Hemorrhoids are an uncomfortable topic—literally. They are painful and appear in an embarrassing part of the body, and the treatments often take time and great amounts of discomfort to heal.
In the past several decades, however, a new treatment has emerged, first overseas and more recently in the United States: infrared coagulation, or IRC. Hailed as non-invasive and less painful than other surgical options, IRC has become a popular alternative outpatient procedure for the treatment of hemorrhoids.
Williamsburg Surgery, PC, a practice of Sentara Medical Group, began offering the procedure last October, and doctors have since seen good results.
Hemorrhoids occur when veins in the rectum swell inside the anal cavity, causing itching, soreness and some bleeding. Although painful, the condition is typically not dangerous or life-threatening—and it’s fairly common. Fifty percent of Americans have hemorrhoids by age 50, according to the American College of Gastroenterology, but only five percent of sufferers seek medical treatment.
There are two types of hemorrhoids: internal and external. Internal hemorrhoids form inside the anal opening, while external hemorrhoids obtrude outside the anus, forming lumps that can be painful to touch. Many hemorrhoids are so small as to cause no problems whatsoever, going undetected in a large percentage of people.
The condition is graded on a four-degree scale, with first-degree hemorrhoids remaining completely internal and fourth-degree hemorrhoids large enough that they cannot be internal.
Hemorrhoids typically form because of low-fiber diets that require strenuous bowel movements. However, abdominal pressure can spark the condition, which is common among pregnant women and weight lifters.
Common treatments for hemorrhoids range from simple solutions for minor occurrences, like a high-fiber diet and over-the-counter steroid creams, to more invasive surgical procedures such as rubber band ligation (when a band is used to cut off blood flow to the inflamed tissue, allowing it to subsequently wither); injection therapy (to collapse the hemorrhoid); and the most serious alternative, hemorrhoidectomy (in which the vein is surgically removed).
Infrared coagulation was first developed in 1977. It steadily became more popular over time and has become a sought-after alternative—it’s a low-impact procedure with few risks and high efficacy.
Essentially, short bursts of infrared light are applied to the hemorrhoid, heating it and forming clots which seal the tissue and eventually obliterate the lump.
“In effect, what you do is cut the blood supply to the hemorrhoid plexus of veins; they decrease in size and then that usually alleviates the patients of their symptoms,” says Dr. Mark P. Moniz, one of the surgeons at Williamsburg Surgery, PC, who performs the procedure. “It’s the same principle as we use in the operating room with our electrocautery devices; using electricity causes the destruction of the tissue and then the vessels clot and [stop bleeding].”
As IRC became more popular across the U.S., doctors at Sentara heard about it. They had been looking for a new treatment, Moniz explains, one that could be performed in a doctor’s office instead of a surgical suite and offered quality results and a fast recovery time.
“One of my partners came across this technology and discussed it with the rest of us, and we decided it was a good thing to try, so we’ve been offering it ever since,” Moniz says.
It was a simple procedure for Williamsburg Surgery’s doctors to learn—all it takes is shining a light on the affected area for a predetermined amount of time.
“The [best] thing about the equipment is that it’s almost fool-proof,” Moniz says.
Risks and side effects of IRC are low, a marked difference from the alternative surgical treatments.
Says Moniz: “The risks are pretty minimal because the light is on a timer. There’s always the risk that you can have some temporary urinary retention [the inability to urinate]. You can have some mild bleeding or discomfort, but there is no real risk of perforating the rectum.”
Medical journals from around the world have published studies for years reaffirming the effectiveness of IRC treatment. The results of a 2007 study published in Diseases of the Colon and Rectum compared hemorrhoid treatments and found that there were few complications with IRC and that significantly fewer patients experienced pain during recovery than after other procedures. A 2008 article in the Brazilian Journal of Medicine concluded that patients treated with infrared coagulation experienced far less pain with equal results.
IRC has proven to be effective for patients at Williamsburg Surgery, too, where Moniz estimates some 30 or 40 patients have received the procedure since the practice began offering it last year.
“It’s been very effective,” he says. “The patients that we’ve seen back have been very happy. All of [their] symptoms have resolved with little to no discomfort. Following the procedure, many were able to make it back to their normal activity either the same day or within 24 or 48 hours. Even the people who required more than one application of the infrared coagulation seem to be happy with the results.”
Moniz notes that infrared coagulation’s effectiveness, combined with the quick recovery time, makes it an excellent treatment option for hemorrhoid sufferers.
“The thing that we try to emphasize to the primary care physicians who refer to us is, this is something that we can do during a patient’s initial visit, so it’s not only effective but very convenient for the patients, and they seem to tolerate it very well,” Moniz says. “Once we see them during the initial consultation, if we feel they’re a candidate, it’s something we can do right away in the office. It only takes a very short amount of time, maybe five or 10 minutes. And they’re able to go home.”