Can a Gastroenterologist Remove Hemorrhoids During a Colonoscopy?

It’s a question many avoid—until the discomfort becomes impossible to ignore. Can a gastroenterologist remove hemorrhoids during a colonoscopy? The answer isn’t as simple as it seems. While combining procedures might sound convenient, there are key factors to consider. Before your next appointment, it helps to know how hemorrhoid removal actually works.

Trust your gut—Book an appointment with the best gastroenterologist in Brooklyn today! 🩺🌿

Can Hemorrhoids Be Treated During a Colonoscopy?

Yes, internal hemorrhoids can be treated during a colonoscopy, which can be a major benefit by avoiding additional procedures.

The Colonoscopy Procedure

A colonoscopy involves inserting a thin, flexible tube with a camera (a colonoscope) through the anus and into the colon.

Air is used to expand the intestines, giving doctors a better view inside. This also allows access to internal hemorrhoids, making treatment possible without surgery.

Key Considerations

Not all hemorrhoids can be treated during a colonoscopy. The decision depends on their type, size, location, and symptoms. The doctor will assess whether it’s safe to treat them during the same procedure or if it’s better to schedule it separately.

Methods Used to Treat Hemorrhoids During a Colonoscopy

Internal hemorrhoids can often be treated using minimally invasive methods during a colonoscopy. These techniques usually don’t require general anesthesia or hospitalization.

These outpatient procedures are guided by the colonoscope and can relieve symptoms without major surgery.

Common Techniques

Rubber band ligation (banding)
This method places a small rubber band around the base of the hemorrhoid. The blood supply is cut off, causing the tissue to shrink and fall off naturally within days.

• Used for: Grade II or III internal hemorrhoids
• Benefits: Fast recovery; most return to normal activities the next day
• Time required: Short and generally well tolerated

Sclerotherapy
A solution is injected into the hemorrhoid to create local inflammation and scarring, causing it to shrink over time.

• Used for: Patients who can’t undergo banding, especially those on blood thinners
• Limitations: May need multiple sessions; recurrence is possible

Infrared coagulation
This technique uses infrared light to heat the tissue, sealing off blood vessels and reducing the size of the hemorrhoid.

• Benefits: Quick and non-invasive
• Use case: Alternative when banding or sclerotherapy isn’t suitable

Cryotherapy (cryoablation)
Extreme cold is applied to destroy hemorrhoid tissue. While less common, it may be used when other options aren’t available.

• Benefits: Can be effective in specific cases
• Limitations: Less used due to discomfort and inflammation afterward

Laser therapy is occasionally used, but it’s not standard during colonoscopy. If hemorrhoids are external or more severe, a surgical hemorrhoidectomy might be necessary.

Benefits and Risks of Treating Hemorrhoids During a Colonoscopy

Treating hemorrhoids during a colonoscopy may seem like a convenient option. This section outlines the clinical and diagnostic benefits, along with possible risks during or after the procedure.

Benefits:

• Fewer procedures needed: Combining treatment with a colonoscopy means avoiding extra appointments for banding or surgery. This often leads to faster recovery and fewer medical visits.
• Thorough diagnosis of other conditions: The colonoscopy may reveal other causes of rectal bleeding or digestive symptoms, such as polyps or tumors, providing a more complete diagnosis.

Potential Risks:

• General colonoscopy risks: Mild bleeding is possible but rarely serious. There’s a small chance of colon perforation. Sedation reactions or breathing and heart issues may occur in rare cases.
• Hemorrhoid treatment risks: Local bleeding and rare infections can develop in the treated area.
• Anesthesia-related risks: Some may have allergic reactions to sedation drugs or experience breathing or heart issues during administration.

Although the benefits can be significant, there are also risks that should be considered before opting for this treatment option. These risks are grouped into three main categories:

It is important to note that the presence of hemorrhoids does not preclude a colonoscopy. In fact, in many cases, a colonoscopy is indicated precisely to investigate symptoms that may be related to hemorrhoids or other digestive conditions.

Before making a decision, it is advisable to thoroughly discuss with the healthcare professional the risks and benefits of treating hemorrhoids during colonoscopy to ensure that this option is appropriate based on the patient’s medical history.

Treating hemorrhoids during colonoscopy offers significant benefits, such as accuracy and time savings, but also carries risks that should be carefully evaluated. A detailed discussion with the physician will help determine if this option is the most appropriate in each individual case.

Conclusion: Discussing Your Options With Your Doctor

Talking with your doctor about treating or removing hemorrhoids during a colonoscopy begins with an evaluation of whether they are internal or external and how severe your symptoms are. This helps determine the best treatment path for your case.

Your doctor may recommend conservative options like increasing fiber, drinking more water, or using over-the-counter remedies to manage symptoms. In more advanced cases, procedures like hemorrhoidectomy or stapled hemorrhoidopexy may be discussed.

A medical professional will guide you through the pros and cons of each approach so you can make an informed choice. Avoid self-treatment, especially if symptoms persist or worsen. Getting timely medical care ensures your treatment is both safe and effective.

Sources:

• Mott, T., Latimer, K., & Edwards, C. (2018). Hemorrhoids: Diagnosis and treatment options. American Family Physician, 97(3), 172–179.
• Tabbakha, A., Ozsahin, D. U., Uzun, B., & Ozsahin, I. (2021). Selection of Hemorrhoid Treatment Techniques Using a Multi-Criteria Decision-Making Technique. In Applied Machine Learning and Multi-Criteria Decision-Making in Healthcare (pp. 245–271). Bentham Science Publishers.