What can I do for hemorrhoids?

Summary

In this enlightening and humorous conversation, Dr. Megan Turley, a colon and rectal surgeon, dispels myths and sheds light on hemorrhoids, explaining their function, causes, and treatments. She emphasizes the importance of not dismissing rectal bleeding and the need for proper evaluation, advocating for open discussions about anorectal health to reduce stigma and shame. Dr. Turley also highlights her approach to treating hemorrhoids with office procedures and stresses the significance of early detection for conditions like colon cancer.

Takeaways

• 😀 Hemorrhoids are normal anatomical structures that everyone has, serving functions like providing moisture in the anal canal and aiding in 'anal sampling' to differentiate between gas, liquid, or stool.
• 😅 The interview starts with humor, acknowledging the sensitive nature of discussing rectal issues and aiming to normalize conversations around them.
• 🩺 Hemorrhoids can be internal or external, with internal hemorrhoids being up in the anal canal and prone to bleeding and prolapse, while external ones are highly innervated and sensitive due to being made of skin.
• 🤰 Pregnancy and hormonal changes, including those related to breastfeeding and menopause, can exacerbate hemorrhoidal issues due to their effects on bowel habits and the anorectal area.
• 💊 Conservative management of hemorrhoids includes fiber supplementation, warm baths, over-the-counter numbing creams, ibuprofen, and prescription steroid suppositories.
• 🍽 Dietary habits significantly impact hemorrhoidal symptoms; a high-fiber diet can help alleviate constipation and diarrhea, which are common triggers for hemorrhoid problems.
• 🏥 In-office procedures for hemorrhoids include rubber band ligation for internal hemorrhoids and excision for external ones, aiming to reduce symptoms and improve patient quality of life.
• 🚫 The script emphasizes the importance of not self-diagnosing and the potential risks of ignoring rectal bleeding, which could indicate more serious conditions like cancer.
• 👩‍⚕️ Dr. Megan Turley encourages patients not to feel embarrassed about seeking help for anorectal issues and stresses the importance of professional evaluation for proper diagnosis and treatment.
• 🔍 The discussion highlights the need for further investigation when conservative treatments fail to stop rectal bleeding, with a colonoscopy being a critical step in ruling out serious conditions.
• 🌐 The interview concludes with a reminder of the importance of screening for colorectal cancer, especially for those with a family history or showing symptoms, and the value of seeking second opinions in healthcare.

Q & A

What is Dr. Megan Turley's specialization?

Dr. Megan Turley is a fellowship-trained colon and rectal surgeon with a comprehensive robotic surgery practice.

What is the primary function of hemorrhoids according to the discussion?

Hemorrhoids serve as vascular cushions in the anal canal, providing moisture and mucus, and aiding in anal sampling, which is the body's ability to discern the nature of rectal gas or content.

What is the difference between internal and external hemorrhoids?

Internal hemorrhoids are located up in the anal canal, can bleed, and may prolapse or fall out during bowel movements. External hemorrhoids are made of skin and can become engorged and sensitive, often causing discomfort or pain.

What are some common causes of hemorrhoidal troubles mentioned in the script?

Common causes include constipation, diarrhea, straining from various activities, pregnancy, hormonal changes, and lifestyle changes like starting a new exercise regimen or diet.

How does Dr. Turley describe the process of treating hemorrhoids in her practice?

Dr. Turley starts with a consultation to understand the symptoms, followed by an examination that includes looking for external issues, performing a digital rectal examination, and using an anoscope to examine the hemorrhoidal tissue.

What is the role of fiber in managing hemorrhoidal symptoms?

Fiber supplementation is crucial in managing hemorrhoidal symptoms as it helps regulate bowel movements, reducing constipation and diarrhea, which can exacerbate hemorrhoids.

What are some non-surgical in-office procedures for treating hemorrhoids?

In-office procedures include rubber band ligation for internal hemorrhoids, which cuts off blood supply causing the tissue to fall off, and excision for external hemorrhoids to change the topography of the anal opening.

What is the significance of the cultural stigma around discussing rectal issues, and how does it affect patients?

The cultural stigma around discussing rectal issues can cause patients to feel shame and embarrassment, which may prevent them from seeking necessary medical care and evaluation.

Why is it important for individuals experiencing rectal bleeding to seek medical attention?

Rectal bleeding is not normal and can be a symptom of more serious conditions like colon cancer. It is essential to seek medical attention for proper evaluation and diagnosis.

What are some common misconceptions about hemorrhoids discussed in the script?

Common misconceptions include the belief that hemorrhoids are always painful or problematic, and that rectal bleeding is a normal symptom of hemorrhoids. In reality, hemorrhoids are normal anatomical structures, and bleeding is a symptom that requires medical evaluation.

What advice does Dr. Turley give regarding the use of over-the-counter treatments for hemorrhoids?

Dr. Turley suggests that over-the-counter treatments like Preparation H or other creams may not be as effective as more targeted approaches like hot baths, ibuprofen, and prescription steroid suppositories, especially for acute hemorrhoidal problems.

What is the role of a colonoscopy in evaluating rectal bleeding?

A colonoscopy is essential in evaluating rectal bleeding as it allows doctors to examine the colon and rectum for abnormalities such as polyps or cancer, which may be causing the bleeding.

What are some alternative methods to a traditional colonoscopy mentioned in the script?

Alternative methods include the use of a pill cam, which is a swallowable camera, and a colig guard or 'poo in the box' test, which analyzes stool for signs of blood or other abnormalities.