Same-day & next-day appointments sometimes available for urgent concerns — Call (551) 321-1388
Hemorrhoids — Fast Office Treatment, Lasting Relief
Hemorrhoids are among the most common — and most undertreated — conditions in colorectal care. Most patients suffer in silence for months or years before seeking help. Dr. Karmina Choi offers effective in-office procedures that resolve hemorrhoids without surgery, without general anesthesia, and without a hospital stay.
ANORECTAL CONDITION
75%
of people will have hemorrhoids at some point in their lifetime
No
hospital, no general anesthesia, no long recovery for most patients
Most
internal hemorrhoids treated with a quick, painless office procedure
What are hemorrhoids?
Hemorrhoids are cushions of vascular tissue normally present in the anal canal — they play a role in fine stool control. They become a problem when the veins within these cushions become swollen, inflamed, or prolapsed. The result is bleeding, discomfort, itching, or tissue protruding from the anus.
Hemorrhoids are not a sign of serious disease — but their symptoms overlap with conditions that are, including anal fissure, rectal polyps, proctitis, and colorectal cancer. This makes accurate diagnosis by a specialist an essential first step, not just a formality. Many patients who self-treat for hemorrhoids are actually dealing with a different condition entirely.
Internal vs external hemorrhoids
Internal hemorrhoids
Located inside the anal canal, above the dentate line — the border between pain-sensitive and pain-insensitive tissue. Because they lie in a zone with few pain receptors, internal hemorrhoids are often painless even when significantly enlarged. The most common symptom is bright red bleeding during bowel movements. When large, they may prolapse — protrude outside the anus — causing discomfort and mucus discharge. Internal hemorrhoids respond very well to in-office banding.
External hemorrhoids
Located at or below the dentate line, under pain-sensitive perianal skin. External hemorrhoids cause pain, swelling, and itching — particularly when a blood clot forms inside (thrombosed external hemorrhoid), causing sudden intense pain. Most external hemorrhoids are managed with dietary and lifestyle changes. A thrombosed external hemorrhoid can be excised in the office for immediate pain relief, ideally within the first 48–72 hours of onset.
Hemorrhoid grades - determining the right treatment
Grades I, II, and most Grade III internal hemorrhoids are excellent candidates for in-office rubber band ligation — no operating room, no general anesthesia required. Dr. Choi will assess your grade at your first visit and recommend the most effective approach.
Bleeding only
Internal. No prolapse. Bleeds with straining.
Prolapse, self-reduces
Protrudes with straining, returns on its own.
Prolapse, manual reduction
Must be pushed back in manually.
Irreducible prolapse
Cannot be reduced. Often requires surgery.
I
III
II
IV
Symptoms - when to stop waiting and see a specialist
Rectal bleeding
Bright red blood on the toilet paper, in the bowl, or coating the stool — the most common symptom of internal hemorrhoids. Always warrants evaluation to rule out other causes.
Pain or pressure
External hemorrhoids and thrombosed hemorrhoids cause significant pain. Internal hemorrhoids are usually painless — pain alongside bleeding suggests another condition may be present.
Prolapse - tissue protruding
A sensation of something bulging out of the anus, especially with bowel movements. May reduce on its own or require manual replacement.
Itching and irritation
Mucus leakage from internal hemorrhoids or skin irritation from external hemorrhoids causes persistent anal itch — often the most bothersome day-to-day symptom.
Skin tags
Residual stretched skin after a hemorrhoid resolves — causing hygiene difficulty, irritation, or discomfort. Can be excised in the office under local anesthesia.
Sudden severe anal pain
A thrombosed external hemorrhoid — a blood clot forming in an external hemorrhoid — causes abrupt, intense pain and a tender lump. Most effectively treated in the office within the first 48–72 hours.
Don't assume it's hemorrhoids. Rectal bleeding, prolapse, and anal discomfort are also symptoms of anal fissure, colorectal polyps, proctitis, rectal cancer, and other conditions. Self-treating without a diagnosis is a common and potentially dangerous mistake. A brief specialist examination gives you an accurate diagnosis — and peace of mind — that over-the-counter products never can.
In-office procedures - effective treatment, no hospital needed
Procedure takes minutes in the office
Local anesthesia only - no sedation needed
Return to normal activities the same day
Go home immediately after
High success rate with minimal discomfort
Multiple hemorrhoids treated in staged visits
The majority of patients with symptomatic internal hemorrhoids — grades I, II, and selected grade III — can be treated with rubber band ligation at the same visit as their evaluation, or at a dedicated follow-up. No operating room, no general anesthesia, no hospital stay. Thrombosed external hemorrhoids and anal skin tags are similarly treated with a quick in-office excision under local anesthesia.
Most hemorrhoids are treated right here in the office
Thrombosed external hemorrhoid excision - immediate pain relief
When a blood clot forms in an external hemorrhoid, the result is sudden, severe pain that can be debilitating. If evaluated within 48–72 hours of onset, Dr. Choi can excise the thrombosed hemorrhoid in the office under local anesthesia — providing dramatic, near-immediate relief. After 72 hours, the clot begins to resolve on its own and conservative management is typically preferred. If you develop a painful anal lump, call us promptly — timing matters significantly for this procedure.
Rubber band ligation - the gold standard office treatment
A small rubber band is placed at the base of the internal hemorrhoid, cutting off its blood supply. The hemorrhoid shrinks and falls off within a week, leaving a small scar that prevents recurrence at that site. Because the band is placed above the pain-sensitive dentate line, most patients feel only a mild sensation of pressure — not pain — and return to normal activity the same day. Grades I, II, and selected grade III hemorrhoids are treated this way. Multiple hemorrhoids are addressed in staged sessions spaced several weeks apart for comfort and safety.
Anal skin tag excision - comfort and hygiene restored
Anal skin tags are soft, excess skin folds at the anal opening — often the residual remnant of a resolved external hemorrhoid or thrombosis. While harmless, they can cause persistent itching, hygiene difficulty, and discomfort with prolonged sitting or activity. Dr. Choi excises skin tags in the office under local anesthesia, with a straightforward healing course and immediate improvement in comfort.
Hemorrhoidectomy - for advanced or refractory hemorrhoids
For grade IV hemorrhoids, large mixed internal-external hemorrhoids, or cases where banding has not achieved adequate control, surgical hemorrhoidectomy is the definitive treatment. Performed under anesthesia as an outpatient procedure, it removes the hemorrhoidal tissue directly and provides long-term relief. Dr. Choi recommends this selectively — most patients are successfully treated in the office and never require surgery.
Between visits - managing symptoms at home
Fiber and hydration
Soft, bulky stools are the single most important factor in hemorrhoid prevention and recovery. Aim for 25–35g of soluble fiber daily — from whole grains, fruits, vegetables, and psyllium husk supplements — and drink at least 8 glasses of water. Straining on the toilet is the primary driver of hemorrhoid development and recurrence.
Toilet habits that protect, not harm
Avoid prolonged sitting on the toilet — reading, scrolling, or straining all increase venous pressure in the anal canal. Don't delay bowel movements when the urge comes. Warm sitz baths (10–15 minutes) after bowel movements significantly reduce discomfort and promote healing.
Topical agents for symptom control
Over-the-counter creams and suppositories (hydrocortisone, witch hazel, lidocaine-based preparations) can reduce itch, inflammation, and discomfort short-term. These manage symptoms but do not treat the underlying hemorrhoid. If symptoms persist beyond two weeks of conservative care, an office visit is the right next step.
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3
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Why choose Dr. Karmina Choi?
In-office treatment - same visit
Rubber band ligation can often be performed at your first visit. No separate procedure appointment, no hospital scheduling.
Thrombosis - timing matters
If you have a thrombosed external hemorrhoid, call immediately. The 48–72 hour window for office excision closes quickly.
Surgery only when needed
Most patients are fully treated in the office. Hemorrhoidectomy is recommended selectively, not as a default.
Accurate diagnosis first
Dr. Choi examines and diagnoses before treating — ruling out fissure, polyps, and other conditions that mimic hemorrhoids.
Convenient location
Fort Lee, NJ — easily accessible from Bergen County, Manhattan, and surrounding areas.
Female physician option
A comfortable, sensitive environment for a condition many patients find embarrassing to discuss.
Common Questions
Do hemorrhoids go away on their own?
Small, acute hemorrhoids — particularly those triggered by a specific event like pregnancy or a bout of constipation — can resolve with conservative care. However, most symptomatic internal hemorrhoids that cause persistent bleeding or prolapse do not resolve fully on their own and benefit significantly from in-office treatment. External hemorrhoids and skin tags rarely disappear without intervention.
Is rubber band ligation painful?
Most patients experience mild pressure or a sensation of fullness for a day or two after banding — not significant pain. Because the band is placed above the dentate line in pain-insensitive tissue, the procedure itself is well-tolerated in the office without sedation. Some patients feel a brief ache for 24–48 hours, easily managed with over-the-counter pain relief. Severe pain after banding is uncommon and should prompt a call to the office.
How many banding sessions will I need?
Most patients have two to four sessions spaced four to six weeks apart. Only one to two hemorrhoids are banded per visit to minimize discomfort and allow safe healing. The total number of sessions depends on how many symptomatic hemorrhoids are present and how well each responds to treatment.
Can hemorrhoids come back after treatment?
Rubber band ligation has a high success rate — the treated hemorrhoid at that specific site does not recur. However, new hemorrhoids can develop over time if the underlying causes — straining, constipation, low-fiber diet — are not addressed. Dr. Choi provides dietary and lifestyle guidance to help prevent recurrence after treatment.
I have both internal and external hemorrhoids. Can both be treated?
Yes. Internal hemorrhoids are addressed with rubber band ligation in staged office sessions. External hemorrhoids and associated skin tags can be excised in the office under local anesthesia. In some cases — particularly large mixed hemorrhoidal disease — surgical hemorrhoidectomy is the most efficient approach. Dr. Choi will recommend the combination of treatments best suited to your specific anatomy at your consultation.
Should I be worried that rectal bleeding is something more serious?
Rectal bleeding should always be evaluated — not assumed to be hemorrhoids without examination. While hemorrhoids are the most common cause, bleeding is also a symptom of anal fissure, colorectal polyps, proctitis, and colorectal cancer. A specialist examination quickly distinguishes between these possibilities and gives you accurate information rather than reassurance based on assumption. If you are over 45, have a family history of colorectal cancer, or have any change in bowel habits alongside bleeding, a colonoscopy may also be recommended.
Is tissue protruding that won't reduce? If tissue protrudes from the anus and cannot easily be pushed back — or if you experience a heavy sensation of prolapse separate from a bowel movement — this may be anal prolapse rather than hemorrhoids. The two conditions share some symptoms but are anatomically distinct and require different treatment. Learn about anal prolapse ->
Stop putting it off — hemorrhoids are very treatable.
Most patients leave their first visit with a treatment plan in place — and many get adequate relief soon after the appointment. Relief is closer than you think.
1625 Anderson Avenue, Suite 203, Fort Lee, New Jersey 07024
This page is for informational purposes only and does not constitute medical advice. Individual results vary. Please consult Dr. Choi for a personalized evaluation and treatment plan.
© 2026 Colorectal Care of New Jersey. All rights reserved.
Colorectal Care of New Jersey
Expert, compassionate colorectal care — from office procedures to complex surgery — with a natural-first approach and a commitment to your long-term quality of life.
1625 Anderson Ave, Ste 203
Fort Lee, New Jersey 07024
ANORECTAL CONDITIONS
DIGESTIVE & GI CONDITIONS
PROCEDURES
(551) 321-1388
Monday - Friday & some Saturdays by appointment
SERVING
Fort Lee · Edgewater · Englewood · Teaneck · Hackensack · Palisades Park · Ridgefield · Manhattan (via GWB)
ABOUT
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