Hemorrhoids

What it is

Hemorrhoids are normal vascular structures in the anal canal that, when they dilate and shift downward, start causing symptoms such as bleeding, pain, itching and a feeling of bulging. They can be internal, external or mixed, and are classified in grades according to the degree of prolapse. They are extremely common, especially during pregnancy, after childbirth and in people who struggle with constipation, but many women delay seeking care out of embarrassment. At Femi Saúde, the coloproctology team evaluates each case with in-office anoscopy and offers the full range of treatment, from clinical measures to rubber band ligation, laser and surgery, choosing the option best suited to each patient's grade and symptoms, in a welcoming, discreet setting.

Most common symptoms

• Bright red blood on the paper or in the toilet
• Pain or burning during bowel movements
• Itching and irritation around the anus
• A feeling of bulging or anal heaviness
• Prolapse that comes out during bowel movements
• A painful, hardened lump (thrombosis)

Causes and risk factors

• Constipation and straining during bowel movements
• Pregnancy and childbirth
• Long periods sitting on the toilet
• A diet low in fiber and water
• Family predisposition
• Chronic diarrhea or excess weight

How it is diagnosed

The diagnosis is clinical: the coloproctologist listens to the history of symptoms, examines the anal area and performs a digital rectal exam and in-office anoscopy, which allow the internal hemorrhoids to be seen and graded. Since bleeding can also have other causes, in certain situations — such as age over 45, a family history of colorectal cancer, or atypical symptoms — a colonoscopy is requested for a complete evaluation of the bowel. This exam is quick, requires no preparation, and is conducted with privacy and an explanation of each step.

How we treat it at Femi Saúde

Treatment starts with clinical measures: more fiber and water, avoiding straining and prolonged time on the toilet, sitz baths and ointments for relief. When symptoms persist, the coloproctology team at Femi Saúde recommends office procedures such as rubber band ligation or laser treatment for grade I to III internal hemorrhoids. Grade III and IV hemorrhoids, large mixed hemorrhoids, or those with recurrent thrombosis may require hemorrhoidectomy. The choice takes into account the grade, symptoms, pregnancy and the patient's preferences.

What we offer