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What are hemorrhoids?

50% of the American population have suffered or will suffer from hemorrhoids. Hemorrhoids naturally occur in our body. Hemorrhoids are swollen or dilated blood vessels located inside the rectum (internal hemorrhoids) or around the exterior of anus (external hemorrhoids).

What causes hemorrhoids?

Hemorrhoids are often caused by a combination of many things such as straining during a bowel movement, constipation, diarrhea, and pregnancy.  Obesity, pregnancy, Standing or sitting for a long time, Straining during bowel movements, Coughing , Sneezing, Vomiting, Holding your breath when you do something that’s physically hard.

What are the symptoms of hemorrhoids?

The symptoms of hemorrhoids can be pain and pressure in the anal canal; a grape-like lump on the anus; itching and soreness in and around the anus; and/or blood on underwear, toilet paper, the surface of the stool or in the toilet bowl.

What are internal hemorrhoids?

The classic symptom of an internal hemorrhoid is the presence of blood on the stool or toilet paper or in the toilet bowl. Internal hemorrhoids occasionally extend outside of the anus. Certain conditions may cause internal hemorrhoids to bulge and/or become irritated and bleed, including the following: pregnancy and trauma during childbirth, obesity, chronic constipation with straining, diarrhea and anal intercourse. Typically, internal hemorrhoids only cause discomfort not severe pain.

What is hemorrhoidal prolapse?

Prolapse is enlargement of the hemorrhoidal tissue. When prolapse occurs, the rectal mucosa protrudes outside the anus. At first, prolapse of the rectum may occur only at defecation. Later, it may accompany sneezing and coughing, and may also occur at any exertion. This can eventually progress to persistent protrusion of the prolapsed tissue through the anus.

How are hemorrhoids treated?

You may need to have surgery to treat the internal hemorrhoids. Several different procedures are available to eliminate or shrink hemorrhoids. These include:
1. Rubber band ligation: the doctor ties a rubber band around the hemorrhoid to cut off the circulation; the hemorrhoid then shrivels and disappears.
2. Sclerotherapy: the doctor injects a chemical solution into the hemorrhoid to shrink it.
3. Hemorrhoidectomy: this is a surgical procedure to remove hemorrhoids.
4. Transanal Hemorrhoidal Dearterialization or THD which is a less invasive, less traumatic, dramatically less painful approach to  traditional hemorrhoid treatment.

Hemorrhoid Energy Therapy (HET bipolar system) is a procedure which is utilizes bipolar energy to desintegrate and/or coagulate the hemorrhoid tissue.

Dr. Klause will help you decide what is best for you.

Where are hemorrhoids treated?

Depending on the severity of your hemorrhoids, Dr. Klause may perform the procedure in our office or in the Operating Room.

Transanal Hemorrhoidal Dearterialization (THD Procedure)

What is the THD procedure?

During the THD procedure, which is minimally invasive, the surgeon restricts only the blood vessels with doppler-guided technology and suture. There is not excision or “cutting” of tissue. Because there is no tissue removal, there is less pain.

When can I go back to normal activities?

THD allows for very quick recovery. Normal activities may be resumed within 24-48 hours except for avoiding heavy lifting greater than 10 lbs. Dr. Klause may also advise a high fiber diet and  stool softeners.

How can I prevent hemorrhoids?

Remember hemorrhoids occur naturally. You can prevent aggravating hemorrhoids by keeping bowel movements regular and stool soft with a high fiber diet and keep well hydrated. Also, avoid prolonged standing, sitting, and heavy lifting, and chronic coughing, straining at stool, and aggressive wiping.

Remember hemorrhoids occur naturally. You can prevent aggravating hemorrhoids by keeping bowel movements regular and stool soft with a high fiber diet and keep well hydrated. Also, avoid prolonged standing, sitting, and heavy lifting, and chronic coughing, straining at stool, and aggressive wiping.

Elvira Klause, MD, FACS

General Surgeon located in South Orange County, San Clemente, CA

Dr. Elvira Klause, M.D., FACS, is a highly skilled, board-certified general surgeon specializing in hernia repair, hemorrhoids, laparoscopic surgery, abdominal surgery, robotic surgery, breast surgery, oncological procedures and dermatology procedures at her warm and personalized offices in San Clemente, CA. Praised by patients for her small-town hospitality and extreme quality of care, Dr. Klause brings over 15 years of experience in caring for the general, breast, advanced laparoscopic, colorectal, oncologic, skin cancer and hemorrhoid surgery needs of patients throughout South Orange County. 

Dr. Klause earned a bachelor of science degree from UCLA in 1989. She received her medical training at the University of Missouri in Columbia in 1993 and completed her residency in surgery in 1999 at Martin Luther King Hospital. After earning the Chief Resident Award, she was chosen for a fellowship in trauma surgery and critical care from Martin Luther King Hospital in 2000.

In addition to providing quality care to her patients, Dr. Klause was also a clinical preceptor for the University of Southern California and a clinical associate professor for the Western University of Health Sciences Physician Assistant program for many years.  She was also a member-at-large for Saddleback Memorial Medical Center from 2008–2010, and Chief of Surgery from 2013-2014 also was on the Cancer Committee and the Chart Review Committee.

Dr. Klause is a board-certified diplomat of the American Board of Surgery and a fellow of the American College of Surgeons. She holds hospital privileges at Saddleback Memorial Medical CenterLaguna Hills, Mission Hospital in Mission Viejo and Laguna Beach, Surgery Center at Saddleback, Foothill Ranch Surgery Center and the Laguna Niguel Surgery Center. She is a specialist at the highly advanced single-incision laparoscopic surgery method and Robotic assisted surgery.

Dr. Klause happily lives in South Orange County along with her loving husband and three children. In her free time, she loves being a supermom for her children by helping them with crafting adventures as well as cooking delicious gourmet meals.

Why My Patients Prefer the THD Treatment
  •  Quick out-patient procedure; allows you to be home the same day!
  • NO cutting or removal of tissue, providing minimal discomfort & rapid recovery!
  • Most patients return to their normal activity within 4 days!

Call my office for an appointment, "let us see if THD can help you too!"

For more information about the noninvasive THD treatment please visit our Hemorrhoids FAQ page. 


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Elvira Klause, MD, FACS
665 Camino De Los Mares
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San Clemente, CA 92673