Chronic Hemorrhoids Treatment

Quick Summary

Chronic hemorrhoids can cause persistent bleeding, itching, pain, swelling, and discomfort during bowel movements. They may result from constipation, straining, prolonged sitting, pregnancy, obesity, or family history. Treatment can include dietary changes, topical medications, sitz baths, and pain relief. When conservative care fails, hemorrhoidal artery embolization (HAE) offers a minimally invasive option for eligible patients with grade 1 to 3 internal hemorrhoids. Evaluation can help determine the cause of symptoms and the most appropriate treatment.

Chronic hemorrhoids can cause persistent bleeding, itching, pain, and discomfort during bowel movements. When conservative care does not relieve symptoms, minimally invasive treatment options such as hemorrhoidal artery embolization may be considered.

Approximately half of all Americans experience hemorrhoids in their lifetimes. Hemorrhoids will usually go away on their own, or with conservative approaches such as diet changes, topical treatments, medications or supplements. But if they persist, they can cause bleeding, itching and painful bowel movements.

Symptoms of Chronic Hemorrhoids

Hemorrhoid symptoms can vary depending on whether the hemorrhoids are internal or external. Common symptoms include:

• Bright red bleeding during or after bowel movements
• Itching or irritation around the anus
• Pain or discomfort
• Swelling around the anal area
• Painful bowel movements
• A lump or bulge near the anus
• Prolapsed hemorrhoids that extend outside the anus

Occasional hemorrhoid symptoms may improve with home care. Persistent or recurring symptoms should be evaluated by a healthcare professional, particularly when bleeding continues or becomes severe.

The potential complications of hemorrhoids can include a burst hemorrhoid, prolapsed hemorrhoid, blood clots, infection, anemia and perianal thrombosis.

Patient Brochure

Doctor discussing chronic hemorrhoid treatment with a patient

What Causes Chronic Hemorrhoids?

Hemorrhoids are swollen veins inside the lower rectum or under the skin around the anus. Similar in nature to varicose veins, they most often are diagnosed in adults 45 and 65 years old. They are thought to be caused by an increase in pressure in the lower rectum, and are linked to the following lifestyle factors and health conditions:

• Sitting for long periods
• Straining or excessive exercise
• Spinal cord injury
• Constipation or diarrhea
• Being overweight
• Pregnancy or childbirth
• Family history

Chronic hemorrhoids can develop when symptoms continue or repeatedly return despite conservative care. Increasing fiber intake, drinking enough fluids, staying physically active, and avoiding excessive straining may help reduce pressure on the rectal veins.

Treatment Options, Including Hemorrhoid
Artery Embolization

Changes in diet, hemorrhoid creams, sitz baths and pain medication (such as Tylenol and Advil) are considered “conservative” treatments for hemorrhoids. If the symptoms do not go away, the condition becomes known as chronic hemorrhoids.

Before treatment, your healthcare provider may review your symptoms and medical history and perform an examination to determine the cause of bleeding or discomfort. Additional testing may be recommended when needed to rule out other conditions.

Hemorrhoidectomy is a surgical procedure to remove chronic hemorrhoids. However, this approach has risks and complications can include infection, bleeding, difficulty emptying the bladder, rectal prolapse and more. In addition, it can be as long as 3-6 weeks before a full recovery.

Hemorrhoidal Artery Embolization

A new and minimally invasive option to treat hemorrhoids, and performed by NG Vascular, is called hemorrhoidal artery embolization (HAE). We recommended this treatment for patients with grade 1 to 3 internal hemorrhoids who have not responded to conservative treatment.

During HAE, an interventional radiologist uses image guidance to place a small catheter into an artery supplying the hemorrhoids. Tiny particles or specialized materials are then used to reduce blood flow to the hemorrhoidal tissue. This can cause the hemorrhoids to shrink and may reduce symptoms such as bleeding and discomfort.

HAE is performed as an outpatient procedure and does not require the large incision associated with hemorrhoidectomy. Your doctor can determine if this treatment is appropriate based on the type and severity of your hemorrhoids.

Frequently Asked Questions About Chronic Hemorrhoids

Hemorrhoids may be considered chronic when symptoms persist or repeatedly return despite conservative measures such as dietary changes, topical treatments, medications, or lifestyle adjustments.

Some hemorrhoids improve with conservative care, but persistent or recurring symptoms may require additional treatment. A healthcare professional can recommend an appropriate approach based on your condition.

Seek medical evaluation for persistent bleeding, severe pain, recurring symptoms, changes in bowel habits, or hemorrhoids that interfere with daily activities or quality of life.

Hemorrhoidal artery embolization is a minimally invasive procedure that reduces blood flow to hemorrhoidal tissue. It may be recommended for certain patients with grade 1 to 3 internal hemorrhoids.

For appropriately selected patients, HAE can offer a minimally invasive alternative to hemorrhoidectomy. Your doctor can determine if embolization is suitable based on your symptoms and hemorrhoid grade.

Eating enough fiber, drinking adequate fluids, exercising regularly, avoiding prolonged sitting, and limiting straining during bowel movements may help reduce the risk of recurring hemorrhoid symptoms.