Many Americans suffer from hemorrhoids for a long time before they seek intervention due to the stigma associated with the condition. Nonetheless, as embarrassing as hemorrhoids seemingly are, they are no laughing matter, and choosing to ignore them will only prolong your suffering.

Getting them treated by a gastroenterologist (GI doctor) can prevent them from becoming a major problem and the necessity for surgical intervention.

If you’re not sure as to what specific questions to ask your GI doctor during your appointment, here’s a shortlist to help you make the most out of your doctor’s visit.

Q: What Causes Hemorrhoids?

Chronic constipation and prolonged sitting and standing are among the most common causes of hemorrhoids, but the condition can also be due to any of the following:

• A narrower anal opening
• Anal Intercourse
• Frequent episodes of diarrhea
• Lack of regular exercise
• Lax muscles in the anus and rectum (related to advancing age)
• Obesity
• Pregnancy

Q: What Are My Treatment Options?

Your GI doctor will do a thorough evaluation, which consists of a review of your medical history and symptoms, a digital rectal exam, and a visual inspection, to confirm a diagnosis.

Your GI doctor will likely recommend any or a combination of the following interventions:

• Increased fiber in your diet
• Improved hydration (six to eight glasses of water daily)
• Exercise- If you sit or stand for long periods of time, make sure you move around at regular intervals.
• Sitz baths (installed on your toilet) two to three times daily
• Prescription medications to shrink hemorrhoids and relieve pain (e.g., creams, ointments, and suppositories)

If you’re suffering from chronic or severe hemorrhoids, your gastroenterologist will likely recommend CRH banding. This is a quick, minimally invasive in-office procedure in which the internal hemorrhoid tissue is tied with a rubber band, causing it to shrivel up and form a scar. This completely addresses the symptoms associated with the condition. The procedure involves no special preparation and downtime.

Another option is a stapled hemorrhoidopexy, which involves the use of a circular stapling device to eliminate the hemorrhoid tissue and close the area. Unlike traditional hemorrhoidectomy, a stapled hemorrhoidopexy involves less discomfort and a quicker recovery time. A significant drawback of this procedure is that it poses a higher risk of recurrence. It is also a highly complex procedure, typically performed by a colorectal surgeon.