Gastroenterologist Now Treating Hemorrhoids
Hemorrhoid banding is not a common gastroenterology procedure but that is changing. More and more gastroenterologists are performing anoscopy services like rubber band ligation. Why? The reasons vary, but mostly, because it makes sense. A gastroenterologist focuses on diseases that affect the gastrointestinal tract. Common sense says that hemorrhoids would be a concern along with other anorectal complaints. Consider why many gastroenterologists are adding nonsurgical anoscopic procedures like banding to their list of services.
A Little about Rubber Band Ligation
Hemorrhoid banding, or rubber band ligation, is a treatment that cuts off the blood flow to the hemorrhoid, causing it to shrink and fall away. This method of treating hemorrhoids dates back to Hippocrates who used to tie off these vascular structures at the base with thread.
Modern practitioners use a similar technique in the treatment of hemorrhoids. The practitioner inserts an anoscope to visualize the structure. Using an instrument, the doctor grasps the hemorrhoid and places a band at the base. Over time, the lack of blood flow causes the tissue to shrink and drop off. A scar forms over the spot to hold in veins and prevent further bulging.
The National Center for Health Statistics reports 23 million people, or 12.8 percent of the adult population, suffers from symptomatic hemorrhoid disease. A percentage of hemorrhoids are caught during a routine colonoscopy. Reports show that 38.9 percent of colonoscopy patients have hemorrhoids at time of the screening procedure with 44.7 percent presenting with symptoms.
Patients often avoid going to doctors when they have hemorrhoids because they are embarrassed, think they can treat them with over-the-counter products or are afraid of a cancer diagnosis. They will see a gastroenterologist when they have lower GI bleeding or perianal complaints and then discover they have hemorrhoids.
The Changing Training Standards
Patients who experience GI difficulties believe that a specialist like a gastroenterologist is able to provide comprehensive care for anorectal ailments like hemorrhoids. What they don’t know is gastroenterology curriculum does not cover common procedures like hemorrhoid banding, but that standard is changing.
Anoscopy, the most accurate method for examining the anal canal and rectum, is rarely taught in GI fellowship programs. Robert A. Ganz reports in a Clinical Gastroenterology and Hepatology, that more facilities are recognizing a gap exists in gastroenterology training. GI programs are now including nonsurgical anorectal treatments in their core curriculum, giving gastroenterologists the opportunity to do procedures like hemorrhoid banding.
Since, hemorrhoids are part of the anorectal anatomy, treatment is only necessary if they become symptomatic. Painful, thrombosed hemorrhoids must be excised to ease the patient’s comfort and reduce bleeding. More gastroenterologists are learning treatment options like hemorrhoid banding to increase their revenue stream and to meet patient expectations. Patients don’t always understand why they need to see a colorectal surgeon for a nonsurgical anoscopy procedure.
Rubber band ligation is a growth opportunity for the gastroenterology industry. It offers practitioners a way to improve their services, cut medical costs for their patients by performing all treatments in one office and enhance the continuum of care. It is a win-win scenario for both the patient and the practice.