So many patients blame their symptoms on their external hemorrhoids when in fact it is their internal hemorrhoidal disease causing the bleeding, itching, etc.
We’ve always preached that patient histories are pretty much worthless when it comes to patients’ perianal complaints, including their description of “where” their symptoms are coming from. That’s why we always encouraged folks to come in for an evaluation to see what the real story was with them. So often, when patients blamed their symptoms on their external “stuff”, we could fix the SYMPTOMS by banding their internal hemorrhoids.
In our experience, so often when patients tell us that “my external hemorrhoids are bothering me”, their symptoms are coming from their internal hemorrhoids. This is why, rather than telling our patients “We don’t treat external hemorrhoids”, our staff would recommend that the patient come in for an evaluation. So often, these same patients have rashes, fissures and/or internal hemorrhoidal disease which actually is responsible for the patients’ symptoms, and which can be successfully treated.
Obviously, banding the internal hemorrhoids doesn’t do anything directly to the external hemorrhoids. We explain to patients that internal hemorrhoid banding has no effect on the external tags that they may have. Also, even though some patients may think that their external hemorrhoids may have decreased in size after banding, they usually haven’t – these external hemorrhoids just tend to not distend as much as they did pre-banding.
That all being said, most of the time, “external symptoms” improve after internal hemorrhoid banding, despite leaving the tags, etc., alone.