Hemorrhoids — Patient Information

A clear guide for Valley Gastroenterology patients.

What are hemorrhoids?

Hemorrhoids are swollen veins in the lower rectum/anus. Internal hemorrhoids form inside the rectum; externalhemorrhoids form under the skin around the anus. They are common and often improve with simple measures.

Common symptoms

  • Bright‑red rectal bleeding (on the toilet paper or in the bowl)
  • Itching, irritation, mucus
  • Tissue that prolapses (bulges) with bowel movements
  • External hemorrhoids: swelling or a tender lump; sudden severe pain may be a thrombosed hemorrhoid

Red‑flags — seek care promptly

  • Heavy bleeding, black/tarry stools, dizziness or fainting
  • Persistent pain, fever, or foul drainage (possible infection)
  • Bleeding that does not improve after a few days of self‑care

Not all rectal bleeding is from hemorrhoids. We may recommend colonoscopy based on your age, symptoms, and risk factors.

Self‑care first (usually 1–2 weeks)

  • Fiber: Aim for 25–30 g/day (foods and/or psyllium). Increase gradually; drink water.
  • Hydration: 6–8 glasses/day unless on fluid restriction.
  • Toilet habits: Don’t strain; limit sitting on the toilet to <5 minutes; don’t delay the urge to go.
  • Sitz baths: Warm water 10–15 minutes, 1–2 times daily and after BMs.
  • Topicals: Short courses of petroleum jelly/zinc oxide for protection; medicated creams/suppositories briefly for flares.
  • Pain: Prefer acetaminophen; avoid NSAIDs if you’re bleeding unless we advise otherwise.

When office procedures help

If symptoms persist or prolapse/bleeding is frequent, we may recommend an office treatment for internal hemorrhoids:

  • Rubber Band Ligation (RBL): tiny band cuts off blood supply; banded tissue falls off in 7–10 days. Often needs 2–3 sessions, 2–4 weeks apart.
  • Infrared Coagulation (IRC): heat seals small internal hemorrhoids.
  • Sclerotherapy: medication shrinks the hemorrhoid (selected cases).

External hemorrhoids are not treated with bands. A thrombosed external hemorrhoid may be managed with pain control; in select cases office removal within 72 hours of onset can help.

Surgical options (for advanced disease)

For large prolapsing hemorrhoids, mixed internal/external disease, or symptoms unresponsive to office therapy, we may refer for hemorrhoidectomy or other surgical approaches.

After a banding/office treatment (what to expect)

  • Pressure/fullness is common for 24–48 hours; use acetaminophen.
  • Light bleeding or mucus may occur, especially when the band falls off (day 7–10).
  • Avoid heavy lifting/straining for 24–48 hours; continue fiber + fluids.
  • Call us urgently for severe/worsening pain, heavy bleeding, fever >101°F, chills, or difficulty urinating.

Prevention for the long term

  • Daily fiber + fluids; regular physical activity
  • Don’t strain; respond to the urge to have a BM
  • Limit time on the toilet and avoid heavy lifting when constipated

Alaska‑specific note

Bad weather or unsafe roads? We’ll reschedule without penalty and offer telehealth for counseling and follow‑ups when appropriate.

Next steps

If you have ongoing bleeding, prolapse, or pain, schedule a visit. We’ll confirm the cause and build a stepwise plan—from self‑care to office treatment, and surgery only if needed.

Valley Gastroenterology

3190 E Meridian Park Loop, Suite 206

Wasilla, Alaska 99654

Phone: (907) 373-2544

Fax: (844) 689-4240

Web: ValleyGastroAK.com