When Hemorrhoids Rupture by Michael Epstein, MD


senior member
Concord, NH
Hemorrhoids can make life miserable... and thats especially so if you have the ones that are internal, because these can cause problems that range from being very uncomfortable to actually being dangerous. Some people who have internal hemorrhoids dont even realize it (they may be found during a colonoscopy or blood in the stool may reveal their presence), but other people experience a great deal of pain.

Internal hemorrhoids may cause constipation, pain, itching, bleeding and even soiling. If they get large enough to extend through the anus (a condition called prolapse), they sometimes rupture and bleed. This type of hemorrhoid can be difficult to treat, but a new technology uses infrared energy to shrink them. Michael Epstein, MD, a gastroenterologist in Annapolis , Maryland , and one of the founders of the company that makes the medical device, MAX Endoscopy, told me how it works.

New & Improved Technology

Face it, theres nothing pleasant about having hemorrhoids and the typical treatments are pretty awful, too. Most commonly, doctors treat internal hemorrhoids with a procedure that involves putting a tight rubber band around the base of the hemorrhoid inside the rectum, cutting off blood flow so that it shrinks and withers away. Since this is quite painful, it requires a local anesthetic and sometimes general anesthesia (which carries the usual risks). There also is a risk for excessive bleeding, and patients often have to stay overnight in the hospital for monitoring, which is expensive and inconvenient. Other treatment options include injection with a chemical solution (sclerotherapy), which shrinks up the bulging vein and also requires anesthesia... or surgical removal, which is usually reserved for larger, more serious hemorrhoids.

Dr. Epstein told me that the new form of treatment for internal hemorrhoids is easier for both doctor and patient. Its a procedure performed with a fiber optic tool (with a lamp and a tiny video camera) that gets passed into the rectum, where it delivers bursts of infrared light to the tissue above the vein, coagulating the blood and thereby shrinking the tissue. The patient feels some heat and sometimes some minor discomfort, but its over in just a few minutes. This can be done as outpatient surgery, even in the doctors office (or as part of a colonoscopy, if the hemorrhoids are discovered that way and/or a patient is scheduled to have one), and the patient can go home immediately afterward and resume normal activities. Treatment typically costs about $300 and usually is covered by Medicare and most insurance companies.

New research sponsored by MAX Endoscopy found that 53 patients whose internal hemorrhoids were treated with the Infrared Coagulator experienced an average 87.6% reduction in six symptoms -- pain, bleeding, itching, burning, prolapse and soiling.

Natural Hemorrhoid Treatments

Daily Health News medical editor Andrew L. Rubman, ND, wanted me to point out to readers that while the new device may indeed work quite well, it doesnt solve the root problem -- why a particular patient suddenly has developed a problem with internal hemorrhoids. He said that its important to recognize that even a small change in the digestive environment -- like taking antibiotics, experiencing an unusual amount of stress or even dental issues that mean you arent chewing well -- can indirectly lead to hemorrhoids. Simply removing them without addressing the cause is merely a temporary fix.

For comparisons sake, I asked Dr. Rubman to tell me how he treats patients suffering from this particularly troublesome type of hemorrhoid. He explained that he would likely start by trying to determine the cause and then would advise dietary changes and perhaps supplements to correct the imbalance in intestinal flora or inflammation that likely started the process ... then he often prescribes a botanical suppository (he likes the ones manufactured by Earths Botanical Harvest), which can be very soothing... and only then, if that doesnt resolve the complaint, proceed to treat the tissue with either electrical current or ultrasound (the appropriate therapy depends on the particulars of each situation) if needed.

So there you have it. While hemorrhoids are a pain in the you-know-where, there are solutions to be had that will have you sitting pretty again quickly -- its a matter of choosing the treatment approach that would be comfortable for you.


Michael Epstein, MD, a gastroenterologist in Annapolis, Maryland, and a founder and board member of Macedonia, Ohio-based MAX Endoscopy, www.MaxEndoscopy.com.

Andrew L. Rubman, ND, founder and director, Southbury Clinic for Traditional Medicines, Southbury, Connecticut . www.SouthburyClinic.com.