Hemorrhoids Treatment in Lebanon Diagnosis & Individualized Treatment for Hemorrhoidal Disease

Hemorrhoidal tissue is naturally present within the anal canal and contributes to normal continence. Problems develop when this tissue becomes enlarged, symptomatic, or prolapses outside the anus.

Hemorrhoids are generally classified as:

Internal Hemorrhoids

These develop inside the anal canal and may cause painless rectal bleeding or prolapse during bowel movements.

External Hemorrhoids

These develop beneath the skin around the anus and may cause swelling, irritation, or pain, particularly if a blood clot develops.

Identifying the type and severity of hemorrhoids helps determine the most appropriate treatment.

Hemorrhoids symptoms can vary according to the type and severity of the condition.

They may include:

• Bright red bleeding during or after bowel movements
• Anal itching or irritation
• Swelling around the anus
• Discomfort or pain
• A lump near the anus
• Prolapse during bowel movements
• A feeling of incomplete evacuation

Rectal bleeding should not automatically be assumed to be caused by hemorrhoids. Medical evaluation is important to exclude other potential causes.

Hemorrhoidal disease can be associated with increased pressure in the anal and rectal veins.

Contributing factors may include:

• Chronic constipation
• Straining during bowel movements
• Prolonged sitting on the toilet
• Pregnancy
• Obesity
• Aging
• Low-fiber diet
• Repeated heavy lifting

Identifying contributing factors can form an important part of both treatment and prevention.

Diagnosis begins with a discussion of symptoms and medical history followed by an appropriate clinical examination.

Depending on the patient's symptoms, assessment may include:

• Examination of the anal and perianal area
• Digital rectal examination
• Anoscopy or proctoscopic examination when indicated
• Additional colorectal investigations when clinically necessary

The objective is not only to confirm hemorrhoids but also to exclude anal fissures, fistulas, colorectal disease, or other conditions that may produce similar symptoms.

Treatment depends on the type and grade of hemorrhoids, severity of symptoms, previous treatments, and individual patient factors.

Conservative Treatment

Mild hemorrhoidal symptoms can often be managed initially without surgery.

Treatment may include:

• Increasing dietary fiber
• Adequate hydration
• Avoiding excessive straining
• Improving bowel habits
• Managing constipation
• Appropriate medications for symptom relief when indicated

These measures aim to reduce pressure during bowel movements and improve symptoms.

For selected internal hemorrhoids that remain symptomatic despite conservative management, an office-based procedure may be considered.

The appropriate technique depends on the grade and characteristics of the hemorrhoids and the patient's symptoms.

Not every patient with hemorrhoids requires surgery.

Surgical treatment may be considered for selected patients with:

• Advanced hemorrhoidal disease
• Significant prolapse
• Persistent or recurrent bleeding
• Symptoms that do not respond adequately to conservative or office-based treatment
• Combined internal and external disease
• Other appropriate clinical indications

The surgical approach is selected according to the individual case, with the objective of treating symptoms while preserving normal anal function.

Medical evaluation is recommended when:

• Rectal bleeding is recurrent
• Symptoms persist despite basic measures
• There is significant pain or swelling
• Tissue repeatedly prolapses from the anus
• Symptoms interfere with daily activities
• There is a change in bowel habits
• The cause of bleeding is uncertain

Severe bleeding, significant worsening pain, or other acute symptoms may require more urgent assessment.

Hemorrhoids and anal fissures can both cause discomfort and bleeding, but they are different conditions.

Hemorrhoids involve enlarged or prolapsing vascular tissue in the anal canal.

An anal fissure is a tear in the lining of the anal canal and typically causes sharp pain during or after bowel movements.

Accurate diagnosis is important because treatment differs between the two conditions.

Learn More about Anal Fissure →

• American Society of Colon and Rectal Surgeons (ASCRS)
• European Society of Coloproctology (ESCP)
• Evidence-based clinical guidelines for hemorrhoidal disease