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Dr. Shustina is an incredibly knowledgeable doctor who truly takes time to find root cause.
RG
Rochel Gordon
Condition · General & Women’s
Hemorrhoids
Painful bowel movements, rectal bleeding, and that uncomfortable swelling around your anus aren't just embarrassing inconveniences—they're signs of hemorrhoids, a condition affecting nearly 50% of adults by age 50 and accounting for over 3.3 million outpatient visits annually in the United States. Research shows that while most people focus on topical treatments for temporary relief, hemorrhoids typically result from underlying digestive dysfunction, chronic constipation, gut microbiome imbalances, and increased intra-abdominal pressure. Our comprehensive approach addresses these root causes through gut health optimization to provide lasting relief and prevent recurrence.
What Exactly Are Hemorrhoids?
Hemorrhoids are swollen and inflamed veins in the lower rectum and anus that occur when increased pressure causes the normal anal cushions—clusters of veins that aid in continence and sphincter protection—to become enlarged and symptomatic. These structures are part of normal human anatomy, but when compromised by chronic straining, constipation, poor gut health, or increased abdominal pressure, they can cause significant pain, bleeding, and quality of life issues. Rather than simply managing symptoms with topical treatments, effective hemorrhoid care requires addressing the underlying digestive dysfunction, gut microbiome imbalances, and lifestyle factors that create the conditions for hemorrhoid development and recurrence.
Types of Hemorrhoids and Their Characteristics
Hemorrhoids are classified based on location and severity, each requiring specific assessment and targeted treatment approaches for optimal resolution.
| Type | Location and Characteristics | Common Symptoms | Considerations |
|---|---|---|---|
| Internal Hemorrhoids (Grades I-IV) | Inside the rectum; graded by degree of prolapse | Usually painless bleeding, possible prolapse, mucus discharge | Often respond well to conservative treatment and dietary changes |
| External Hemorrhoids | Under the skin around the anus | Painful swelling, itching, discomfort with sitting | More symptomatic due to nerve endings in external skin |
| Thrombosed Hemorrhoids | Blood clot formation in external hemorrhoid | Severe sudden pain, purple/blue lump, significant swelling | Require immediate intervention within 48-72 hours for best outcomes |
| Prolapsed Hemorrhoids | Internal hemorrhoids that protrude outside the anus | Visible tissue, pain, bleeding, difficulty with hygiene | May require manual reduction or surgical intervention |
Why Hemorrhoids Impact More Than Rectal Health
Hemorrhoids affect multiple aspects of health and wellbeing due to their connection with underlying digestive dysfunction and the psychological stress of dealing with chronic symptoms. The conditions that lead to hemorrhoids—including chronic constipation, gut microbiome imbalances, and increased inflammation—also contribute to systemic health issues such as poor nutrient absorption, immune dysfunction, and increased toxin load. Additionally, the pain, bleeding, and anxiety associated with hemorrhoids can significantly impact quality of life, affecting sleep, mood, physical activity levels, and social interactions. The chronic straining that often accompanies hemorrhoids can also contribute to pelvic floor dysfunction and other anorectal disorders.
Common Signs of Hemorrhoids Include
Internal Hemorrhoids:
- Painless bright red bleeding during bowel movements
- Blood on toilet paper or in toilet bowl
- Mucus discharge from the anus
- Feeling of incomplete bowel evacuation
- Possible tissue prolapse outside the anus
External Hemorrhoids:
- Pain and discomfort in the anal region
- Swelling or lumps around the anus
- Itching or irritation around the anal area
- Difficulty sitting comfortably
- Sensitivity during bowel movements
Thrombosed Hemorrhoids:
- Sudden, severe anal pain
- Purple or blue lump near the anus
- Significant swelling and tenderness
- Inability to sit or move comfortably
Systemic Signs:
- Chronic constipation or straining
- Fatigue from chronic discomfort
- Anxiety about bowel movements
- Social withdrawal due to symptoms
Diagnostic Options at Whole Gut Health
Comprehensive hemorrhoid evaluation goes beyond visual examination to identify and address the root causes of hemorrhoid development. At Whole Gut Health, we use advanced diagnostics to create personalized treatment protocols that prevent recurrence.
Testing options may include:
Digital Rectal Examination and visual inspection to assess hemorrhoid type, severity, and rule out other anorectal conditions.
Comprehensive Stool Analysis to assess gut microbiome composition, beneficial bacteria levels, and digestive function contributing to constipation.
Functional Lab Work including inflammatory markers, nutrient assessments, and evaluation for conditions contributing to constipation.
Pelvic Floor Assessment when chronic straining or defecation difficulties are present.
Lifestyle and Dietary Analysis to identify contributing factors such as fiber intake, hydration status, and bowel habits.
We customize diagnostic protocols based on your symptom severity, hemorrhoid type, and underlying health factors to ensure comprehensive evaluation and optimal treatment planning.
Our approach
Why Whole Gut Health is different
At Whole Gut Health, we go beyond conventional symptom management and traditional functional medicine protocols. We trust your body's innate ability to heal itself when given the right support.
In Dr. Shustina's many years of practice, she has seen that many digestive diseases have their root cause in emotional traumas and unhealed wounds. When these underlying causes are healed, the body can heal from the inside out in a lasting way.
We focus on the mind-gut connection, incorporating energy healing techniques, personalized nutrition that evolves as you heal, and integrative approaches addressing mind, body, and spirit. If this resonates with you, contact our office to schedule your consultation and take the first step on your healing journey.
Our Hemorrhoid Treatment Approach
Our Three-Phase Hemorrhoid Resolution Protocol Includes:
Phase 1 — Assessment and Root-Cause Identification
- Comprehensive evaluation of hemorrhoid type, severity, and contributing factors
- Detailed analysis of digestive health, bowel habits, and lifestyle factors
- Chronic constipation and straining patterns
- Gut microbiome imbalances affecting stool consistency
- Dietary triggers and fiber deficiency
- Pelvic floor dysfunction and defecation mechanics
- Inflammatory conditions affecting tissue integrity
Phase 2 — Targeted Intervention
- Lifestyle factors increasing abdominal pressure
- Visceral Manipulation: Gentle manual therapy designed to optimize gut motility and address root cause
- Immediate Symptom Relief: Natural anti-inflammatory protocols, topical treatments, and pain management strategies for acute symptom relief
- Digestive Optimization: Comprehensive protocols to restore normal bowel function, eliminate constipation, and improve stool consistency
- Gut Microbiome Restoration: Targeted interventions to restore beneficial bacteria and improve digestive function
Phase 3 — Rebuilding and Prevention
- Anti-Inflammatory Support: Dietary modifications and natural compounds to reduce local and systemic inflammation
- Pelvic Floor Education: Proper defecation techniques and exercises to reduce straining and improve evacuation
- Sustained Digestive Health: Long-term protocols for maintaining regular, comfortable bowel movements and preventing constipation
- Tissue Strengthening: Nutritional support for connective tissue health and vascular integrity
- Lifestyle Optimization: Comprehensive strategies for maintaining healthy bowel habits, weight management, and stress reduction
- Ongoing Monitoring: Regular assessment to prevent recurrence and address any symptom changes
- Education and Support: Continuous guidance on maintaining hemorrhoid-free health through proper digestive function
Expert-Led, Personalized Care
Dr. Alexandra Shustina is a board-certified gastroenterologist and internist specializing in complex digestive disorders, gut health, and the gut–brain connection. Drawing from both conventional gastroenterology and integrative medicine, she takes a comprehensive approach to uncovering the underlying factors contributing to illness and guides patients toward lasting wellness.
At Whole Gut Health, every patient receives highly personalized care rooted in a deep understanding of digestive health, nutrition, the gut microbiome, and the interconnected systems that influence overall well-being. By combining evidence-based medicine with a thoughtful, individualized approach, we help patients move beyond symptom management and create a clear path toward long-term healing and vitality.
Frequently Asked Questions
Common questions, answered
What are hemorrhoids?
+
Hemorrhoids are swollen and inflamed veins in the lower rectum and anus that occur when increased pressure causes the normal anal cushions to become enlarged and symptomatic. These structures are part of normal anatomy but become problematic when compromised by chronic straining, constipation, poor gut health, or increased abdominal pressure.
What are the different types of hemorrhoids?
+
Internal Hemorrhoids (Grades I-IV)
- Location: Inside the rectum; graded by degree of prolapse
- Common symptoms: Usually painless bleeding, possible prolapse, mucus discharge
- Often respond well to conservative treatment and dietary changes
External Hemorrhoids
- Location: Under the skin around the anus
- Common symptoms: Painful swelling, itching, discomfort with sitting
- More symptomatic due to nerve endings in external skin
Thrombosed Hemorrhoids
- Location: Blood clot formation in external hemorrhoid
- Common symptoms: Severe sudden pain, purple/blue lump, significant swelling
- Require immediate intervention within 48-72 hours for best outcomes
Prolapsed Hemorrhoids
- Location: Internal hemorrhoids that protrude outside the anus
- Common symptoms: Visible tissue, pain, bleeding, difficulty with hygiene
- May require manual reduction or surgical intervention
What are the common signs and symptoms of hemorrhoids?
+
Internal Hemorrhoids: Painless bright red bleeding, blood on toilet paper, mucus discharge, feeling of incomplete evacuation, possible tissue prolapse
External Hemorrhoids: Pain and discomfort in anal region, swelling or lumps, itching or irritation, difficulty sitting comfortably, sensitivity during bowel movements
Thrombosed Hemorrhoids: Sudden severe anal pain, purple or blue lump, significant swelling and tenderness, inability to sit comfortably
Systemic Signs: Chronic constipation, fatigue from discomfort, anxiety about bowel movements, social withdrawal
How are hemorrhoids diagnosed?
+
Comprehensive evaluation includes multiple assessment approaches:
Digital Rectal Examination
- Visual inspection to assess hemorrhoid type and severity
- Rules out other anorectal conditions
Comprehensive Stool Analysis
- Assesses gut microbiome composition and digestive function
Functional Lab Work
- Includes inflammatory markers and nutrient assessments
Pelvic Floor Assessment
- Evaluates defecation mechanics when chronic straining is present
Diagnostic protocols are customized based on symptom severity and hemorrhoid type.
What does hemorrhoid treatment involve?
+
Our comprehensive three-phase hemorrhoid resolution protocol includes:
Phase 1: Assessment and Root-Cause Identification
- Comprehensive evaluation of hemorrhoid type, severity, and contributing factors
- Detailed analysis of digestive health, bowel habits, and lifestyle factors
- Identification of underlying causes including chronic constipation, gut microbiome imbalances, and lifestyle factors
Phase 2: Targeted Intervention
- Visceral manipulation for direct manual therapy to address root cause and target constipation
- Immediate symptom relief with natural anti-inflammatory protocols
- Digestive optimization to restore normal bowel function and eliminate constipation
- Gut microbiome restoration with targeted interventions
- Anti-inflammatory support through dietary modifications
- Pelvic floor education for proper defecation techniques
Phase 3: Long-Term Prevention and Tissue Health
- Sustained digestive health protocols for maintaining regular bowel movements
- Tissue strengthening with nutritional support for vascular integrity
- Lifestyle optimization for healthy bowel habits and weight management
- Ongoing monitoring and education for long-term hemorrhoid-free health
Why is it important to address the root causes of hemorrhoids?
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Addressing only symptoms with topical treatments provides temporary relief but doesn't prevent recurrence. Root causes like chronic constipation, gut microbiome imbalances, and poor digestive function must be corrected to achieve lasting resolution and prevent new hemorrhoid development.
Can hemorrhoids be permanently resolved?
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Yes, hemorrhoids can often be permanently resolved when underlying causes are properly addressed. By restoring normal digestive function, optimizing gut health, and eliminating chronic constipation, many people achieve long-term hemorrhoid-free health without recurrence.
What makes your approach to hemorrhoid treatment different?
+
At Whole Gut Health, we go beyond symptom management to address the digestive dysfunction underlying hemorrhoid development:
- Comprehensive assessment of gut health and digestive function
- Integration of conventional gastroenterology with functional medicine approaches
- Targeted gut microbiome restoration and digestive optimization
- Focus on permanent resolution through root-cause treatment rather than symptom suppression
- Personalized protocols based on individual contributing factors
Who provides hemorrhoid care at your practice?
+
Dr. Alexandra Shustina is a board-certified gastroenterologist and internist who serves as Miami's premier gut health specialist. She has training in both conventional gastroenterology and functional gut health, with expertise in the gut microbiome and its role in health and wellness.
How do I get started with hemorrhoid treatment?
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The first step is scheduling a comprehensive consultation where we'll:
- Review your symptoms, hemorrhoid type, and medical history in detail
- Assess your digestive health and identify contributing factors
- Develop a personalized hemorrhoid resolution plan based on your specific underlying causes and treatment goals
Contact our office to schedule your initial consultation and begin your journey toward lasting hemorrhoid relief through comprehensive digestive health restoration.
Reviews
The body remembers when it's finally heard
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Dr. Shustina goes to the root level of the issue, not only superficial, so there's healing.
LG
Leah Glickman
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She has significantly improved my health. I was suffering from Ulcerative Colitis and now live normally.
ML
Monica LaBadia
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Dr. Shustina has helped me change my lifestyle and heal my gut in a way I thought impossible.
DL
Dalit Lonstein
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She listens to patients and treats conditions, not symptoms.
GS
Gabriela Salazar
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Dr. Shustina is the best doctor I have ever been to. She assesses the root of the problem.
MS
M. S.
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She is an outstanding doctor who understands the body's ability to heal itself and holistic remedies.
SS
Sibel Sebi Sharabi
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Dr. Shustina has a wealth of knowledge and is helping me heal years of gastrointestinal issues.
DC
Daniela Chaparro
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Dr. Shustina is an amazing doctor. She diagnosed my cancer early and saved my life.
MW
Mordechai Weinstein
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After one session with Dr. Shustina, my digestive pain went away.
TP
Taryn Parascand
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Doctor Shustina is the absolute best. She has helped me resolve numerous issues other doctors dismissed.
RS
Rachel S.
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Dr. Shustina is a fantastic doctor who truly cares. Her holistic approach attacks the root cause.
CS
Clay Simonsen
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