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Hemorrhoids
December 2001

Q. I am undergoing rubber band ligation for hemorrhoids, and I fear that surgery (my second time) is the inevitable next step. Is laser hemorrhoidectomy still available and does it reduce post-operative pain? Is HAL (hemorrhoidal artery ligation) a legitimate alternative?

A. Hemorrhoids are swollen veins that can occur internally in the lower rectum or can protrude externally. In mild cases, the swelling and pain resolve with pain medication and frequent hot baths. Prevention methods include a high fiber diet (fruits, vegetables, grains) and increased water intake. An increase in physical activity is important as well. Acutely painful hemorrhoids usually require prompt medical treatment for an office surgical procedure. Despite these measures, some cases fail to resolve and may cause ongoing pain and bleeding. Surgery is considered for these conditions and a variety of methods exist for treatment. Choice of treatment methods will be largely determined by the extent and location of the swollen veins. Details are well described at the following sites:

http://www.niddk.nih.gov/health/digest/pubs/hems/hemords.htm

http://www.familydoctor.org/healthfacts/090/

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