When Should You Consider Surgery for Hemorrhoids? A Comprehensive Guide

Hemorrhoids, or piles as many people know them, are a common issue that most experience at some point. These swollen veins in the rectum or anus may cause discomfort, pain, and even bleeding. It’s important to raise awareness about the condition and the treatment options available for relief. While many hemorrhoids can be managed with home remedies or over-the-counter treatments, sometimes surgery is needed for lasting relief.

In this guide, we will explain when surgery might be necessary, the types of surgeries available, what to expect during the procedure, and the potential risks involved.

When Should You Consider Surgery for Hemorrhoids? ^[1]

Most hemorrhoids can be treated with non-surgical methods like lifestyle changes, creams, or other remedies. However, there are certain situations where surgery might be the best way to get relief. So, when should you consider surgery for hemorrhoids?

Persistent Pain or Discomfort: If you’ve tried different treatments but the pain or discomfort keeps coming back, it might be time to consult your doctor about surgery. Chronic pain that affects your daily life is a strong sign that surgery could help.
Bleeding Hemorrhoids: If your hemorrhoids bleed often, it can be a concern. While minor bleeding may be controlled with other treatments, continuous or heavy bleeding may need surgical intervention to avoid further complications.
Prolapsed Hemorrhoids: A prolapsed hemorrhoid happens when it pushes out through the anus and can’t go back in on its own. If this happens regularly and doesn’t improve with non-surgical treatments, surgery may be needed to resolve the issue.
Failure of Non-Surgical Treatments: If you’ve tried various creams, lifestyle changes, or other remedies without seeing any improvement, surgery might offer a more lasting solution.
Severe Hemorrhoids: Large, external hemorrhoids or thrombosed hemorrhoids (those with a blood clot inside) can be especially painful. In these cases, surgery is often the best option for relief.

Types of Hemorrhoid Surgery ^[2]

If you and your doctor decide that surgery is the best course of action, there are several types of procedures available, depending on the severity of your hemorrhoids and your specific needs. Here are some of the most common types of hemorrhoid surgery:

Hemorrhoidectomy: This is the most common type of surgery for hemorrhoids. During a hemorrhoidectomy, the surgeon removes the hemorrhoid tissue. This option is usually recommended for large, external hemorrhoids or prolapsed internal hemorrhoids. It’s considered one of the most effective ways to prevent hemorrhoids from coming back.
Stapled Hemorrhoidopexy: In this procedure, the hemorrhoid is stapled back into place inside the rectum. This surgery reduces the blood supply to the hemorrhoid, causing it to shrink. Compared to a hemorrhoidectomy, stapled hemorrhoidopexy is less painful and typically requires shorter recovery time.
Hemorrhoid Banding (Rubber Band Ligation): Hemorrhoid banding is a less invasive option where a small rubber band is put around the base of the hemorrhoid. This blocks the blood flow, making the hemorrhoid shrink and eventually fall off. This is typically used for internal hemorrhoids and is often performed in a doctor’s office.
Sclerotherapy: In this procedure, a chemical solution is injected into hemorrhoid to shrink it. Sclerotherapy is less invasive and is generally used for smaller internal hemorrhoids.
Laser or Infrared Coagulation: This type of procedure uses laser or infrared light to cut off the blood supply to hemorrhoid. As a result, the hemorrhoid shrinks and eventually disappears. This option is less invasive than traditional surgery but may require multiple treatments for long-term relief.

What to Expect During and After Hemorrhoid Surgery ^[3]

Surgery for hemorrhoids is generally a simple procedure, but it’s helpful to know what to expect before and after. While your experience may vary depending on the type of surgery, here’s a general idea of what happens.

During the Surgery:

Most hemorrhoid surgeries are done on an outpatient basis, which means that you can go home the same day.
The procedure usually lasts less than an hour, although this can vary depending on the type of surgery.
You’ll receive anaesthesia, either to numb the area or put you to sleep, so you won’t feel any pain during the surgery.

After the Surgery:

There are chances of you feeling some discomfort or mild pain in the days following the surgery. Your doctor may prescribe pain relief medication to help with this.
It’s normal to experience some bleeding and swelling in the area where the surgery was performed, but these symptoms should gradually improve.
Depending on the surgery type and recovery time, most patients are able to resume to their regular activities in a week or two.

Risks and Complications ^[3]

While hemorrhoid surgery is generally safe, like any surgery, there are risks and potential complications to be aware of. Some of these include:

Pain: After surgery, it’s common to feel some pain, especially during bowel movements. Your doctor may prescribe pain relief to help with this.
Bleeding: Some bleeding after surgery is normal, but heavy or prolonged bleeding should be reported to your doctor.
Infection: As with any other surgery, there is a risk of infection. Keeping the area clean and following your doctor’s post-surgery instructions can reduce this risk.
Urinary Issues: In some cases, people experience difficulty urinating after hemorrhoid surgery. This is usually temporary and resolves within a few days.
Recurrence: Although surgery can effectively remove hemorrhoids, there’s still a chance they could come back. Following a healthy diet and avoiding straining during bowel movements can help prevent recurrence.

Conclusion

Hemorrhoids can be quite painful and uncomfortable, but surgery isn’t always the first step. However, if your hemorrhoids are causing ongoing pain, bleeding, or other issues, and non-surgical treatments haven’t helped, surgery might be the next option to consider.

It’s essential to talk openly with your healthcare provider about your symptoms and concerns before making any decisions. They can help guide you toward the right treatment plan that will provide relief and improve your quality of life.