Joliet and Morris gastroenterologist offers new hemorrhoid treatment

JOLIET – About half of all people have noticeable hemorrhoids by age 50, and they often occur earlier, especially during pregnancies, in weightlifters and in those with frequent constipation or diarrhea who strain during bowel movements.

“It’s a very common problem overall,” Joliet and Morris gastroenterologist Dr. Richard Rotnicki said. “It’s pretty much a function of walking upright, because of gravity.”

It’s such a common problem that Rotnicki said it’s really not a taboo subject for conversation anymore. And now, he said, there is a new treatment that’s practically painless.

It’s called bipolar radiofrequency hemorrhoidectomy. Rotnicki has used the procedure on patients for about a year and said the results have been very good.

“When they leave, most are pain-free,” Rotnicki said of his patients who have received the treatment. “It gives them a 70 to 80 percent decrease in symptoms.”

Rotnicki said the procedure is the most gentle of the hemorrhoid treatments, and it can be done along with a routine colonoscopy in a hospital’s endoscopy suite.

Bonnie Lardi of South Wilmington had the procedure in October and said it was not a bad experience.

“The colonoscopy preparation was the worst, but the procedure was nothing,” Lardi said. “I felt nothing. I went in on a Friday and was back at work on a Monday.”

Lardi said she hadn’t much discomfort from her hemorrhoids, but she was having bleeding that was becoming more frequent.

“I probably had them before I had my kids,” Lardi said. “I kind of knew they were there, and I just put it off.”

Lardi said she had a bit of bleeding for about a week after the procedure, but that was it. She’s fine now.

Rotnicki described hemorrhoids as essentially varicose veins on the rectum. Those veins and tissues are there to hold stool back, and to cushion the sphincter muscles when people empty their bowels, the American Gastroenterological Association states on its website.

When those veins and tissue swell and bulge, the condition is called hemorrhoids. Straining can cause them, as can pregnancy, sitting too long on the toilet, running, obesity and liver disease.

The National Institutes of Health at www.ncbi.nlm.nih.gov classifies hemorrhoids into four grades.

Grade I is when they bleed but do not protrude out of the anal canal. Grade II is when they protrude out of the body on defecation but go back inside afterward. In Grade III, the hemorrhoids require manual placement back inside the body. In the most severe stage, Grade IV, the hemorrhoids are permanently outside the anal canal.

Rotnicki said there are many ways to treat hemorrhoids, including some at-home methods he advises to some. Getting enough fiber and water in the diet is important no matter what the stage, he said.

The recommended amount of fiber intake per day is 30 to 35 grams, he said, and most people get only 15 to 20 grams.

If it’s difficult to get enough fiber in the diet, Rotnicki said he’ll often recommend a fiber supplement, such as MiraLAX or Metamucil clear.

For discomfort, he sometimes recommends hot sitz baths.

It’s important people with bleeding hemorrhoids realize the blood may be coming from something else, such as rectal cancer. That’s why Rotnicki recommends anyone with rectal bleeding visit their physician.

There are several surgical and procedural treatments for hemorrhoids, including banding and surgery, but Rotnicki said the bipolar radiofrequency hemorrhoidectomy is the least invasive and quite effective, and it can be performed on patients in Grades I and II. Banding is better on Grade III hemorrhoids, he said, and surgery normally is required for Grade IV.

The new procedure can be done at the end of a regular colonoscopy or on its own. The scope uses radiofrequency waves to coagulate the problem tissue around the anal canal, which then dies off later on its own.

Furthermore, the new procedure is quick, Rotnicki said.

Hemorrhoids may return, however, as they might with any other procedure, if a person still strains from chronic constipation or from other situations.

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KNOW MORE

Ways to prevent hemorrhoids:

• Pass bowel movements as soon as possible after the urge occurs.
• Avoid straining during a bowel movement.
• Be active. Move around, walk and exercise to help move the stools through your body.
• Stay regular by eating enough fiber and drinking enough fluid. Most Americans only take in 13 grams of fiber in their daily diet – half of what is recommended. Adding fiber to your diet helps to produce stools that are softer and easier to pass.
• Stay hydrated. Be sure you're taking in the recommended amount of liquids throughout the day.

Sources: American Gastroenterological Association at www.gastro.org and Dr. Richard Rotnicki