Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Provider photo for Ninad Dabadghav

Ninad Dabadghav, MD

Surgery: General

Welcome to My Doctor Online, a web site that my colleagues and I developed to make it easier for you to take care of your healthcare needs. On this site you will find answers to many of your questions about my clinical practice. Also included are several online features that will allow you to e-mail me, check your laboratory results and refill prescriptions. I hope you find its content informative and useful.

My Offices

Santa Clara Homestead
Appt/Advice: 1-408-851-2000

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Overview

Hemorrhoids are swollen tissues that can develop inside or outside the anus or rectum. These tissues are made up of blood vessels, smooth muscle, and connective tissue.

Once symptoms develop, they often recur. It’s important to practice good lifelong preventive care to keep symptoms from returning, such as:

  • Eat a diet high in fiber.
  • Avoid constipation and straining.
  • Avoid sitting on the toilet for long periods of time. 

Use over-the-counter hemorrhoid remedies to treat hemorrhoids at home. 

You may need to see a specialist if your hemorrhoids persist after trying other typical treatment methods. Treatment options may include procedures done in the clinic to reduce swelling and surgery.

Additional References:

Causes and Symptoms

When tissue swells and muscle and connective tissue weaken, hemorrhoid problems can develop. This can result from:

  • Prolonged straining to pass hard stools, such as from constipation.
  • Sitting or standing for long periods of time.
  • Diarrhea.
  • Reading on the toilet.
  • Pregnancy and labor.
  • Some forms of liver disease.
  • Family history.

Conditions that can cause similar symptoms are:

  • Anal fissure
  • Anal abscess or fistula
  • Anal warts
  • Growth or mass (such as cancer)

Symptoms depend on the location and type of hemorrhoid.

  • Internal hemorrhoids cause bleeding, a knot (bulge), and mucus discharge and irritation around the anus.
  • External hemorrhoids cause pain when swollen and sometimes a clot (thrombosed).
  • External skin tags can result from a previously swollen external hemorrhoid. The skin tags can cause discomfort and difficulty cleaning the area after a bowel movement.

Home Treatment

You can usually manage mild to moderate hemorrhoids at home.

  • Drink plenty of water.
  • Take extra fiber to keep your stools soft and regular. Your daily goal is 25 to 35 grams per day.
  • Use moistened toilet paper or cloth for cleaning.
  • Wear cotton underwear and loose clothing.
  • Apply cold compresses or an ice pack to the anus to relieve itching.
  • Take Sitz baths to reduce pain and swelling.
  • Avoid straining and sitting on the toilet for long periods of time.
  • Use over-the-counter hemorrhoid creams or suppositories.
  • Use zinc oxide, petroleum jelly, or over-the-counter hydrocortisone cream to reduce itching and irritation.

If home treatment doesn’t work or pain persists, talk with your doctor about seeing a surgeon.

Internal Hemorrhoid Treatment

Internal hemorrhoids develop inside the anus around the lower rectum. Large hemorrhoids may fall outside the body (prolapse). They often cause bleeding during bowel movements.

When usual treatments don’t relieve symptoms, we may recommend a procedure that can be done in the clinic.

Rubber band ligation. This highly successful treatment is used for small and medium hemorrhoids that are bleeding or slightly prolapsed (appear outside the anus). It has few side effects. We use a special rubber band to cut off blood supply to the hemorrhoid. The rubber band and hemorrhoid fall off within a week or so.

Bipolar, infrared, and laser coagulation. We create scar tissue using heat, a laser, or an electrical current. This allows the hemorrhoids to shrink.

Sclerotherapy. We inject the hemorrhoid with phenol or hypertonic saline to shrink the tissue.

External Hemorrhoid Treatment

External hemorrhoids appear outside the anus. You may have trouble cleaning the area after a bowel movement. A painful blood clot can develop in the hemorrhoid (thrombosed external hemorrhoid).

Removal of thrombosed external hemorrhoid. You may have severe pain within the first 48 to 72 hours of developing this hemorrhoid. Pain and swelling gradually decrease.

During the period of severe pain, we can remove the clot and hemorrhoid in our clinic. We first numb the area with local anesthesia.

We may also recommend home treatment, such as:

  • Sitz baths
  • More fiber in your daily diet
  • Creams 

Surgery isn’t usually needed for an external hemorrhoid without a clot. We may instead recommend:

  • Home treatment
  • Preventing constipation and straining

Surgery

There are several surgical options used to treat hemorrhoids, depending on your symptoms and hemorrhoid location.

Stapled hemorrhoidopexy (PPH) is used to treat prolapsing internal hemorrhoids with little to no abnormal tissue. Your recovery is quicker. However, it has a higher rate or recurrence than excisional hemorrhoidectomy

Transanal hemorrhoidal dearterialization (THD) is used to treat large internal hemorrhoids with little to no abnormal tissue (external disease). It’s usually less painful and has a shorter recovery time. However, it may be associated with higher rates of recurrence

Excisional hemorrhoidectomy is the most common treatment for hemorrhoids. We remove the affected tissue. This surgery may cause pain and bleeding. It takes about 2 to 4 weeks to recover.

Risks

Nonsurgical treatments are usually successful with few risks. Possible problems may include:

  • Mild pain and discomfort. Most people return to work the next day.
  • Minor bleeding.
  • Infection, although rare.

Surgical treatments can be uncomfortable and carry more risks, such as:

  • Pain that may last for weeks, especially when passing bowel movements.
  • Bleeding, which may last for a few days. Severe bleeding requires further treatment.
  • Trouble urinating or passing stools.
  • Problems with bowel movement accidents, although rare.
  • Serious infection (very rare).

Your Care with Me

If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms. If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day.

When You See Me

During your office visit, we will discuss your medical and family history and I will perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options based on the findings.

Lab resources

We will also discuss the results of any tests ordered by your personal physician. If further tests are needed I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice.

  • When the results are ready, you can view most of them online, along with any comments that I have attached to explain them.
  • If your results are normal, I will also send the results in the mail.
  • If they are outside the normal range, I will call you to discuss the results.
Pharmacy resources

If medications are warranted, I will prescribe them and work with you to minimize side effects. If refills are indicated in the future, you can order them online from my home page or by phone using the pharmacy refill number on your prescription label.

  • You can also arrange to have your refill mailed to you at no extra cost. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
  • You can choose to pick up your medications at the pharmacy or have them delivered by mail at no extra cost.
After Visit Summary

At the end of our visit, you will receive a document called the After Visit Summary that will summarize the issues we discussed during your visit. You can also view it online from this site.  The online version is called Past Visits.

  • This summary includes my name and the date and time of your visit, your vital signs, my test orders and your medications or immunizations.
  • It often includes the instructions I have given you during our visit and follow-up information.
  • You can refer to your After Visit Summary if you forget what we discussed, or if you just want to recheck your vital signs and weight.
Coordinating your care

Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology and health education, makes getting your care easier for you. Another major benefit is our comprehensive electronic medical record system in which all of the doctors and clinicians involved in your care can stay connected on your health status and collaborate with each other as appropriate. When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

Preparing for Surgery

If surgery is indicated, I will ask you to review an online educational program called Preparing for Your Procedure (Emmi). This online program is available on this site. It will help you decide whether surgery is right for you. It will also provide information about how to prepare and what to expect.

If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a pre-operative medical evaluation that will assure that you are properly prepared for your surgery.

Contacting Me

If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.

If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line, available 24 hours a day, 7 days a week. You will be connected with a nurse who can give you immediate advice.

If you are experiencing an emergency, call 911 or go to the nearest Emergency Room.

Related Health Tools:

Prepare for Your Procedure
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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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