Hemorrhoids: Types, Symptoms, and Treatment Options in Southwest Louisiana

By the Surgical Team at Sulphur Surgical Clinic — Dr. W. Devin Seale, Dr. Stephen Castleberry, and Dr. Matthew Ayo

Hemorrhoids are among the most common conditions in medicine — affecting an estimated 75% of Americans at some point in their lives — and among the most undertreated. Not because effective treatments don’t exist, but because patients are too embarrassed to bring them up.

Let’s fix that.

Hemorrhoids are swollen veins in the rectum or around the anus. They’re not a character flaw. They’re not a sign of poor hygiene. They’re a structural issue — and like most structural issues, they respond well to the right treatment.

This guide covers what hemorrhoids are, how to identify them, and what your treatment options look like — from simple dietary changes all the way to surgery when it’s needed.

What Are Hemorrhoids?

Hemorrhoids are cushions of tissue containing blood vessels located in the lower rectum and around the anus. Everyone has them — they’re a normal part of anatomy. The term “hemorrhoids” refers to the condition when these vascular cushions become inflamed, swollen, or symptomatic.

There are two main types:

Internal Hemorrhoids

Internal hemorrhoids form inside the rectum, above the dentate line (the anatomical boundary between the rectum and the anal canal). Because this area has very few pain receptors, internal hemorrhoids are often painless — even when they bleed.

The most common symptom is painless bright red bleeding with bowel movements. You may notice blood on the toilet tissue or in the toilet bowl. Internal hemorrhoids may also cause a feeling of fullness or incomplete evacuation.

When internal hemorrhoids enlarge significantly, they may begin to prolapse — protrude through the anus during straining. This is graded on a scale of I through IV:

Grade	Description
I	Bulge into the rectal canal; do not prolapse
II	Prolapse with straining, reduce spontaneously
III	Prolapse with straining, require manual reduction
IV	Permanently prolapsed; cannot be reduced

Grade I–II hemorrhoids are typically managed conservatively or with office procedures. Grade III–IV hemorrhoids may require more definitive treatment, including surgery.

External Hemorrhoids

External hemorrhoids form below the dentate line, in the area around the anal opening. This area is richly supplied with pain-sensitive nerves, which is why external hemorrhoid symptoms tend to be more uncomfortable.

Common symptoms include:

Itching or irritation around the anus
Pain or discomfort, especially when sitting
Swelling around the anus
Difficulty with hygiene after bowel movements

One particularly painful complication is a thrombosed external hemorrhoid — when the blood inside an external hemorrhoid clots suddenly, causing severe localized pain and a firm, tender lump at the anal margin. While this typically resolves on its own over 1–2 weeks, surgical drainage in the acute phase (within 48–72 hours) can provide immediate relief.

What Causes Hemorrhoids?

Hemorrhoids develop when the veins in the anorectal area become engorged, typically due to increased pressure. Contributing factors include:

Chronic straining with bowel movements (often from constipation)
Low-fiber diet leading to hard stools and prolonged sitting on the toilet
Chronic diarrhea, which irritates the anorectal area
Pregnancy, which increases pelvic pressure significantly
Obesity
Prolonged sitting, particularly on the toilet
Heavy lifting that increases abdominal pressure
Advancing age (supporting tissue weakens over time)
Family history — hemorrhoids have a genetic component

Pregnancy deserves special mention: the combination of increased blood volume, hormonal changes that relax vein walls, and the growing uterus compressing pelvic veins makes hemorrhoids extremely common during and after pregnancy.

Symptoms of Hemorrhoids

Symptoms vary depending on the type and severity:

Internal hemorrhoids typically cause:

Painless bright red bleeding with bowel movements
Mucus discharge
Feeling of fullness or incomplete evacuation
Prolapse (in grade II–IV)

External hemorrhoids typically cause:

Anal itching and irritation
Pain, especially when sitting or wiping
Swelling around the anal opening
Discomfort during bowel movements

Thrombosed external hemorrhoids cause:

Sudden, severe anal pain
A firm, tender, bluish lump at the anus
Difficulty sitting or walking comfortably

Important: These symptoms are not exclusive to hemorrhoids. Rectal bleeding, in particular, can be a sign of polyps, colorectal cancer, inflammatory bowel disease, or other serious conditions. Do not self-diagnose rectal bleeding as hemorrhoids — get it evaluated.

→ Read more: [Rectal Bleeding: Causes, When to Worry, and When to See a Surgeon]

When Should You See a Surgeon?

Many patients try to manage hemorrhoids at home for months or years before seeking care. While mild hemorrhoids often do respond to conservative measures, there are clear signs it’s time to see a surgeon:

Rectal bleeding that is new, persistent, or worsening
Hemorrhoids that prolapse and don’t reduce on their own (grade III–IV)
Significant pain that interferes with daily activities
Symptoms that haven’t improved with 2–4 weeks of conservative treatment
A thrombosed external hemorrhoid in the acute phase (within 72 hours)
Any uncertainty about whether your symptoms are hemorrhoids or something else

No referral is required to see Dr. Seale, Dr. Castleberry, or Dr. Ayo at Sulphur Surgical Clinic.

Treatment Options

Treatment for hemorrhoids is matched to the grade, type, and severity of disease. Here’s a full overview:

Conservative (Non-Surgical) Measures

For mild to moderate hemorrhoids, conservative management is often effective as a first step:

Dietary fiber: Increasing fiber to 25–35 grams per day softens stools and reduces straining. Fruits, vegetables, whole grains, and fiber supplements (psyllium) are all helpful.
Hydration: Adequate fluid intake — at least 8 glasses of water daily — helps prevent constipation.
Avoid prolonged sitting on the toilet: The toilet seat is a pressure trap for anorectal veins. Keep bowel movements brief and purposeful.
Sitz baths: Soaking in warm water for 10–15 minutes after bowel movements reduces inflammation and provides symptom relief.
Topical creams and suppositories: Over-the-counter products (hydrocortisone, witch hazel, lidocaine) can reduce itching and inflammation temporarily, but do not treat the underlying problem.
Stool softeners: Docusate sodium can reduce straining in the short term.

Conservative measures work well for grade I–II hemorrhoids and for reducing symptoms in grade III–IV while awaiting definitive treatment. They do not typically resolve significant prolapse or eliminate high-grade hemorrhoids.

Rubber Band Ligation (Hemorrhoid Banding)

Rubber band ligation is the most commonly performed outpatient procedure for internal hemorrhoids and is highly effective for grade I–III disease. A small rubber band is placed around the base of the internal hemorrhoid, cutting off its blood supply. The hemorrhoid withers and falls off within 1–2 weeks.

The procedure is quick (5–10 minutes), performed in the office without anesthesia or sedation, and most patients return to normal activities the same day.

→ Full guide: [Hemorrhoid Banding (Rubber Band Ligation): What to Expect at Sulphur Surgical Clinic]

Hemorrhoidectomy

Hemorrhoidectomy — surgical removal of hemorrhoids — is the most definitive treatment and provides the lowest long-term recurrence rates. It’s indicated for:

Grade III–IV internal hemorrhoids not responding to banding
Large external hemorrhoids causing significant symptoms
Combined internal and external hemorrhoid disease
Acutely thrombosed hemorrhoids in some cases

Hemorrhoidectomy is performed in the operating room under anesthesia. Recovery is typically 2–4 weeks. While it involves a more significant recovery than banding, it offers lasting relief for patients with severe hemorrhoid disease.

→ Full guide: [Hemorrhoidectomy: When Surgery Is the Right Choice]

Infrared Coagulation (IRC)

Infrared coagulation uses heat energy to shrink internal hemorrhoids. It is less widely used than rubber band ligation and is generally considered slightly less effective for higher-grade disease, though it has a favorable side effect profile for patients with blood clotting disorders.

Sclerotherapy

Sclerotherapy involves injecting a chemical solution into the hemorrhoid to scar and shrink it. It’s less commonly used in the U.S. than rubber band ligation but can be useful in select patients.

Choosing the Right Treatment

The right treatment depends on:

Grade of internal hemorrhoids (I–IV)
Whether external hemorrhoids are also present
Severity of symptoms
Prior treatment history
Patient health and preference

At Sulphur Surgical Clinic, our approach is always to start with the least invasive effective option. For most patients with symptomatic internal hemorrhoids, rubber band ligation is the right first step. For patients with grade III–IV disease, significant external hemorrhoids, or prior failed banding, hemorrhoidectomy may be the better long-term solution.

Dr. Seale, Dr. Castleberry, and Dr. Ayo will review your specific situation and recommend the approach most likely to give you durable relief.

Frequently Asked Questions

Can hemorrhoids go away on their own? Small, grade I internal hemorrhoids and mild external hemorrhoids may improve significantly with dietary changes and conservative measures. Grade III–IV prolapsing hemorrhoids and large external hemorrhoids generally will not resolve without treatment.

Are hemorrhoids dangerous? Most hemorrhoids are not dangerous — they cause discomfort and bleeding, but not long-term harm. However, significant rectal bleeding always needs to be evaluated because other, more serious conditions can present similarly.

Will banding cure my hemorrhoids permanently? Rubber band ligation is highly effective for grade I–III internal hemorrhoids. Most patients have excellent long-term results, though a minority may need repeat treatment. Grade IV hemorrhoids and large external hemorrhoids are better treated with hemorrhoidectomy for the most durable results.

What’s recovery like after hemorrhoid treatment? Banding: most patients return to normal activity the same day, with mild discomfort for a few days. Hemorrhoidectomy: 2–4 weeks for full recovery, with the first week being the most uncomfortable.

I’m embarrassed. Is this something you see often? Absolutely — every day. Anorectal conditions are extremely common. Our surgeons and staff handle these appointments with complete professionalism and discretion. You’re in good company.

Why Sulphur Surgical Clinic?

Dr. W. Devin Seale, Dr. Stephen Castleberry, and Dr. Matthew Ayo offer the full spectrum of hemorrhoid care — from outpatient rubber band ligation to surgical hemorrhoidectomy — right here in Southwest Louisiana.

You shouldn’t have to drive to New Orleans or Houston for expert anorectal care.

📞 Call (337) 527-6363 to schedule your consultation. 📍 914 Cypress Street, Sulphur, LA 70663 📍 1920 W Sale Rd, Lake Charles, LA 70605 🌐 sulphursurgicalclinic.com

No referral required.

This blog is for general informational purposes only and does not constitute medical advice. Consult with a qualified healthcare provider for guidance specific to your situation.