For some people, a healthy diet and lifestyle and over-the-counter medicines aren't enough to treat hemorrhoids.
There are also procedures that shrink or remove them, such as using a laser, that can be done in your doctor's office. Although these may hurt less and have fewer complications, surgery might be a better long-term choice, especially if your hemorrhoids are large and very painful or bleeding.
Hemorrhoid surgery is safe and effective most of the time. But you'll still need to eat a high-fiber diet, avoid constipation, and take care of your bottom to help prevent new hemorrhoid flare-ups.
Talk to your doctor to figure out what's right for you.
Surgery to remove hemorrhoids is called hemorrhoidectomy. The doctor makes small cuts around the anus to slice them away.
You may get local anesthesia (the area being operated on is numb, and you're awake though relaxed) or general anesthesia (you're put to sleep). Hemorrhoidectomyis often an outpatient procedure, and you can usually go home the same day.
Because it's highly sensitive near the cuts and you might need stitches, the area can be tender and painful afterward.
Recovery most often takes about 2 weeks, but it can take as long as 3 to 6 weeks to feel like you're back to normal.
Procedure for Prolapse and Hemorrhoids (PPH)
PPH is also called a stapled hemorrhoidectomy. The doctor will use a stapler-like device to reposition the hemorrhoidsand cut off their blood supply. Without blood, they'll eventually shrivel and die.
It can treat hemorrhoids that have and have not prolapsed, or slipped down out of the anus.
This procedure moves the hemorrhoid to where there are fewer nerve endings, so it hurts less than a traditional hemorrhoidectomy. You'll also recover faster and have less bleeding and itching. And there are generally fewer complications.
Hemorrhoidal Artery Ligation and Recto Anal Repair (HAL-RAR)
Hemorrhoidal artery ligation and recto anal repair (HAL-RAR) is a new procedure in which a miniature Doppler sensor is inserted in the anus to detect the arteries supplying blood to hemorrhoids.
The surgeon can pinpoint the arteries supplying the hemorrhoids and can tie them off to cut the blood supply. The hemorrhoids are reduced almost immediately and, within weeks, are no longer noticeable. The procedure is effective and virtually painless.
Rubber-Band Ligation (Banding)
Your doctor will take a tiny rubber band (only a few millimeters wide) and put it over the base of an internal hemorrhoid to cut off the flow of blood. The hemorrhoid usually shrinks and falls off (along with the band) in about a week.
If you have several hemorrhoids, you may need to have this done every few weeks. This treatment can be painful and cause bleeding. More rarely, it also may cause blood clots or infections.
Hemorrhoids treated this way are less likely to come back than with other treatments.
Your doctor will give you a shot that puts chemicals into the hemorrhoid tissue. These chemicals also cut off blood flow to the hemorrhoids and shrink them. You may need to have this done every few weeks until they go away completely.
You may feel mild pain or pressure after, but infections are rare. With this treatment, the hemorrhoids often come back in a few years.
With this treatment, your doctor focuses an infrared light on a hemorrhoid, and the heat causes scar tissue to form and blood flow to the hemorrhoid to be cut off.
Generally, coagulation treatments have few side effects and cause very little pain. But hemorrhoids are more likely to come back with these treatments than with banding.
This is similar to infrared coagulation, except instead of an infrared light, your doctor uses heat from an electric current to create scar tissue and cut off the hemorrhoid’s blood supply.
After Hemorrhoid Surgery
Pain is the most common complaint, especially when you're pooping. You can take over-the-counter pain relievers, such as acetaminophen, aspirin, or ibuprofen, if your doctor says it's OK. Soaking in a warm bath may help, too.
Stool softeners can make it easier to poop.
Risks of Hemorrhoid Surgery
It's very common and is considered safe. But any surgery has some risks, including:
- Reaction to anesthesia
You might have some trouble peeing afterward because of swelling or muscle spasms.
If your anal sphincter gets damaged during surgery, you could have accidental bowel or gas leaks, a condition called fecal incontinence.
Call your doctor right away if you:
- Are bleeding a lot
- Can't pee or poop
- Have a fever