Hemorrhoids Specialist In Bozeman, Montana

What are hemorrhoids?

Hemorrhoids are enlarged vascular cushions in and around the anal canal. They are classified as either internal or external.

Internal hemorrhoids develop inside the anal canal. They commonly cause painless rectal bleeding, prolapse, mucus drainage, irritation, or difficulty with hygiene.

External hemorrhoids develop beneath the skin around the anus. They may cause swelling, itching, tenderness, or severe pain if a blood clot forms within them.

Many patients delay treatment because they feel embarrassed or assume that hemorrhoid care will be painful. Others assume that any rectal bleeding must be caused by hemorrhoids. Because bleeding, pain, and changes in bowel habits can have other causes, an accurate examination is essential.

What causes hemorrhoids?

Hemorrhoids enlarge when repeated pressure and straining affect the tissues that support the anal canal. Common contributing factors include:

• Constipation and hard stools
• Straining during bowel movements
• Prolonged sitting on the toilet
• Frequent diarrhea
• Pregnancy
• Obesity
• Heavy lifting
• Aging and weakening of the supporting tissues

Improving bowel habits is an important part of both treatment and prevention.

How are hemorrhoids treated?

Treatment depends on whether the hemorrhoids are internal or external, the severity of symptoms, the amount of prolapse, and the patient’s priorities.

Dr. Zehnpfennig provides conservative, non-procedural management as well as office-based procedures and surgical treatment.

Conservative treatment

Mild hemorrhoid symptoms often improve with changes that reduce straining and improve stool consistency. Treatment may include fiber supplementation, increased fluid intake, stool-softening measures, avoidance of prolonged toilet sitting, and topical medication when appropriate.

Rubber band ligation

Rubber band ligation is an effective office treatment for symptomatic internal hemorrhoids. A small band is placed at the base of the hemorrhoid, cutting off its blood supply. The treated tissue shrinks and separates over the following days.

The procedure is brief, does not require a surgical incision, and is usually associated with minimal discomfort because the treated internal hemorrhoid tissue lies above the pain-sensitive portion of the anal canal.

Coagulation

Bipolar electrocoagulation is an office-based treatment for internal hemorrhoids. Controlled electrical energy is applied to the hemorrhoidal tissue, reducing blood flow and causing the tissue to shrink.

Infrared coagulation uses infrared energy to produce a similar effect. These treatments may require more than one session, depending on the size and number of hemorrhoids and the severity of symptoms.

Excisional hemorrhoidectomy

Hemorrhoidectomy is the most definitive treatment for large external hemorrhoids, advanced internal hemorrhoids, mixed internal and external disease, or hemorrhoids that have not responded to less invasive treatment.

Dr. Zehnpfennig uses careful surgical technique and a structured postoperative pain-control plan to make recovery as manageable as possible.

Treatment of thrombosed external hemorrhoids

A thrombosed external hemorrhoid can cause sudden, severe anal pain and a tender lump near the anus. When evaluated promptly, the clot and affected tissue can often be removed in the office for rapid relief.

When should I see a colorectal specialist?

Schedule an evaluation if you have:

• Rectal bleeding
• A painful or enlarging anal lump
• Tissue protruding from the anus
• Persistent itching or drainage
• Difficulty cleaning after bowel movements
• Symptoms that continue despite fiber and improved bowel habits
• A previous hemorrhoid treatment that did not provide lasting relief

Rectal bleeding should not automatically be attributed to hemorrhoids. Dr. Zehnpfennig evaluates the full clinical picture and determines whether additional testing, including colonoscopy, is appropriate.

What can I expect from treatment?

Dr. Zehnpfennig explains the anatomy of the anal canal and the likely diagnosis, reviews all reasonable treatment options, and recommends the approach most likely to provide durable relief. The goal is not simply to treat the visible hemorrhoid, but to improve bleeding, pain, prolapse, hygiene, and quality of life with the least burdensome effective treatment.

To learn more about hemorrhoid treatment, call the office or schedule an appointment online.