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Carey Strom M.D., F.A.S.G.E.

Dr. Strom's Monthly Newsletter

"Digest This"

June 2012

The Ultimate Pain in the.........

This month’s newsletter, we are going to talk about something that a lot of people have, but do not like to talk about:  hemorrhoids.  What are hemorrhoids?  Hemorrhoids are made up of loose tissue and abnormal vessels in the lower rectum or anus.  With onset commonly occurring after the age of 30, hemorrhoids will affect more than half of the population at some point in their lives.  In the past, causes were said to be constipation, pregnancy, childbirth, obesity, heavy lifting, sitting for long periods, and diarrhea.  Lack of soluble fiber in the diet is now considered the most important reason.


There are two types of hemorrhoids based on location:  Internal hemorrhoids, which occur inside of the lower rectum and can be seen or felt.  As this form is typically painless, the only symptom, which we may notice includes some bleeding, itching, prolapsed (protruding), or feeling of fullness following a bowel movement.  If hemorrhoid remains outside the anus, it can cause pain as well.  Internal hemorrhoids could be classified into different grades depending how big they are and how much they prolapse.


As opposed to internal hemorrhoids, external hemorrhoids are noticeable as bulges or lumps around the exterior of the anus.  As opposed to internal hemorrhoids, there are many sensory nerve fibers in this area, so external hemorrhoids may be associated with pain as well as bleeding and itching.  Should blood become stagnant in an external hemorrhoid in the form of clots, this could be very painful and this is called a thrombosed hemorrhoid.  This is often associated with anal spasm or fissure.  External hemorrhoids and external skin tags most often occur in conjunction with internal hemorrhoids and are typically extensions of the internal hemorrhoids.  By treating the internal hemorrhoids in these patients, many patients will experience relief of these external symptoms.


Treatment of hemorrhoids vary:  there are local treatments with suppositories or creams, or patients sometimes require injection or banding of hemorrhoids. Surgery would only be indicated for the most severe cases. Some patients with severe  symptoms would require surgery.  There is a new method out called CRH O-REGAN system, which is an easy banding technique, which could be safely performed in minutes in the outpatient setting. Results for this technique have been great.


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If you would like to know more about treatments of hemorrhoids, please contact our office. 
9090 Wilshire Blvd., Suite 101
Beverly Hills, California 90211 Telephone: 310.550.0400
Facsimile: 310.285.0482

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Carey B. Strom MD
9090 Wilshire Blvd.
Beverly Hills, 90211

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