On the Beat 11/23/20 - Gastroenterology Associates on Hemorrhoids

Troy chats with Dr. Ricky Johnston of Gastroenterology Associates of Columbus on the delicate subject of hemorrhoids.

For more information, call (662) 327-7525 or visit www.columbusgi.com

Midday slate troy thompson: welcome to on the beat, everyone.

I'm troy thompson.

Joining me in the studio today is dr. ricky johnston from gastroenterology associates of columbus.

Today, we're talking all about a topic that maybe you don't want to discuss with your loved ones and family, and it's, you bet, hemorrhoids.

How are you, my friend?

Dr. johnston: well, thank you, troy.

Troy thompson: we really do talk about some strange topics with you, don't we?

Dr. johnston: we do.

We do.

That's what happens when you have a gastroenterologi st on your tv show.

Troy thompson: exactly.

All right.

Now, most people know what hemorrhoids are.

How are they caused?

Dr. johnston: actually, we're born with hemorrhoids.

Troy thompson: oh, we are?

Dr. johnston: yeah, contrary to common thinking.

Everybody has hemorrhoids as part of human anatomy, and basically hemorrhoids are just a venous, a plexus of veins around the anus and the lower part of the rectum.

Everybody has hemorrhoids.

It's a matter of whether they get engorged or enlarged enough to cause any symptoms. troy thompson: so it's a bit like a varicose vein.

We all have varicose veins.

Dr. johnston: exactly.

Yeah.

Right.

Right.

Troy thompson: but sometimes they're protruding, they cause pain.

Dr. johnston: exactly.

Troy thompson: okay.

How common are they to develop into that next level of uncomfort?

Dr. johnston: yeah, that's a good question.

I don't have stats on the exact numbers on that, but i think it's probably a lot more common than you would think, because a lot of people, number one, think that there's really not much that can be done for them, or they've had it for so long they just tend to grin and bear it and deal with it and don't think really to seek any kind of care fcare for it.

Troy thompson: isn't it a painful issue?

Dr. johnston: it can be.

It can be.

It may be or it may not be.

Troy thompson: oh, really?

Dr. johnston: there's two kinds of hemorrhoids.

You can have hemorrhoids on the outside, which we call external hemorrhoids, and those can be swollen and painful, itch, burn.

Internal hemorrhoids, on the other hand, are inside of the anus in the rectum, and those generally don't hurt.

They don't cause any kind of pain or discomfort like that.

Typically, what they result in is bleeding, or they can get engorged enough where they actually prolapse out and have to be pushed back in.

Troy thompson: more common in women than men?

Dr. johnston: tends to be, yeah.

Mainly because of pregnancy.

Most women, if you get a history from them, will tell you that they've had hemorrhoids since... and they can recount it to the birth of their child, and it's been an issue since then.

Troy thompson: yes.

I was about to say, because a lot of my girlfriends have said to me over the years that they developed hemorrhoids, and i was like, "how is that possible?"

Dr. johnston: it's just the- troy thompson: the pushing.

Dr. johnston: the physiology associated with pregnancy.

Troy thompson: it is what it is.

Dr. johnston: yeah, yeah.

Troy thompson: all right, so how do we treat it?

Dr. johnston: well, conservative measures initially is what we recommend.

That would be things like increasing fiber in the diet, which can be hard to do.

If you start counting the fiber content of your food, it's really hard to get 25 or 30 grams of fiber a day.

Troy thompson: that's a lot of fiber.

Dr. johnston: it is.

It is.

We generally will recommend fiber supplements on top of high fiber foods.

Troy thompson: right.

Dr. johnston: a common one that i like to tell people is avoid sitting on the toilet for longer than two minutes.

Two minutes on and off the toilet.

Troy thompson: you've said that before.

Dr. johnston: yeah.

We tend to take our devices and books and whatever and kind of park on the toilet while we have a bowel movement.

That's probably not the best thing.

So i tell people, "leave your devices to the side and try to get on and off."

If you don't have to go, then come back later.

Troy thompson: let it happen naturally.

Dr. johnston: exactly.

Instead of forcing it.

Some people just feel like they have to have a bowel movement every morning, and that's not necessary.

If you don't have to go, you don't have to go.

Just come back later.

Those are the typical things we do conservative-wise first.

Weightlifters, actually, people who lift weights or people who sit for long periods of time.

We'll recommend some lifestyle changes.

And then if it gets beyond that, there's some over- the-counter ointments and creams you can do, which decrease the inflammation.

There's suppositories.

Then, beyond that, you get into more procedural-based treatments, which historically has been a hemorrhoidectomy that's performed by a surgeon.

Troy thompson: oh, wow.

Dr. johnston: yeah.

Which can be kind of painful and gruesome and has some lingering effects that are not very- troy thompson: i was about to say, if you said having to go under the knife.

Or is it done with laser?

Dr. johnston: both.

I think they've got a couple different ways that they do.

Troy thompson: i was about to say, i'm sure there's side effects to having that.

Dr. johnston: most people who do that would not recommend it to their friends.

Troy thompson: really.

Dr. johnston: what we have started doing the last few years is something called hemorrhoid banding, where we actually take a small device, and it can be done in the office with no prep, no sedation, just like a clinic visit, we stick this little device just inside the anus, deploy a rubber band on the hemorrhoid.

It's generally painless.

There might be a little bit of pressure, but it doesn't hurt, and that's it.

Troy thompson: it all sounds very painful.

All of it.

Dr. johnston: the banding that we do is not actually very painful.

Troy thompson: but just the thought of all of that.

Dr. johnston: yeah.

That's why people are discouraged from doing anything about it, because they think that the treatment is going to be so miserable.

But banding, we've found it to be very, very effective.

Troy thompson: we appreciate.

You always touch a topic that we don't like to talk about.

Right?

Dr. johnston: that's right.

Troy thompson: okay.

Thank you so much.

Dr. johnston: yes.

Thank you, troy.

Troy thompson: if you want to find out more information, there it all is up on the screen for you.

Gastroenterology and associates of columbus, back after this short break, everyone.