swollen veins that can be internal, which means they’re inside the rectum, or external,
which means they’re outside the rectum.
Most hemorrhoidal flareups stop hurting within two weeks
without treatment. Eating a high-fiber diet and drinking eight to 10 glasses of
water per day can usually manage the symptoms. You may also need to use stool
softeners to reduce straining during bowel movements. Your doctor may recommend
over-the-counter topical ointments to ease occasional itching, pain, or
Sometimes, hemorrhoids can lead to other complications.
External hemorrhoids may develop painful blood clots. If this happens, they’re
called thrombosed hemorrhoids. Internal hemorrhoids may prolapse, which means
they drop through the rectum and bulge from the anus. External or prolapsed
hemorrhoids can become irritated or infected and may require surgery. The American
Society of Colon and Rectal Surgeons (ASCRS) estimates that less than 10
percent of hemorrhoid cases require surgery.
Internal hemorrhoids often cause no discomfort. They may
bleed painlessly after a bowel movement. They become a problem if they bleed
too heavily or prolapse. It’s typical to see blood after a bowel movement when
you have a hemorrhoid.
External hemorrhoids may also bleed after bowel movements.
Because they’re exposed, they often become irritated and may itch or become
painful. Another common complication of external hemorrhoids is the formation
of blood clots inside the vessel, or a thrombosed hemorrhoid. While these clots
are not usually life-threatening, they can cause sharp, severe pain. Proper
treatment for such thrombosed hemorrhoids consists of an “incision and
drainage” procedure. A surgeon or a doctor in the emergency room can perform
of Hemorrhoid Surgeries
Some types of hemorrhoid surgery can be done in your
doctor’s office without anesthetic. Other types of surgery need to be performed
in a hospital.
Banding is an office procedure used to treat internal hemorrhoids.
Also called rubber band ligation, this procedure involves using a tight band
around the base of the hemorrhoid to cut off its blood supply. Banding usually
requires two or more procedures that take place about two months apart. It’s
not painful, but you may feel pressure or mild discomfort. Banding is not
recommended for those taking blood thinners because of the high risk of
This procedure involves injecting a chemical into the
hemorrhoid. The chemical causes the hemorrhoid to shrink and stops it from
bleeding. Most people experience little or no pain with the shot.
Sclerotherapy is done at the doctor’s office. There are few
known risks. This may be a better option if you’re taking blood thinners because
your skin is not cut open. Sclerotherapy tends to have the best success rates
for small, internal hemorrhoids.
Coagulation therapy is also called infrared
photocoagulation. This treatment uses infrared light, heat, or extreme cold to
make the hemorrhoid retract and shrink. It’s another type of procedure that’s
done at your doctor’s office, and it’s usually performed along with an anoscopy.
An anoscopy is a visualization procedure where a scope is inserted several
inches into your rectum. The scope allows the doctor to see. Most people
experience only mild discomfort or cramping during treatment.
A hemorrhoidectomy is used for large external hemorrhoids
and internal hemorrhoids that have prolapsed. This procedure usually takes place
in a hospital. You and your surgeon will decide on the best anesthesia to use
during the surgery. Choices include:
- general anesthesia, which puts you into a deep
sleep throughout the surgery
- regional anesthesia, which involves medication that
numbs your body from the waist down being delivered by a shot in the back
- local anesthesia, which numbs only your anus and
You may also be given a sedative to help you relax during
the procedure if you receive local or regional anesthesia.
Once the anesthesia takes effect, your surgeon will cut out
the large hemorrhoids. When the operation is over, you’ll be taken to a
recovery room for a brief period of observation. Once the medical team is sure
that your vital signs are stable, you’ll be able to return home. Pain and
infection are the most common risks associated with this type of surgery.
Hemorrhoidopexy is sometimes referred to as stapling. It’s
usually handled as a same-day surgery in a hospital, and it requires general,
regional, or local anesthesia. Stapling is used to treat prolapsed hemorrhoids.
A surgical staple fixes the prolapsed hemorrhoid back into place inside your
rectum and cuts off the blood supply so that the tissue will shrink and be
reabsorbed. Stapling recovery takes less time and is less painful than recovery
from a hemorrhoidectomy.
You can expect rectal and anal pain after having hemorrhoid
surgery. Your doctor will probably prescribe a painkiller to ease the
You can aid in your own recovery by:
- eating a high-fiber diet
- staying hydrated by drinking eight to 10 glasses
of water per day
- using a stool softener so you won’t have to
strain during bowel movements
Avoid any activities that involve heavy lifting or pulling.
Some people find that sitz baths help ease postsurgical
discomfort. A sitz bath involves
soaking the anal area in a few inches of warm water several times a day.
Although individual recovery times vary, many people can expect to make a full recovery within about 10 to 14
When you follow up with your doctor, they’ll probably
- diet changes, such as eating foods high in fiber
- making lifestyle changes, such as losing weight
- adopting a regular exercise program
These adjustments will reduce the likelihood of hemorrhoids