Common Questions Answered

Hemorrhoid Q&A

What is the best hemorrhoid cream?


While hemorrhoids may not be cured with topical treatment, symptomatic relief from pain and itching can be obtained with over-the-counter creams such as Preparation H and Lidocaine, or prescriptions medications like Nifedipine cream. We also recommend CBD topical relief cream (available in our online CBD store or in-office).




What are hemorrhoid symptoms?


What do hemorrhoids feel like? Watch out for these symptoms that may indicate you have hemorrhoids: • Painful swelling • Red marble-like growth or lump • Sharp rectal pain • Anal discharge • Irritation and itching • Rectal bleeding Usually, symptoms last only a few days and there are plenty of effective ways to treat. Contact us for quick, painless, easy treatment for hemorrhoids - performed in-office. We offer solutions without need for surgery, except in the worst case scenarios.




What does a hemorrhoid look like?


A hemorrhoid can appear as a sudden onset painful lump that may be red, angry, and inflamed. Hemorrhoids can cause discomfort, swelling, rectal pain, anal discharge, and itching or irritation of the anus. These signs of hemorrhoids should not be ignored.




What is rubber band ligation (RBL) for hemorrhoids?


ColoWell America’s gold standard RUBBER BAND LIGATION - a quick, non-surgical, in-office procedure with little to no pain or complications. -- Rubber band ligation is preferred for hemorrhoids because of its effectiveness and affordability compared to other more invasive interventions and non-beneficial over-the-counter remedies. -- How the treatment works: • The treatment targets the blood vessel which feeds the hemorrhoid ligating the blood vessel and cutting off the blood supply to the hemorrhoid. • The blood flow to the hemorrhoid is interrupted and it begins to shrink. • Since the hemorrhoid has lost its connection with the feeding vessel, it continues to shrink and fall off during the 3-7 days following treatment. Affordable, no time off necessary No hospital visits No need for special prep before procedure Performed in office in minutes




How are pregnancy and hemorrhoids related?


During pregnancy and delivery hemorrhoids can occur due to anal pressure, constipation, and pushing. Hemorrhoids are also commonly known as piles. It is recommended to eat fiber during pregnancy to avoid constipation, which can lead to hemorrhoidal issues. See a proctologist if you are suffer from hemorrhoids during or after pregnancy.




How can you prevent hemorrhoids?


To help prevent hemorrhoids and hemorrhoid recurrence you can eat more high fiber foods, including fruits, vegetables and whole grains. There are also fiber supplements like Metamucil or Citrucel. Our doctor also highly recommends daily flax seed powder ingestion (2tbsp/day). You can also help prevent hemorrhoids by drinking four to six glasses of water a day and exercising regularly to help the bowels to move normally.




What are surgery options for hemorrhoids?


We use rubber band ligation (RBL) as our standard for hemorrhoid surgery. The doctor places a small rubber band at the base of the hemorrhoid, which in result stops the blood supply and causes the hemorrhoid to shrink and fall off. A hemorrhoidectomy is another choice for hemorrhoid surgery. The procedure removes the hemorrhoid, blood clot and blood vessels. You may get partial anesthesia during this procedure and a hemorrhoidectomy is only performed for the most severe hemorrhoid cases.




What causes a thrombosed hemorrhoid?


There are many causes of thrombosed hemorrhoids, including excessive straining with bowel movement when constipated, diarrhea, abnormal and irregular bowel movements, pregnancy and postpartum state, and prolonged sitting (for example, during travel, working at a desk, etc.)




What is a thrombosed hemorrhoid?


Thrombosed hemorrhoids are blood clots in a hemorrhoid. This can result in itching around your anus, bleeding when you have a bowel movement, and swelling or lumps around the anus.




Are hemorrhoid treatments covered by insurance?


Yes! Contact us or your provider to verify your eligibility for services. We also offer Self-Pay rates.




Does rubber band ligation (RBL) hurt?


Rubber band ligation is the best treatment modality. Complications with banding are little to none. The procedure does not require surgery or a hospital visit, and you don’t have to take off work or require any difficult preparation!




Will I need to schedule multiple visits to treat hemorrhoids?


How to treat hemorrhoids is based on a patient's individual condition. Most cases require one to three appointments to prevent recurrence.




Will I heal completely from hemorrhoid treatment?


Many patients ask us: "Will the hemorrhoids go away on there own?" The answer lies in the lifestyle choices you make following treatment. Make FIBER a daily part of your diet. "Ground flax seed is an excellent source of fiber!" - Shiraz Farooq, MD • Choose a plant-based diet to avoid constipation • Be sure to drink four to six glasses of water throughout the day • Avoid strenuous activities




Do hemorrhoids bleed?


Internal hemorrhoids that prolapse and protude can often cause bright red bleeding. Mostly this is painless bleeding seen on the toilet paper with wiping. External skin tags or external hemorrhoidal tissue usually doesn't cause bleeding. These external hemorrhoids can cause itching and problems with hygeine.





Fissure and Fistula Q&A

What are anal fissure symptoms?


With anal fissure you may experience sharp, knife-like pain that can last up to a few hours. You will have mild to severe painful bowel movements and possible rectal bleeding. Many describe the feeling of passing shards of glass. Anal fissure can also cause anal itching and irritation.




What is the medical treatment for anal fissure?


To treat anal fissure you can receive a botulinum toxin injection from your doctor. There are also topical solutions such as nifedipine cream, hydrocortisone cream or CBD cream that can be applied to the fissure area for relief of pain symptoms. We recommend taking other measures, like changing your diet to incorporate ground flax seed powder and eating high fiber foods. Relief for anal fissure can additionally be aided by using a “squatty potty” stool while using the bathroom and trying methods like soaking in a sitz bath to help with symptoms.




How to heal an anal fissure?


The surgical option for anal fissure is lateral internal sphincterotomy. Your doctor may also perform an anal manometry test to determine how your anus and rectum is preforming during bowl movements and prescribe other methods for healing, such as a botulinum toxin injection or topical creams like nifedipine cream, hydrocortisone cream or CBD cream. You can also try methods to reduce symptoms like incorporating flax seed powder and high fiber foods into your diet. We also recommend using a “squatty potty” in the bathroom and a soothing sitz bath for relief.




What is the cause of anal fistula?


Anal fistula can be the result of infection near the anus. Causes of anal fistula from infection can stem from side-effects from constipation, metabolic disorders, Crohn’s disease, diabetes, and hormonal imbalance.




What are options for anal fistula treatment?


To treat anal fistula you can undergo a fistulotomy surgery by your doctor. There is also the option to have a ligation of intersphincteric fistula tract (LIFT) procedure to close the fistula opening and remove the infected material. Other treatments for fistula are a mucosal advancement flap (MAF) repair surgery and a less invasive option of a seton placement to help clear the fistula infection.




What is a perianal fistula?


A perianal fistula is infection of the anal gland which leads to drainage of the gland to the outside skin surface, causing a tract infection and abscess.





Fecal Incontinence and IBS Q&A

What is the best hemorrhoid cream?


While hemorrhoids may not be cured with topical treatment, symptomatic relief from pain and itching can be obtained with over-the-counter creams such as Preparation H and Lidocaine, or prescriptions medications like Nifedipine cream. We also recommend CBD topical relief cream (available in our online CBD store or in-office).




What are hemorrhoid symptoms?


What do hemorrhoids feel like? Watch out for these symptoms that may indicate you have hemorrhoids: • Painful swelling • Red marble-like growth or lump • Sharp rectal pain • Anal discharge • Irritation and itching • Rectal bleeding Usually, symptoms last only a few days and there are plenty of effective ways to treat. Contact us for quick, painless, easy treatment for hemorrhoids - performed in-office. We offer solutions without need for surgery, except in the worst case scenarios.




What does a hemorrhoid look like?


A hemorrhoid can appear as a sudden onset painful lump that may be red, angry, and inflamed. Hemorrhoids can cause discomfort, swelling, rectal pain, anal discharge, and itching or irritation of the anus. These signs of hemorrhoids should not be ignored.




What is rubber band ligation (RBL) for hemorrhoids?


ColoWell America’s gold standard RUBBER BAND LIGATION - a quick, non-surgical, in-office procedure with little to no pain or complications. -- Rubber band ligation is preferred for hemorrhoids because of its effectiveness and affordability compared to other more invasive interventions and non-beneficial over-the-counter remedies. -- How the treatment works: • The treatment targets the blood vessel which feeds the hemorrhoid ligating the blood vessel and cutting off the blood supply to the hemorrhoid. • The blood flow to the hemorrhoid is interrupted and it begins to shrink. • Since the hemorrhoid has lost its connection with the feeding vessel, it continues to shrink and fall off during the 3-7 days following treatment. Affordable, no time off necessary No hospital visits No need for special prep before procedure Performed in office in minutes




How are pregnancy and hemorrhoids related?


During pregnancy and delivery hemorrhoids can occur due to anal pressure, constipation, and pushing. Hemorrhoids are also commonly known as piles. It is recommended to eat fiber during pregnancy to avoid constipation, which can lead to hemorrhoidal issues. See a proctologist if you are suffer from hemorrhoids during or after pregnancy.




How can you prevent hemorrhoids?


To help prevent hemorrhoids and hemorrhoid recurrence you can eat more high fiber foods, including fruits, vegetables and whole grains. There are also fiber supplements like Metamucil or Citrucel. Our doctor also highly recommends daily flax seed powder ingestion (2tbsp/day). You can also help prevent hemorrhoids by drinking four to six glasses of water a day and exercising regularly to help the bowels to move normally.




What are surgery options for hemorrhoids?


We use rubber band ligation (RBL) as our standard for hemorrhoid surgery. The doctor places a small rubber band at the base of the hemorrhoid, which in result stops the blood supply and causes the hemorrhoid to shrink and fall off. A hemorrhoidectomy is another choice for hemorrhoid surgery. The procedure removes the hemorrhoid, blood clot and blood vessels. You may get partial anesthesia during this procedure and a hemorrhoidectomy is only performed for the most severe hemorrhoid cases.




What causes a thrombosed hemorrhoid?


There are many causes of thrombosed hemorrhoids, including excessive straining with bowel movement when constipated, diarrhea, abnormal and irregular bowel movements, pregnancy and postpartum state, and prolonged sitting (for example, during travel, working at a desk, etc.)




What is a thrombosed hemorrhoid?


Thrombosed hemorrhoids are blood clots in a hemorrhoid. This can result in itching around your anus, bleeding when you have a bowel movement, and swelling or lumps around the anus.




Are hemorrhoid treatments covered by insurance?


Yes! Contact us or your provider to verify your eligibility for services. We also offer Self-Pay rates.




Does rubber band ligation (RBL) hurt?


Rubber band ligation is the best treatment modality. Complications with banding are little to none. The procedure does not require surgery or a hospital visit, and you don’t have to take off work or require any difficult preparation!




Will I need to schedule multiple visits to treat hemorrhoids?


How to treat hemorrhoids is based on a patient's individual condition. Most cases require one to three appointments to prevent recurrence.




Will I heal completely from hemorrhoid treatment?


Many patients ask us: "Will the hemorrhoids go away on there own?" The answer lies in the lifestyle choices you make following treatment. Make FIBER a daily part of your diet. "Ground flax seed is an excellent source of fiber!" - Shiraz Farooq, MD • Choose a plant-based diet to avoid constipation • Be sure to drink four to six glasses of water throughout the day • Avoid strenuous activities




Do hemorrhoids bleed?


Internal hemorrhoids that prolapse and protude can often cause bright red bleeding. Mostly this is painless bleeding seen on the toilet paper with wiping. External skin tags or external hemorrhoidal tissue usually doesn't cause bleeding. These external hemorrhoids can cause itching and problems with hygeine.





Proctology Q&A

What is a proctologist?


A proctologist is a specialist that treats common ailments and diseases of the anus and rectum including hemorrhoids, anal fissures, anal fistula and abscess, rectocele problems and fecal incontinence etc. This extra training and experience , along with board certification in colorectal surgery can make all the difference for some patients.




What is a colorectal doctor?


A colorectal specialist is a surgeon who has extra fellowship training in treating various diseases of the colon, rectum and anus and is recognized by the American Board of Colon and Rectal Surgery. Colorectal doctors specialize in diseases and cancers of the colon and rectum, including surgery options for colorectal cancers, cancer screening, cancer symptoms, and disgnosis and treatment of conditions of the lower digestive tract. Colorectal doctors or colorectal surgeons are sometimes refered to as proctologists.




What causes blood in stool?


Blood in the stool can be caused by bright red bleeding coming from hemorrhoids, anal fissures, fistulae or cancer of the rectum and anus. Bleeding can also come from diverticular problems in the colon, colon cancer and colonic polyps etc. Colitis or gastroenteritis can also cause bleeding that needs to be checked. Upper gastrointestinal bleeding can come from the stomach or small bowel also. Mostly bleeding from these sources is dark brown or black. These symptoms should not be ignored and patients should seek medical help soon.




What are symptoms of rectal cancer?


Rectal cancer is very common and can present with fresh rectal bleeding, rectal pain, anorectal swelling, weight loss and more. Some patients may have a feeling of incomplete evacuation of their bowel movement called “tenesmus” or rectal cramping.




What is gastroesophageal reflux disease (GERD)?


GERD or Gastroesophageal reflux disease is a common name for a variety of problems that present with symptoms of indigestion including acid brash and heart burn, upper abdominal pain and bloating, atypical chest pain or vomiting and nausea. Some patients report a reflux of undigested food also. It may be caused by increased acid production, mechanical valve problem between the stomach and esophagus (food pipe), or bile acid issues. A specialist can diagnose and treat this disease.




How can I improve my gastrointestinal health?


Our motto at ColoWell America is #ItsAGutFeeling. Gastrointestinal health begins at home with food that we see, smell and ingest. Eating a balanced diet full of nutrients from various plants and vegetables can make all the difference. Avoid eating processed meats and foods with artificial chemicals and preservatives. Adding fiber rich food to the diet is a sure way to boost immunity and improve digestion. Undigested fiber acts as brush for the colon and removes unwanted waste to prevent constipation and bloating. We recommend adding ground or milled flax seed powder to the diet daily. A daily walk, hydration and “portion control” are methods to improve digestive health also.





Privileges and Insurances Q&A

What is a proctologist?


A proctologist is a specialist that treats common ailments and diseases of the anus and rectum including hemorrhoids, anal fissures, anal fistula and abscess, rectocele problems and fecal incontinence etc. This extra training and experience , along with board certification in colorectal surgery can make all the difference for some patients.




What is a colorectal doctor?


A colorectal specialist is a surgeon who has extra fellowship training in treating various diseases of the colon, rectum and anus and is recognized by the American Board of Colon and Rectal Surgery. Colorectal doctors specialize in diseases and cancers of the colon and rectum, including surgery options for colorectal cancers, cancer screening, cancer symptoms, and disgnosis and treatment of conditions of the lower digestive tract. Colorectal doctors or colorectal surgeons are sometimes refered to as proctologists.




What causes blood in stool?


Blood in the stool can be caused by bright red bleeding coming from hemorrhoids, anal fissures, fistulae or cancer of the rectum and anus. Bleeding can also come from diverticular problems in the colon, colon cancer and colonic polyps etc. Colitis or gastroenteritis can also cause bleeding that needs to be checked. Upper gastrointestinal bleeding can come from the stomach or small bowel also. Mostly bleeding from these sources is dark brown or black. These symptoms should not be ignored and patients should seek medical help soon.




What are symptoms of rectal cancer?


Rectal cancer is very common and can present with fresh rectal bleeding, rectal pain, anorectal swelling, weight loss and more. Some patients may have a feeling of incomplete evacuation of their bowel movement called “tenesmus” or rectal cramping.




What is gastroesophageal reflux disease (GERD)?


GERD or Gastroesophageal reflux disease is a common name for a variety of problems that present with symptoms of indigestion including acid brash and heart burn, upper abdominal pain and bloating, atypical chest pain or vomiting and nausea. Some patients report a reflux of undigested food also. It may be caused by increased acid production, mechanical valve problem between the stomach and esophagus (food pipe), or bile acid issues. A specialist can diagnose and treat this disease.




How can I improve my gastrointestinal health?


Our motto at ColoWell America is #ItsAGutFeeling. Gastrointestinal health begins at home with food that we see, smell and ingest. Eating a balanced diet full of nutrients from various plants and vegetables can make all the difference. Avoid eating processed meats and foods with artificial chemicals and preservatives. Adding fiber rich food to the diet is a sure way to boost immunity and improve digestion. Undigested fiber acts as brush for the colon and removes unwanted waste to prevent constipation and bloating. We recommend adding ground or milled flax seed powder to the diet daily. A daily walk, hydration and “portion control” are methods to improve digestive health also.





Medical Marijuana Q&A

What is the best hemorrhoid cream?


While hemorrhoids may not be cured with topical treatment, symptomatic relief from pain and itching can be obtained with over-the-counter creams such as Preparation H and Lidocaine, or prescriptions medications like Nifedipine cream. We also recommend CBD topical relief cream (available in our online CBD store or in-office).




What are hemorrhoid symptoms?


What do hemorrhoids feel like? Watch out for these symptoms that may indicate you have hemorrhoids: • Painful swelling • Red marble-like growth or lump • Sharp rectal pain • Anal discharge • Irritation and itching • Rectal bleeding Usually, symptoms last only a few days and there are plenty of effective ways to treat. Contact us for quick, painless, easy treatment for hemorrhoids - performed in-office. We offer solutions without need for surgery, except in the worst case scenarios.




What does a hemorrhoid look like?


A hemorrhoid can appear as a sudden onset painful lump that may be red, angry, and inflamed. Hemorrhoids can cause discomfort, swelling, rectal pain, anal discharge, and itching or irritation of the anus. These signs of hemorrhoids should not be ignored.




What is rubber band ligation (RBL) for hemorrhoids?


ColoWell America’s gold standard RUBBER BAND LIGATION - a quick, non-surgical, in-office procedure with little to no pain or complications. -- Rubber band ligation is preferred for hemorrhoids because of its effectiveness and affordability compared to other more invasive interventions and non-beneficial over-the-counter remedies. -- How the treatment works: • The treatment targets the blood vessel which feeds the hemorrhoid ligating the blood vessel and cutting off the blood supply to the hemorrhoid. • The blood flow to the hemorrhoid is interrupted and it begins to shrink. • Since the hemorrhoid has lost its connection with the feeding vessel, it continues to shrink and fall off during the 3-7 days following treatment. Affordable, no time off necessary No hospital visits No need for special prep before procedure Performed in office in minutes




How are pregnancy and hemorrhoids related?


During pregnancy and delivery hemorrhoids can occur due to anal pressure, constipation, and pushing. Hemorrhoids are also commonly known as piles. It is recommended to eat fiber during pregnancy to avoid constipation, which can lead to hemorrhoidal issues. See a proctologist if you are suffer from hemorrhoids during or after pregnancy.




How can you prevent hemorrhoids?


To help prevent hemorrhoids and hemorrhoid recurrence you can eat more high fiber foods, including fruits, vegetables and whole grains. There are also fiber supplements like Metamucil or Citrucel. Our doctor also highly recommends daily flax seed powder ingestion (2tbsp/day). You can also help prevent hemorrhoids by drinking four to six glasses of water a day and exercising regularly to help the bowels to move normally.




What are surgery options for hemorrhoids?


We use rubber band ligation (RBL) as our standard for hemorrhoid surgery. The doctor places a small rubber band at the base of the hemorrhoid, which in result stops the blood supply and causes the hemorrhoid to shrink and fall off. A hemorrhoidectomy is another choice for hemorrhoid surgery. The procedure removes the hemorrhoid, blood clot and blood vessels. You may get partial anesthesia during this procedure and a hemorrhoidectomy is only performed for the most severe hemorrhoid cases.




What causes a thrombosed hemorrhoid?


There are many causes of thrombosed hemorrhoids, including excessive straining with bowel movement when constipated, diarrhea, abnormal and irregular bowel movements, pregnancy and postpartum state, and prolonged sitting (for example, during travel, working at a desk, etc.)




What is a thrombosed hemorrhoid?


Thrombosed hemorrhoids are blood clots in a hemorrhoid. This can result in itching around your anus, bleeding when you have a bowel movement, and swelling or lumps around the anus.




Are hemorrhoid treatments covered by insurance?


Yes! Contact us or your provider to verify your eligibility for services. We also offer Self-Pay rates.




Does rubber band ligation (RBL) hurt?


Rubber band ligation is the best treatment modality. Complications with banding are little to none. The procedure does not require surgery or a hospital visit, and you don’t have to take off work or require any difficult preparation!




Will I need to schedule multiple visits to treat hemorrhoids?


How to treat hemorrhoids is based on a patient's individual condition. Most cases require one to three appointments to prevent recurrence.




Will I heal completely from hemorrhoid treatment?


Many patients ask us: "Will the hemorrhoids go away on there own?" The answer lies in the lifestyle choices you make following treatment. Make FIBER a daily part of your diet. "Ground flax seed is an excellent source of fiber!" - Shiraz Farooq, MD • Choose a plant-based diet to avoid constipation • Be sure to drink four to six glasses of water throughout the day • Avoid strenuous activities




Do hemorrhoids bleed?


Internal hemorrhoids that prolapse and protude can often cause bright red bleeding. Mostly this is painless bleeding seen on the toilet paper with wiping. External skin tags or external hemorrhoidal tissue usually doesn't cause bleeding. These external hemorrhoids can cause itching and problems with hygeine.





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