What medical and surgical procedures are available to treat hemorrhoids?

If home remedies do not succeed in relieving hemorrhoid symptoms, a doctor may recommend medical or surgical procedures. These procedures aim to shrink or remove hemorrhoids by cutting off their blood supply or surgically excising them. Options range from simple office-based procedures to surgeries that require anesthesia.

Hemorrhoids are swollen and inflamed veins around the anus or in the lower rectum. They can be external, occurring under the skin around the anus, or internal, located in the lining of the anus and lower rectum [1].

Office-Based Medical Procedures

There are several procedures a doctor can perform in the clinic to treat hemorrhoids that have not responded to home treatments. These procedures use different techniques to create scar tissue within the hemorrhoid, which cuts off its blood supply and causes it to shrink [1]:

• Rubber band ligation: This is a common procedure for internal hemorrhoids. The doctor places a small rubber band around the base of the hemorrhoid, cutting off its blood supply. The hemorrhoid withers and typically falls off within a week [1].
• Infrared photocoagulation: This procedure uses infrared heat to cauterize the tissue around the hemorrhoid, causing it to shrink.
• Sclerotherapy: A chemical solution is injected into the hemorrhoid to make it shrink and harden.

The patient may feel some discomfort or mild pain after these procedures, but they usually have a short recovery period.

Surgical Options for Severe Hemorrhoids

In severe cases or when other procedures fail, surgery may be necessary [1]. Surgical options include:

• Hemorrhoidectomy: This is the most effective surgical procedure for removing large or prolapsed hemorrhoids. The surgeon removes the excessive tissue that causes bleeding or prolapse. This surgery is typically performed under anesthesia and may require a longer and more painful recovery compared to other procedures [1].
• Stapled hemorrhoidopexy: In this procedure, a special stapler is used to reposition prolapsed hemorrhoids back into their normal position inside the rectum and reduce blood flow to them. This procedure may be less painful than a traditional hemorrhoidectomy, but it may not be suitable for all cases.

When Should You Consult a Doctor?

You should consult a doctor if hemorrhoid symptoms persist for more than a week after home treatment, or if there is rectal bleeding [1]. Although hemorrhoids are a common cause of bleeding, other conditions such as Crohn's disease, ulcerative colitis, colorectal cancer, and anal cancer can also cause bleeding, so it is important to determine the cause [1]. A doctor can diagnose hemorrhoids through a physical exam, a digital rectal exam, or by using an anoscope to examine internal hemorrhoids [2].

For more information on the causes, symptoms, and home and surgical treatments of hemorrhoids, you can visit Hemorrhoids: Causes, Symptoms, and Home and Surgical Treatment (Arabic).

Recovery and Post-Procedure Care

After any procedure to treat hemorrhoids, it is important to follow the doctor's instructions for proper recovery. These instructions may include taking over-the-counter pain relievers, avoiding straining during bowel movements, maintaining a high-fiber diet, and drinking sufficient fluids to prevent constipation [1]. If a biopsy is taken during the examination, the doctor may request that you avoid strenuous activities or heavy lifting until bleeding and pain have ceased [2].

Medical references

• Hemorrhoids
• Anoscopy