Hemorrhoids are swollen (enlarged, dilated) veins (varicose veins ) inside (internal) or outside (external) the anus that are usually caused by increased pressure, such as straining when constipated or during pregnancy. Hemorrhoids can cause pain, bleeding, clots, and itching. Hemorrhoids can be removed surgically while the patient is sedated and pain-free (local or spinal anesthesia) or deep asleep and pain-free (general anesthesia). The enlarged vein (hemorrhoid) is removed and a gauze packing is inserted to reduce bleeding. Smaller hemorrhoids can be banded -- a small rubber band is placed around the base of the hemorrhoid, causing the hemorrhoid tissue to die and fall off from lack of blood flow. Alternatively, such hemorrhoids can be injected with a sclerosing (hardening) agent, which has the same effect. These procedures can often be done as an outpatient or office procedure with minimal or no anesthesia.
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