(Ask to be booked into the hemorrhoid clinic)
2. What causes hemorrhoids?
Hemorrhoids result from an increase in pressure in the veins of the rectum This may be caused by constipation, pregnancy, childbirth, obesity, heavy lifting, long periods of sitting, or diarrhea. In Western countries, constipation is associated with diets low in fiber and high in fat.
3. Who gets hemorrhoids?
Hemorrhoids affect both men and women. The incidence of hemorrhoids increases after age 30, and by age 50, about half of the population will have experienced the condition.
4. How does Rubber Band Ligation work?
This treatment is appropriate for most hemorrhoids. No anesthetic (local or general) is required. A tiny rubber band is placed around the tissue above the hemorrhoid. This cuts off blood supply to the hemorrhoid, causing it to shrink and fall off typically within one to five days. You probably won’t even notice when this happens or be able to spot the rubber band in the toilet.
5. Does banding hurt?
No.Normally the band placement is painless. You may experience a feeling of fullness or dull ache in the rectum for the first 24 hours, but this can generally be relieved by over-the-counter pain medication. Most patients experience no significant post-procedural pain.
6. How many bands are necessary?
There are three sites where hemorrhoids form frequently, and it is not uncommon for all three sites to require treatment. We generally only band one hemorrhoid site at a time in separate visits, as multiple bandings have been found to increase complications. Also, some extremely large hemorrhoids may require additional banding sessions. Thus, multiple bands may be used in severe cases, but one to three is standard.
7. Can you treat external hemorrhoids?
Yes. Most hemorrhoid symptoms are from dilated internal hemorrhoids and or anal fissures. The banding of internal hemorrhoids usually shrinks the external hemorrhoids as well and is highly effective in relieving the symptoms of pain and bleeding. After banding is completed there may be an external component or skin tag that persists, but usually they do not cause much in the way of symptoms.
8. What should I expect at my visit?
The first appointment will typically consist of a consultation and physical exam. During the diagnosis you may receive a physical examination, anoscopy and/or proctoscopy which are visual examinations of the ano-rectal region. There is no need for anesthesia, fasting or other preparation.You and your physician will determine an appropriate treatment for your diagnosis during your examination.
If your diagnosis includes hemorrhoids, treatment may start immediately. In the event of multiple hemorrhoids, often the largest, most symptomatic hemorrhoid is banded first. Additional appointments are then scheduled to treat the remaining hemorrhoids at two week intervals with a final check-up two or more weeks after the last remaining hemorrhoid is banded.
Sometimes patients have both an anal fissure and hemorrhoids. Our ligation system often allows us to begin concurrent treatment of both conditions allowing for a quicker recovery.
9. Will I have to miss work or other activities?
Your first appointment with our office will probably be the longest, as it involves a consultation, obtaining a medical history, making a diagnosis of your problems and formulating a treatment plan. We suggest you allot up to an hour. Subsequent treatment sessions will be shorter, around 15-30 minutes total. After a hemorrhoid banding procedure, we recommend that you refrain from vigorous activities the rest of the day and resume full activity the next day. Most patients with office jobs find they can return to work immediately following their appointment. It may be advisable to bring along another driver with you in case you experience discomfort after treatment.
10. What Can I expect longer term?
Soon you’ll be feeling much better, but you’ll need to make some changes to prevent future problems. Straining due to constipation should be diligently avoided, so be sure to drink several glasses of water a day and add 15 grams of fiber to your diet (two tablespoons of natural oat or wheat bran). Metamucil, Benefiber, flax or other soluble fiber may be helpful as well.
We also recommend that you not sit longer than two minutes on the toilet. If you can’t have a bowel movement in that time, come back later. This two-minute rule can help keep you from straining during bowel movements without realizing it. Finally, when traveling by air, stay hydrated, avoid alcohol, eat fiber and walk around when you can.
11. Why aren’t creams and home remedies enough?
Hemorrhoid creams and suppositories are designed to provide temporary relief for symptoms such as pain and itching. They cannot shrink the hemorrhoid, stop it from growing larger or make it go away. Ultimately, the best solution for recurrent symptoms is the destruction or removal of the hemorrhoid itself.
12. How do I know if I have hemorrhoids or an anal fissure?
Good question. Anal pain, itching and rectal bleeding are symptoms of both hemorrhoids and anal fissures. As a result, it’s possible for people to incorrectly self-diagnose themselves. Always consult a physician for a proper diagnosis. Because bleeding is also a symptom of colorectal cancer, it’s important to rule out other problems as well.
13. How much does banding cost?
Please call our office for the most up-to-date pricing on the services you may require. Most major insurance plans as well as Medicare, cover hemorrhoid banding, anal fissure treatment and colorectal cancer screening. The out of pocket expense per treatment after the Medicare rebate is less than $150.00
14. Do hemorrhoids increase the risk of colorectal cancer?
No. Hemorrhoids do not increase your risk of developing colorectal cancer. But since both conditions can produce rectal bleeding as a symptom, it’s important to determine whether cancer may also be present. Because of this fact, further diagnostic procedures, such as flexible sigmoidoscopy or colonoscopy may be recommended. Research shows that up to 2.3% of patients with bleeding hemorrhoids may also have colorectal cancer.
15. Will my insurance cover banding?
Most major insurance plans as well as Medicare, cover some of the costs associated with hemorrhoid banding, anal fissure treatment and colorectal cancer screening.
16. How common is banding?
Rubber band ligation is the most frequently used non-surgical treatment for hemorrhoids in the world. Hemorrhoid disease, one of the oldest afflictions of mankind, was probably treated as early as 2250 b.c. in Babylon. Hippocrates (460 b.c.) advised ligation, cautery and excision. Rubber banding treatment was introduced by Barron (Detroit) in 1963.
*Disclaimer: Although we have endeavour to supply the best available information available, we take no responsibility for omissions or errors and results may vary depending on a patients particular situation.
Dr. PT. Wong has been treating Hemorrhoids for over 20 years using Rubber Banding Ligation. This simple cost effective procedure provides a simple treatment by removing the hemorrhoid itself.
He will take you through each step of the procedure and provide you with advice on your best treatment options*.
CALL 9855 9555 for your appointment with Doctor Wong today.