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Banding Bulletin – December 2012

Banding Bulletin – December 2012

We hope that this last “Banding Bulletin” of the year finds you well! 2012 has been our busiest year to date, and we are already gearing up for 2013! We are looking forward to visiting with many of our existing Partners as well as to help bring others onboard with the CRH O’Regan System! We have also planned our most ambitious schedule for attending meetings across the country in the New Year; we will be attending the AGA meeting in San Diego, and the Western Regional ACG meeting in Los Angeles, both in January.

This month, our “Case Study” will respond to a question that we frequently receive — “who should we be banding?” There is a recent publication in EndoEconomics that we would like to highlight and there is a new health issue on top of the 2012 Google Zeitgeist list – read on to find out what!

Case Study – They are NOT “just hemorrhoids”!

OK, you got me! This isn’t a specific “case study”, but we would like to respond to one of the most frequently asked questions that we hear.

Simply put, symptomatic hemorrhoids cause any combination of bleeding, itching, swelling, prolapse and in some cases, fecal soiling. They also are frequently associated with other entities, including anal fissures, skin rashes, etc. RBL, using the CRH O’Regan System, is appropriate for the care of ANY patient with symptoms that recur frequently enough, or are severe enough to warrant treatment! Speaking within the context of my surgical background, the VAST MAJORITY of the patients that I’ve seen have been to their primary care doc, OB/GYN, and/or gastroenterologist before coming to us for treatment. At each stop, they are told “Don’t worry about it . . . They are JUST hemorrhoids!”

It is for this reason that so many of our patients have suffered with their problems for years — often decades, before finally being treated! These patients have been chased away and their complaints from hemorrhoids have been ignored for so long that they have been conditioned to stop talking about them. I think this may well be one of the reasons why our patients are so happy with the results of their treatment with the CRH technology — they had an interaction where not only did someone finally listen to their complaints — but they also had their problems taken care of! Simply asking the question “are you bothered by hemorrhoids?” on your patient admission paperwork will by itself identify a number of potential candidates.

Another misconception is that the patient needs to be acutely symptomatic to warrant treatment. If your patient has a history of multiply recurrent episodes of hemorrhoidal issues over a period of months or years, they are going to continue to have these problems moving forward. When the hemorrhoidal cushions are no longer “anchored” in their proper position by their normal muscular attachments, they begin to slide and prolapse. It is the prolapse that is the problem with these patients, and the prolapse which causes the symptoms. Creams and ointments may well temporize some of the symptoms, but they do nothing about that prolapse — so when recurrent symptoms are an issue, they will continue to be so. Treating these patients will eliminate next week’s exacerbation!

Patients with asymptomatic hemorrhoids obviously do not need to be treated, and your patient that has had a single episode of issues may well get by without a procedural intervention — but when these issues are severe, or multiply recurrent — these patients can and should be treated! I have to admit that, prior to having the CRH O’Regan System available to me, I waited for all of my patients to be miserable before offering to treat their problems — in large part because the treatment that I had to offer was pretty miserable! Conventional banding was very painful, and surgical intervention wasn’t fun for anyone! With a complication rate of only 1%, and with pain being considered a complication (I used to think of pain as being part of the procedure, not as a complication), we’ve been able to help many more patients!

Advertising Hemorrhoid Treatment at Your Practice

Jeff Dew, financial administrator at Gastrointestinal Associates, P.C. in Knoxville, TN, recently published an article in the November issue of Endoeconomics reviewing their practices 3 month advertising campaign on hemorrhoids. CRH provided customized commercials and print ads used throughout the run. The program was successful in attracting numberous new patients to their practice, many of whom also needed other endoscopic procedures.

This campaign not only helped to grow the practice and identify patients in need of both diagnostic and therapeutic procedures, it MORE than paid for itself! The article can be found HERE and if you are interested in advertising hemorrhoid treatment at your practice, contact Brianne.

HEMORRHOIDS – Google’s number 1 Health Trend Based on Search Statistics

Clearly, with such high prevalence rates of symptomatic hemorrhoid disease in the United States (statistically, 75% of us will have symptomatic hemorrhoid disease at some point in our lifetime), it should not be surprising that so many people are searching for help for their symptomatic hemorrhoid disease. is averaging in the neighborhood of 25,000 “hits” per month, with some 2,000 calls being made to our Partner practices. If you haven’t done so already, please take advantage of the visibility that your practice will gain by participating on the CRH website. Contact Brianne and she will make certain that you are properly represented on the website!

The story can be found HERE

Thanks to everyone for their support in 2012! We would like to wish you and your family the Happiest of Holiday Seasons and a Happy and Healthy New Year!


Mitchel Guttenplan, MD, FACS
Medical Director
CRH Medical Corporation
T: 800.660.2153 x1022 | C: 770.363.0125 | F: 770.475.9953

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