Introduction: What Are Hemorrhoids?
Hemorrhoids, often called piles, are swollen blood vessels that form in the lower rectum or anus. They’re a common condition, affecting nearly half of all adults over age 50, though they can develop at any age. Hemorrhoids can occur internally—inside the rectum—or externally, under the skin around the anus.
While many hemorrhoids are mild and resolve with lifestyle changes or over-the-counter remedies, others cause significant discomfort and may require surgical intervention. Understanding their symptoms and knowing when surgery is appropriate is essential for managing this condition effectively.
Common Symptoms of Hemorrhoids
The symptoms of hemorrhoids vary depending on their type and severity. Some people experience no symptoms at all, while others have persistent pain or bleeding.
Internal Hemorrhoids
- Painless rectal bleeding during bowel movements
- Bright red blood on toilet paper or in the toilet bowl
- Prolapsed tissue that protrudes from the anus, which may retract on its own or require manual repositioning
- Mucus discharge or a sensation of incomplete evacuation
Internal hemorrhoids typically don’t cause pain unless they prolapse and become irritated.
External Hemorrhoids
- Itching or irritation around the anus
- Pain or discomfort, especially when sitting
- Swelling or a hard lump near the anus
- Bleeding, particularly if a blood clot forms (thrombosed hemorrhoid)
A thrombosed external hemorrhoid can be extremely painful and may require prompt medical attention.
Causes and Risk Factors
Hemorrhoids are primarily caused by increased pressure in the lower rectum, which can occur due to:
- Straining during bowel movements
- Chronic constipation or diarrhea
- Sitting for long periods, especially on the toilet
- Pregnancy, which increases abdominal pressure
- Obesity and a sedentary lifestyle
- Low-fiber diet and insufficient hydration
- Aging, which weakens the tissues that support veins
Frequent heavy lifting or anal intercourse may also contribute to the development of hemorrhoids. Genetics plays a role, too—if your parents had hemorrhoids, your chances are higher.
When Is Surgery Necessary?
While most hemorrhoids can be treated with dietary changes, topical creams, sitz baths, and increased fiber intake, surgery may be required when:
- There’s persistent or heavy bleeding
- Hemorrhoids prolapse and don’t retract
- Symptoms are not relieved by non-surgical treatments
- Thrombosed hemorrhoid causes extreme pain
- There’s a risk of complications like anemia or infection
Doctors generally consider surgery only after less invasive measures have failed or in cases of large, painful, or recurring hemorrhoids.
Surgical Options for Hemorrhoids
Several surgical and minimally invasive procedures are available for treating advanced or persistent hemorrhoids.
Rubber Band Ligation
One of the most common treatments for internal hemorrhoids, this procedure involves placing a small rubber band at the base of the hemorrhoid. This cuts off circulation, causing the hemorrhoid to wither and fall off within a few days.
It’s typically performed in a doctor’s office and requires no anesthesia.
Sclerotherapy
A chemical solution is injected into the hemorrhoid, causing it to shrink. This method is less effective than banding and may require multiple treatments.
Infrared Coagulation (IRC)
Infrared light is used to cut off blood flow to the hemorrhoid, causing it to shrink. IRC is usually reserved for small to medium-sized hemorrhoids.
Hemorrhoidectomy
This is a surgical procedure to remove large external hemorrhoids or internal ones that haven’t responded to other treatments. It’s performed under local, spinal, or general anesthesia and may require a few weeks of recovery.
Though effective, hemorrhoidectomy can be painful and is usually reserved for the most severe cases.
Stapled Hemorrhoidopexy
Used mainly for internal hemorrhoids, this method involves stapling the prolapsed tissue back into place inside the rectum. It reduces blood flow to the hemorrhoids, causing them to shrink. Recovery time is generally shorter and less painful than with traditional hemorrhoidectomy.
For more details on surgical options, visit the American Society of Colon and Rectal Surgeons.
Recovery After Hemorrhoid Surgery
Post-surgery recovery can vary depending on the procedure used. Most patients can return to normal activities within a few days, though full recovery may take several weeks for more invasive surgeries.
Tips for smoother recovery:
- Take prescribed pain medication as directed
- Use sitz baths to ease discomfort
- Drink plenty of fluids and eat high-fiber foods
- Avoid straining during bowel movements
- Use stool softeners if necessary
Follow-up visits may be required to monitor healing and ensure no complications arise.
Preventing Future Hemorrhoids
Whether you’ve had hemorrhoids before or just want to avoid them, prevention is largely a matter of healthy lifestyle choices:
- Eat a high-fiber diet rich in fruits, vegetables, and whole grains
- Drink plenty of water—at least eight glasses a day
- Exercise regularly to maintain bowel regularity
- Don’t delay bowel movements when the urge strikes
- Avoid sitting too long on the toilet
- Use a footstool to elevate your legs while on the toilet for easier passage
Making these changes not only prevents hemorrhoids but also supports better digestive and overall health.
Conclusion: Relief Is Possible
Hemorrhoids can be painful and persistent, but they’re also highly treatable. Recognizing the symptoms early and addressing the causes can prevent worsening and reduce the need for surgery. When conservative treatments fail, modern surgical options offer safe and effective relief.
If you’re struggling with symptoms or concerned about ongoing rectal pain or bleeding, consult with a medical provider. The right care plan can restore comfort and peace of mind—whether through simple changes or surgical intervention.
Close