Hemorrhoids are a common and often painful problem, as well as being a source of embarrassment. If you have hemorrhoids, Nina Paonessa, DO, of Paonessa Colon & Rectal Surgery, PC, in Brielle and Manahawkin, New Jersey, provides sensitive care and effective treatments.

Dr. Paonessa is a highly skilled colorectal surgeon who specializes in treating hemorrhoids, using conservative approaches where possible. She can also perform advanced procedures like transanal hemorrhoidal doppler ligation (THD). Call Paonessa Colon & Rectal Surgery, PC, to schedule an appointment today.

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What are hemorrhoids?

Hemorrhoids are veins that become swollen with blood and protrude from your anus or anal canal.

Millions of people in the United States suffer from hemorrhoids, for which there are multiple causes. Some common reasons for hemorrhoids include:

  • Straining to pass stools
  • Prolonged constipation
  • Prolonged diarrhea
  • Pregnancy
  • Childbirth
  • Prolonged sitting

Sitting on the toilet for too long can cause hemorrhoids, because of the downward pressure on the veins in your rectum and anus and the lack of support a toilet offers.

What are the symptoms of hemorrhoids?

Common symptoms of hemorrhoids include bleeding when you have bowel movements, anal or rectal pain, and perianal irritation and itching. You might also have a prolapse of your hemorrhoids during a bowel movement, where the swollen veins droop out of your anus.

There are four classifications of hemorrhoids:

Grade I – bleeding
Grade II – protrusion with spontaneous reduction
Grade III – protrusion requiring manual reduction
Grade IV – protrusion of hemorrhoidal tissue that can’t be reduced

The grade of hemorrhoids you have reflects the severity of your symptoms.

How are hemorrhoids treated?

Dr. Paonessa determines the appropriate treatment of your hemorrhoids based upon several factors, including your existing health status and the grade of hemorrhoid you have
Conservative measures include:

  • Stool softeners
  • Increasing dietary fiber
  • Adding a fiber supplement
  • Drinking plenty of water
  • Using sitz baths
  • Avoiding sitting and straining

In many cases, these measures help mild hemorrhoids to heal without the need for further treatment. If your hemorrhoids aren’t improving, Dr. Paonessa can carry out several painless in-office procedures including:

Rubber band ligation

This treatment involves wrapping a rubber band around the hemorrhoids to cut off the blood supply. After a few days, the hemorrhoids and bands simply drop off.


Sclerosis involves using a chemical solution that Dr. Paonessa injects into the hemorrhoids. The solution causes the veins to collapse and wither away.

With both these treatments, blood flow automatically redirects through other, healthier veins.

Would I need surgery for hemorrhoids?

If no other treatments are helping with your hemorrhoids, then you might need to consider surgical options. These include:

  • Traditional hemorrhoidectomy
  • Stapled hemorrhoidectomy
  • THD (transanal hemorrhoidal doppler ligation)

Dr. Paonessa is a leading expert in all aspects of hemorrhoid treatment and surgery. In fact, she is the co-editor of the second edition of the textbook The Surgical Treatment of Hemorrhoids. Get immediate and painless relief of your symptoms. Call Paonessa Colon & Rectal Surgery, PC, to schedule a consultation today.