When Do Hemorrhoids Need Surgery?

While hemorrhoids are a pain, the good news is most do not require surgery and can be managed through other treatments, changes in diet, or at home remedies.

Surgery for hemorrhoids is usually only performed for severe cases, such as when home remedies aren’t working, emergencies (such as extreme bleeding), or when they become so bothersome or painful that they impact your lifestyle.

Minimally Invasive Hemorrhoid Treatments

There are several options to treat hemorrhoids that cause very little pain, if any, and have a quick recovery time.  In most cases, patients can go back to work within a day.

These hemorrhoids treatments are usually performed in a doctor’s office or as an outpatient procedure in a hospital.

Rubber Band Ligation, or banding, is a common procedure to treat internal hemorrhoids.  A small elastic band is placed around the base of the hemorrhoid cutting off its blood supply, which causes the hemorrhoid to shrink.  Most cases require two to four procedures done about two months apart.

Most people don’t feel pain during the procedure but may feel some mild discomfort.

Sclerotherapy involves injecting the hemorrhoid with a solution that causes the hemorrhoid to shrink.  It is typically performed in a doctor’s office with patients feeling little pain or discomfort.

Coagulation therapy is a treatment where infrared light, heat, or extreme cold are used to retract and shrink the hemorrhoid. It is performed using a scope inserted into the rectum, allowing the doctor to see the affected area and perform the procedure.

While this procedure isn’t painful, most people will experience mild discomfort or some cramping.

What About Surgery For Severe Hemorrhoids?hemorrhoidtreatmentrichmond

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.

The procedure does not take long but requires anesthesia and is usually performed in a hospital as an outpatient procedure.

Following stapling for hemorrhoids, patients may feel some pain and pressure, which may require over the counter or prescription pain relievers if your doctor determines they are necessary.  Most patients can return to work within a few days to a week.

Hemorrhoidectomy is usually only performed in cases of large external hemorrhoids or internal hemorrhoids that return even after other procedures, such as rubber band ligation.

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 then removed.

This hemorrhoid treatment is the most invasive, and often painful, of all the hemorrhoid surgery options but is also often provides a permanent solution for severe hemorrhoids.

Following the procedure, your doctor may prescribe pain medications or a list of the counter medications to take.  Recovery often involves rest, using ice packs on the area, sitz baths, and using stool softeners to make bowel movements more comfortable.  Most patients can return to work after 7–10 days.

Are You A Candidate For Hemorrhoid Surgery?

If you tried at home remedies and aren’t getting any relief, or your hemorrhoids keep coming back, you may be a candidate for surgery. The providers at Colon & Rectal Specialists are experts at diagnosing and treating hemorrhoids with the most minimally invasive approach possible.

Contact us to make an appointment at one of our three Richmond area locations.

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