Dr. Benjamin Hopkins, MD, a colon and rectal surgeon with Duke Colon and Rectal Surgery of Raleigh, touches every condition you don’t want to talk about – from hemorrhoids, and fecal incontinence to anal pain and diverticulitis.
Q. What’s the most important thing to do for colorectal health?
A. The best approach to good colorectal health is to maintain a high-fiber diet and drink plenty of water. Eight glasses of water a day helps prevent constipation. A high-fiber diet will help prevent complications of hemorrhoids and anal tears and will help to prevent diverticulitis.
Q. Most people know that surgery is used to treat colorectal cancer, but what other conditions do you treat with surgery?
A. Surgery is necessary to treat recurrent or complicated bouts of diverticulitis and inflammatory bowel diseases that don’t respond to other treatment. It is also used to treat benign problems of the anus and rectum when conservative management fails.
Q. Can surgery really cure these conditions?
A. Yes! That’s why I love my job so much.
Q Does surgery leave an ugly scar?
A. We specialize in minimally invasive surgery, including robotic, laparoscopic, and single-site surgeries, which leave patients with smaller scars, less pain, and a faster recovery. There is no scar from transanal endoscopic microsurgery since all work is done through the anus.
Q. What are hemorrhoids, exactly, and how do you know if you have them?
A. Everyone has hemorrhoids—they are part of our anatomy. It’s just a question of whether they’re bothering you. Hemorrhoids can become aggravated with changes in bowel habits, such as diarrhea and constipation. Over the years, they can pull away from the underlying muscle, prolapse, and bleed. Prolapse means something is hanging out “down there.” Typically, hemorrhoids cause people to experience itching, bleeding, and prolapse. Pregnancy can also cause hemorrhoids to become engorged because of the increased pelvic pressure.
Q. How are hemorrhoids treated when they become aggravated?
A. Initial management includes increasing the amount of fiber and water in the diet. Most of my patients find that’s all that is needed. Be sure to increase fiber slowly: I tell people to increase daily intake by 5 grams for a week, then another 5 grams for another week, until they reach 20 to 25 grams per day. That way they avoid bloating and gassiness. If adding fiber to your diet doesn’t work, there are simple and painless office procedures to treat hemorrhoids. If these fail, surgery may be the next step. One of the procedures my colleague, Linda Farkas, MD, and I perform is a transanal hemorrhoidal de-arterialization (THD). It is a less-painful way to treat hemorrhoids than a standard hemorrhoidectomy. Not all hemorrhoids can be treated with a THD; treatment depends on the severity of the hemorrhoids.