 BC – AD 14) described ligation and excision procedures, and discussed the possible complications. Then approximately 130-200 AD a Roman physician named Emperor Marcus Aurelius (Galen) prescribed ointment, laxatives, and leeches for hemorrhoids treatment. Galen advocated severing the connection of the arteries to veins, claiming that it reduced both pain and the spread of gangrene. The Susruta Samhita, (4th – 5th century AD), similar to the words of Hippocrates, but emphasizes wound cleanliness. During the same time period in India, the use of clamp and cautery was used to get rid of hemorrhoids and control bleeding.

Between the 5th and 10th Century, Byzantine physicians used thread to ligate the base of the hemorrhoid and then followed by its amputation.