Hemorrhoids: Symptoms and Surgical Treatment Options

March 24, 2024

Hemorrhoids, also known as piles, are swollen veins in your lower rectum and anus, similar to varicose veins. They can develop inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids). While often uncomfortable, hemorrhoids are not usually dangerous and can be effectively managed or treated. However, understanding the symptoms and knowing when surgery might be necessary is important for effective treatment and relief.

Symptoms of Hemorrhoids

The symptoms of hemorrhoids depend on their location and whether they are internal or external:

  • Internal Hemorrhoids may not cause noticeable symptoms and often go undetected. When symptoms do occur, they can include:
  • Painless Bleeding: Noticing small amounts of bright red blood on toilet paper or in the toilet.
  • Protrusion During Bowel Movements: Hemorrhoids that prolapse (protrude outside the anal sphincter) during bowel movements may be felt as bulges at the anus and can cause discomfort or pain.
  • External Hemorrhoids are more likely to cause discomfort and can include symptoms such as:
  • Itching or Irritation: In and around the anus.
  • Pain and Discomfort: Especially when sitting or during bowel movements.
  • Swelling: Around the anus.
  • Bleeding: This can occur if the hemorrhoid becomes irritated.

In some cases, an external hemorrhoid may develop a clot (thrombosed hemorrhoid), leading to severe pain, inflammation, and a hard lump near the anus.

When Is Surgery Needed?

Most hemorrhoid symptoms can be relieved with home remedies, lifestyle changes, and over-the-counter treatments. However, surgery may be considered in the following situations:

  • Severe Discomfort: When pain, bleeding, and other symptoms do not improve with nonsurgical treatments.
  • Large Hemorrhoids: Large internal hemorrhoids that prolapse or external hemorrhoids that cause significant discomfort may require surgical removal.
  • Thrombosed Hemorrhoids: If a thrombosed hemorrhoid is very painful, surgical removal within the first 72 hours can provide relief.

Surgical Treatment Options

Several surgical procedures are available for treating hemorrhoids, including:

  • Hemorrhoidectomy: This involves the removal of excessive hemorrhoid tissue. It’s considered the most effective method for severe or recurring hemorrhoids but involves a longer recovery period and more postoperative pain.
  • Stapled Hemorrhoidopexy: Also known as a stapled hemorrhoidectomy, this procedure uses a special stapling device to remove a band of hemorrhoid tissue and reposition the remaining hemorrhoidal tissue back to its normal location. It is less painful than a traditional hemorrhoidectomy and has a quicker recovery time but may have a higher recurrence rate.
  • Rubber Band Ligation: This is a minimally invasive procedure where a rubber band is placed around the base of the hemorrhoid inside the rectum, cutting off its blood supply. The hemorrhoid then withers and falls off within a week. This method is best suited for internal hemorrhoids.
  • Sclerotherapy: A chemical solution is injected into the hemorrhoid tissue, causing it to shrink. This procedure is often used for smaller hemorrhoids.
  • Infrared Coagulation: Infrared light is used to cause scar tissue, which cuts off the blood supply to the hemorrhoid, causing it to shrink. It’s often used for smaller internal hemorrhoids.

Recovery and Aftercare Post-Surgery

Recovery and aftercare following hemorrhoid surgery are critical components for ensuring a smooth healing process and minimizing the chance of recurrence. Patients may experience pain and discomfort post-surgery, managed effectively through prescribed or over-the-counter pain relievers. It’s essential to keep the anal area clean and to avoid straining during bowel movements. A fiber-rich diet and adequate fluid intake are necessary to ensure soft stools and ease the stress on the surgical site. Depending on the type of surgery, recovery times can vary, but most patients can return to their normal activities within a few weeks, with specific restrictions on heavy lifting or rigorous exercise. Following the surgeon’s guidelines for aftercare is crucial for a successful recovery.

Preventative Measures to Avoid Future Hemorrhoid Issues

To reduce the risk of developing hemorrhoids or experiencing a recurrence post-treatment, adopting certain lifestyle changes is advised. Incorporating a diet rich in fiber from fruits, vegetables, legumes, and whole grains can help soften the stool and promote regular bowel movements, decreasing strain during defecation. Staying well-hydrated by drinking plenty of water supports this dietary approach. Regular exercise is also beneficial for preventing hemorrhoids by improving circulation and aiding in weight management. Additionally, avoiding prolonged sitting, especially on the toilet, and refraining from straining during bowel movements are practical measures that can significantly lower the chances of hemorrhoid development.


Hemorrhoids can cause significant discomfort, but with proper management, most people find relief. For those with severe or persistent symptoms, surgical options offer an effective solution. Discussing symptoms and treatment options with a healthcare provider is crucial for choosing the best approach based on individual needs and the severity of the condition. With the right treatment plan, it is possible to alleviate the discomfort of hemorrhoids and improve quality of life.