Colon and Rectal Surgeons
of Kansas City


Hemorrhoids are veins in the anal-rectal area and are a normal piece of anatomy found in everyone. It is when these veins become distended, that problems begin. Everyone has three external hemorrhoids and three internal hemorrhoids -  Two on the right side and one on the left.

External hemorrhoids can swell and cause pain by forming blood clots in the vein. If uncomplicated, immediate relief can be obtained by a minor surgical excision usually as an office procedure with local anesthetic. If excision is not performed, the pain should significantly diminish within 10 days. Occasionally there can be so much pressure in the hemorrhoid vein, it erodes through the skin and decompresses itself, causing minor but alarming bleeding. Medical therapy includes hot baths, bowel regulation with fiber, analgesics and topical steroid creams.

Internal hemorrhoids can bleed and prolapse but do not cause pain. They are located in the lower rectum where there are no pain nerve endings. Bleeding internal hemorrhoids can frequently be treated non-surgically by several modalities or minor office procedures.

  1. Banding. This procedure places a tiny rubber band around the base of the hemorrhoid which causes it to fall off. This is done at two to three week intervals for each hemorrhoid. This is done for larger internal hemorrhoids and is painless. For preparation, a Fleets enema 2 hours prior is required. No Aspirin or blood thinning medications for five days prior.
  2. InfraRed Coagulation (IRC) is used for smaller bleeding internal hemorrhoids and is again painless. The same preparation for banding is used for IRC's. Both of these procedures are not effective for external hemorrhoids.


The majority of hemorrhoids are treated non-surgically. However, when the hemorrhoids are severe and multiple, surgery is the best option for cure. Surgery is usually highly successful with a 1% recurrence rate or less. An overnight stay in the hospital is frequently recommended, with discharge the next morning. If instructions are followed, pain and other problems are minimal. Complications are very few if the procedure is done by an expert.

For more information please visit:
The American Board of Colon and Rectal Surgeons