Skip to main content
Alert icon
COVID-19 Resources Click here for details.

Hemorrhoids, a Real Pain. When Surgery is the Answer.

July 07, 2022

Nearly half of the U.S. population has hemorrhoids at some point in their lifetime, and many people avoid seeking treatment because of fear or embarrassment. In most cases, doctors recommend lifestyle modifications to treat small hemorrhoids. These include eating more fiber, taking a fiber supplement, drinking plenty of fluids, and exercising regularly. Your doctor can also prescribe topical medications to help with symptoms. But for some people, a healthy diet and lifestyle and over-the-counter medicines aren’t enough to treat hemorrhoids. 

In the past, the most prevalent treatment for hemorrhoids was hemorrhoidectomy, or the surgical removal of hemorrhoids. This procedure typically resulted in a painful, weeks-long recovery time. However, hemorrhoidectomies are now necessary only in the most severe cases. Technological developments have led to the discovery of effective nonsurgical treatments for hemorrhoids, such as laser infrared coagulation. These treatments provide lasting relief without the need for stitches or surgery and are usually performed right in the office in just minutes.

Hemorrhoids, commonly known as piles, are engorged veins located around the anus or in the lower rectum. Hemorrhoids occur as a result of excessive straining, usually during defecation.

Hemorrhoids on the inside of the anus are considered internal hemorrhoids, while those on the outside of the anus are external hemorrhoids. Internal hemorrhoids may not be painful, but they can bleed and also slip out of position. External hemorrhoids often look like purple lumps and are more likely to be painful.

The goal of hemorrhoid surgery is to remove the enlarged hemorrhoid tissue and relieve rectal pain, itching and bleeding. But surgery is not your only option when lifestyle changes and over-the-counter medications do not work. 

Minimally invasive treatments are available to treat internal hemorrhoids. Some procedures shrink or remove them, such as using a laser, which can be done in your doctor’s office. Rubber band ligation involves placing a rubber band around the base of the hemorrhoid to cut off its blood supply and the hemorrhoid painlessly shrivels up. Sclerotherapy is when a chemical solution is injected into the hemorrhoid which causes it to shrink.  Infrared photocoagulation uses infrared radiation from a special light to destroy hemorrhoidal tissue and it eventually sheds off. Cryotherapy involves freezing the hemorrhoids. Although these may hurt less and have fewer complications, surgery might be a better long-term choice, especially if your hemorrhoids are large and very painful or bleeding.

Where hemorrhoid surgery is concerned, there isn’t a “one size fits all” option. 

Transanal hemorrhoidal artery ligation is a procedure that involves inserting a Doppler sensor in the anus to detect the arteries supplying blood to hemorrhoids. The hemorrhoidal arteries are identified and tied to cut the blood supply. The hemorrhoids shrink immediately and are unnoticeable within weeks.

Stapling is an option for more severe situations.  It can be used to treat internal and external hemorrhoids, especially in cases of prolapse.  During the procedure, a surgical staple is placed on the prolapsed hemorrhoid to hold it in place. The staple also cuts off the blood supply to the hemorrhoid, causing it to shrink. This procedure moves the hemorrhoid to where there are fewer nerve endings. The procedure does not take long but requires anesthesia and is usually performed in a hospital as an outpatient procedure. You typically recover faster and have less bleeding and itching as well as there are generally fewer complications. Compared to traditional hemorrhoidectomy, recovery after stapled hemorrhoidopexy is usually easier, but hemorrhoids are more likely to return. This procedure is not a good option for large external hemorrhoids.

Hemorrhoidectomy is usually only performed in cases of large external hemorrhoids or internal hemorrhoids that cause significant pain or bleeding or return even after other procedures. Hemorrhoidectomies are performed under anesthesia, and most patients go home the same day. During the procedure, small incisions are made in the tissue around the hemorrhoid, and the hemorrhoid is removed. This is the most invasive, and often painful, of all the hemorrhoid surgery options but can provide a permanent solution for severe hemorrhoids. Recovery often takes about two weeks, but it can take as long as three to six weeks to feel back to normal.

If it’s time for you to stop living with discomfort from hemorrhoids, see your doctor. Hemorrhoid surgery is safe and effective most of the time. You will still need to eat a high-fiber diet, avoid constipation, and take care of your bottom to help prevent new hemorrhoid flare-ups. If surgery is something you are facing, West Tennessee Medical Group Jackson Surgical Associates specializes in giving the West Tennessee community the best in general surgical care. Find a surgical provider today!