Hemorrhoids, also known as piles, are medical conditions characterized by swollen and inflamed veins in the rectum and anus.

While the majority of hemorrhoids can be treated using non-surgical methods, some cases may require surgery to relieve symptoms and prevent complications. In this article, we will discuss when to consider surgery for hemorrhoids.

What are Hemorrhoids?

Hemorrhoids are swollen veins in the rectum and anus that can cause discomfort, pain, and bleeding. They occur when the veins in the lower rectum or anus become swollen and stretched, often due to increased pressure in the area.

Hemorrhoids can be internal or external, and they are classified based on their location.

Internal hemorrhoids are located inside the rectum and are not visible. They can cause bleeding when passing stool, as well as a feeling of fullness or discomfort. External hemorrhoids, on the other hand, are located outside the anus and are visible.

They can cause pain, itching, or swelling around the anus.

Non-Surgical Treatment Options

In most cases, hemorrhoids can be managed using non-surgical treatment options, such as:.

Fiber supplements: Increasing your intake of fiber can help soften stools and reduce constipation, which can help reduce the strain on hemorrhoids.
Topical creams: Over-the-counter creams and ointments can help relieve symptoms such as itching and pain.
Warm baths: Soaking in a warm bath for 10-15 minutes several times a day can help reduce discomfort and inflammation.
Sclerotherapy: A chemical solution is injected into the hemorrhoid, causing it to shrink and eventually disappear.
Rubber band ligation: A rubber band is placed around the base of the hemorrhoid, cutting off its blood supply and causing it to shrink and fall off.

If non-surgical treatment options fail to provide relief, surgery may be necessary.

When to Consider Surgery

Surgery for hemorrhoids is typically reserved for cases that do not respond to non-surgical treatments or for patients experiencing severe symptoms. Your doctor may recommend surgery if:.

Your hemorrhoids are large and causing significant discomfort or pain.
Your hemorrhoids are causing rectal bleeding that is persistent or recurrent.
Your hemorrhoids are interfering with your quality of life, such as by repeatedly preventing you from engaging in activities you enjoy.
You have prolapsed hemorrhoids, which occur when internal hemorrhoids protrude outside the anus.
You have thrombosed hemorrhoids, which occur when blood clots form in external hemorrhoids, causing severe pain.

There are several surgical options for hemorrhoids, including:.

Hemorrhoidectomy

A hemorrhoidectomy is a surgical procedure to remove hemorrhoids. It is typically used for severe cases of hemorrhoids that have not responded to non-surgical treatments. During the procedure, the hemorrhoids are removed using a scalpel or laser.

This procedure is performed on an outpatient basis, and general anesthesia is typically used.

Stapled Hemorrhoidopexy

A stapled hemorrhoidopexy, also known as a procedure for prolapse and hemorrhoids (PPH), is a minimally invasive surgical option for treating hemorrhoids.

During the procedure, a stapling device is used to remove a portion of the rectum that contains the hemorrhoids. The remaining tissue is then stapled back together to reduce the size of the hemorrhoids. This procedure is typically performed on an outpatient basis, and general anesthesia is typically used.

Hemorrhoidal Artery Ligation

Hemorrhoidal artery ligation (HAL) is a minimally invasive surgical option for treating hemorrhoids. During the procedure, the arteries that supply blood to the hemorrhoids are identified and ligated to cut off their blood supply.

This causes the hemorrhoids to shrink and eventually disappear. This procedure is typically performed on an outpatient basis and usually requires only local anesthesia.

Risks and Complications

Like any surgical procedure, surgery for hemorrhoids carries certain risks and complications, including:.

Bleeding
Infection
Urinary retention
Dificulty with bowel moviments
Stool becomes incontinente
Mild to severe pain

It is important to discuss the potential risks and complications of surgery with your doctor before undergoing any procedure.

Recovery

Recovery times for hemorrhoid surgery depend on the type of procedure performed. Hemorrhoidectomy typically requires a recovery period of 2-3 weeks, during which time it can be difficult to sit, stand, or walk.

Stapled hemorrhoidopexy and hemorrhoidal artery ligation typically have shorter recovery times, ranging from a few days to a week.

It is important to follow your doctor’s post-operative instructions closely to ensure a successful recovery.

This may include taking pain medication, soaking in warm water, and avoiding activities that can cause strain or discomfort in the affected area.

Conclusion

Surgery for hemorrhoids is typically reserved for cases that do not respond to non-surgical treatments or for patients experiencing severe symptoms.

While there are several surgical options for treating hemorrhoids, it is important to discuss potential risks and complications with your doctor before deciding to undergo any procedure. Following surgery, it is important to follow your doctor’s post-operative instructions closely to ensure a successful recovery.