Hemorrhoid Doctor in Fort Smith, Arkansas

Most hemorrhoids are treated right in our Fort Smith office in about a minute, with no surgery and no anesthesia, using the CRH O'Regan banding system. Most people drive themselves home and go back to work the same day. Bleeding still deserves a proper look before it is assumed to be hemorrhoids.

Hemorrhoid care in Fort Smith

Most hemorrhoids can be treated right in our office in about a minute, with no surgery and no anesthesia. At Digestive & Liver Center of Arkansas, Dr. Ihab Herraka treats hemorrhoids with the CRH O'Regan System, a gentle banding method that removes the hemorrhoid at its source instead of just quieting the symptoms for a few days. Here is what that visit looks like for most patients:

• No surgery and no general anesthesia. You are awake and comfortable the whole time.
• About one minute. Placing the band takes less than 60 seconds.
• No prep and no driver. There is no fasting, no bowel prep, and no sedation, so you can drive yourself to and from the appointment.
• Same-day return to normal life. Most patients go back to work or their usual routine the same day.
• Covered by most major insurance plans, including Medicare. If you have been putting this off out of embarrassment, you are in good company. Hemorrhoids are one of the most common problems in medicine, and treated early, they can usually be handled quickly and comfortably, right here in Fort Smith.

What are hemorrhoids?

Hemorrhoids are cushions of tissue containing swollen blood vessels in the lower rectum and around the anus. Everyone is born with hemorrhoidal tissue, and it only becomes a problem when those vessels swell and start to bleed, itch, or hurt. Hemorrhoids are also extremely common: about half of adults in the United States develop symptomatic hemorrhoids by around age 50. Having them says nothing about your hygiene or your character. It is simply plumbing under pressure.

Causes and risk factors

Hemorrhoid symptoms come from too much pressure in the veins of the rectum over time. Common contributors include constipation and straining, chronic diarrhea, pregnancy and childbirth, carrying extra weight, heavy lifting, and sitting for long stretches, whether that is a desk job, a long haul in a truck, or too much time on the toilet with your phone. Age also plays a role, since the tissue that supports these veins weakens over the years. Eating enough fiber, staying hydrated, and not straining or lingering on the toilet are the main ways to lower your risk.

Internal and external hemorrhoids: what is the difference?

There are two kinds, and the difference matters because it decides how you are treated. Internal hemorrhoids form inside the rectum, above a border called the dentate line, where there are very few pain nerves. That is why they usually cause painless, bright red bleeding rather than pain. As they enlarge, they can push through the anal opening, which is called prolapse. External hemorrhoids form below the dentate line, under skin that is full of sensitive nerve endings. They appear as tender bulges or lumps near the anus and can be genuinely painful, especially when you sit. If a blood clot forms inside one, called a thrombosed external hemorrhoid, the pain can come on suddenly and be severe. Banding treats internal hemorrhoids, which is where most bleeding, itching, and prolapse originate. External hemorrhoid symptoms are managed differently, with fiber, topical treatment, warm sitz baths, and occasionally a small in-office procedure for a painful clot. Dr. Herraka will examine you and tell you exactly what you have. Read more on our page about hemorrhoid signs and symptoms.

How we diagnose hemorrhoids

Diagnosis starts with a conversation about your symptoms and a focused exam of the anus and lower rectum. For internal hemorrhoids, Dr. Herraka often uses anoscopy, a brief in-office look with a short, lighted scope, to confirm what is causing your symptoms. If your history or exam raises any concern beyond hemorrhoids, such as a change in bowel habits or an age over 45 without a recent screening, colonoscopy is available in our on-site endoscopy suite with the same physician who examined you.

Treatment options, in brief

Treatment generally moves from home care, to office banding, to surgery only when needed. Fiber, fluids, and better bathroom habits help prevent flares but are often not enough once bleeding or prolapse has started. Rubber band ligation with the CRH O'Regan System, our primary in-office treatment for internal hemorrhoids, takes about a minute, requires no sedation, and is performed right here in our Fort Smith office; surgery is reserved for cases banding cannot resolve. For a full comparison of every option, see hemorrhoid treatment options compared.

Are you a candidate for hemorrhoid banding?

The manufacturer of the CRH O'Regan System reports that it is appropriate for more than 95% of people with hemorrhoids, so most patients never need surgery. You are likely a good candidate if you have bleeding with bowel movements, ongoing itching or irritation, tissue that bulges or prolapses, or symptoms that keep returning no matter how many creams you try. A few situations call for planning or a different approach first:

• If you take a blood thinner, tell us before your visit so we can time treatment safely.
• An active fissure, abscess, or infection is usually treated before banding.
• Inflammatory bowel disease involving the rectum, or a significantly weakened immune system, may change the plan.
• If you are pregnant, hemorrhoids often improve on their own after delivery, so treatment is usually deferred.
• If the exam shows your symptoms are not actually coming from hemorrhoids, we will find out what is causing them instead. That last point matters. Rectal bleeding should never simply be assumed to be hemorrhoids, particularly if you are 45 or older, if your bowel habits have changed, or if you have a family history of colon cancer. In those cases Dr. Herraka may recommend a screening or diagnostic colonoscopy, and if you are due for routine colon cancer screening in Fort Smith regardless of your hemorrhoid symptoms, we can schedule that as well.

What to expect and recovery

Most patients need about three short office visits, with one band placed each time, and have no meaningful recovery period, returning to work and normal activities the same day. For the full step-by-step walkthrough and what recovery looks like day by day, see how CRH O'Regan banding works.

Care from Dr. Ihab Herraka

Your procedure is performed by Dr. Ihab Herraka, a fellowship-trained gastroenterologist board-certified in Gastroenterology, Internal Medicine, and Obesity Medicine, and a member of the American College of Gastroenterology, the American Society for Gastrointestinal Endoscopy, and the American Association for the Study of Liver Diseases. Dr. Herraka has performed in-office hemorrhoid banding since 2020, and colonoscopy and upper endoscopy are available in his on-site endoscopy suite. He sees patients in English and Arabic. Because we are a full gastroenterology practice and not a single-procedure clinic, that means one physician handles your diagnosis and your treatment. You can read his full background on the page for Dr. Ihab Herraka.

Cost & insurance

Hemorrhoid banding is a covered medical procedure under most major insurance plans, including Medicare and both Arkansas and Oklahoma Medicaid. Your out-of-pocket cost depends on your specific plan, your deductible, and your copay, and our team will verify your benefits before treatment. Because banding requires no operating room, no anesthesia team, and no time away from work, it is usually a far smaller expense than surgical hemorrhoid removal. Self-pay pricing is available for elective services. See our accepted insurance plans for the full list, or call with questions about coverage.

Schedule your hemorrhoid consultation in Fort Smith

You do not have to keep living with bleeding, itching, and discomfort. Digestive & Liver Center of Arkansas sees patients from Fort Smith, Van Buren, Greenwood, Alma, Barling, Charleston, and across the River Valley, including Poteau and Sallisaw in eastern Oklahoma. Call our Main Clinic at (479) 242-2888 to schedule with Dr. Herraka. We are at 3416 Old Greenwood Rd, Fort Smith, AR 72903, open Monday through Friday, 8:00 a.m. to 5:00 p.m.