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Dr. Cole believes the initial treatment for all hemorrhoids is medical therapy. Only after failure of conservative treatment should surgery be considered.

Rectal examination is a relatively simple procedure and is very useful in determining the following: 

  • Diagnosis of rectal tumors and other forms of cancer.
  • Evaluation of hemorrhoids and other abnormalities.

External hemorrhoids

Rectal pain occurs mainly with external hemorrhoids. Blood may pool under the skin, forming a hard, painful lump. This is called a thrombosed, or clotted, hemorrhoid. You might also notice streaks of blood on the toilet paper after straining to pass a stool.

Internal hemorrhoids

The most common symptoms of internal hemorrhoids are rectal bleeding and pain. You may find bright red streaks of blood on the toilet paper or bright red blood in the toilet bowl after having a normal bowel movement. Blood also may be visible on the surface of the stool.


Bleeding during bowel movements, itching, and rectal pain are the most common hemorrhoid symptoms. Additional symptoms may include:

  • Pain and discomfort during passing stool.
  • Bright red blood in the toilet bowl.

What to Expect if Surgery is Required

We will phone in prescriptions for you to have on hand after surgery.  We will prescribe a pain reliever and possibly an antibiotic.

You should have nothing to eat or drink after midnight the night before surgery. This includes candy, water, coffee, and gum. If there are any medications that you take on a regular basis and are concerned about taking them the morning of surgery, please call Dr. Cole to discuss this with him.

Dr. Cole may recommend that you see your primary care doctor or other specialists involved in your care to obtain a surgical clearance.

Please bathe or shower prior to surgery. Remove all makeup, jewelry, hairpieces and false eyelashes. Do not use lotions or oils after bathing.

Wear comfortable clothing that is easy to put on and remove.




Dr. Cole recommends bed rest once you arrive home on the day of surgery.  Dr. Cole will suggest that you stay indoors and take it easy the first 3 days after surgery.  Once Dr. Cole sees you in the office for your 7 day follow up it will be determined the extent of your activities and physical exertion.



Days 1 – 3:

•You can take a shower (NO BATH) on the first post-operative day. There will probably be a clear plastic dressing over your incision. This should be removed 3 days after surgery. There will be a glue-like substance over your incision (no sutures seen as they dissolve on their own). You may shower without the need of a protective bandage

•After every surgery there will be swelling, which is a normal tissue response. Bruising may also be seen under the incision.  Again, ice will help significantly.

•You may sit on a sofa, or at your desk, but minimize your activity

•No heavy lifting greater than 15 pounds for approximately 6 weeks after surgery

Days 4 – 30:

•A ridge of firm tissue will develop beneath your incision. This is part of the normal healing process and will resolve over the next few months

•Massage with Aloe Vera gel for the next 2 – 3 months, 2 – 3 times per day. This will help to break down the scarring process

•Should you develop a fever or the wound becomes very swollen, tender and/or red, contact Dr. Cole immediately


•Please call Dr. Cole the following morning to check-in and make an appointment within 7 – 10 days