Hemorrhoid Surgery - What to Expect and When It's Needed
If you're dealing with painful, hemorrhoid bleeding that don't improve with home treatments, surgery might be the next step. In this article, we’ll break down what hemorrhoid surgery involves, why it’s done, and what you should know before going in. Whether you're looking for relief or exploring your options, this guide will help you understand how surgery can help manage severe cases of hemorrhoids.
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| Hemorrhoid Surgery - What to Expect and When It's Needed |
How Is Hemorrhoid Surgery Done
Hemorrhoid removal is usually done in a doctor’s office or a hospital. Most people go home the same day.
The method used depends on how big the hemorrhoids are, where they are located, and how severe the symptoms are.
Before the surgery, you’ll either get local anesthesia (numbing medicine) or general anesthesia (medicine that puts you to sleep).
The goal is to make sure you don’t feel pain during the procedure.
There are several ways to treat or remove hemorrhoids:
- Rubber band ligation – A tiny rubber band is wrapped around the hemorrhoid to cut off blood flow, which makes it shrink.
- Stapling – The hemorrhoid is stapled to stop its blood supply.
- Surgical removal – The hemorrhoid is cut out with a scalpel. Sometimes stitches are needed.
- Injection (sclerotherapy) – A special chemical is injected to shrink the hemorrhoid.
- Laser treatment – A laser is used to burn and remove the hemorrhoid.
Types of Hemorrhoid Surgery
Traditional Surgery:
Hemorrhoidectomy: (Milligan-Morgan Technique): This is the most effective method, removing hemorrhoids completely. It involves creating three small wounds in the anal canal, making it suitable for both internal and external hemorrhoids.
Minimally Invasive Techniques:
Their goal is to reduce hemorrhoid size and secure them higher in the anal canal.
- Doppler-Guided Hemorrhoidal Artery Ligation (HAL) with Mucopexy: Reduces blood flow to hemorrhoids and secures them in place.
- Stapled Hemorrhoidopexy (Longo’s Technique): Removes a ring of mucosa at the hemorrhoid’s base using an automatic stapling device.
- Laser and Radiofrequency Surgery: These methods destroy hemorrhoids and reposition them using a controlled healing process. However, they are less common and still under evaluation.
Is Surgery Always Necessary for Hemorrhoids
The short answer is NO. Surgery is only recommended for patients who continue to suffer despite medical and instrumental treatments.
However, immediate surgery may be considered for those with permanently externalized hemorrhoids or frequent episodes of external hemorrhoid pain.
Mild hemorrhoids often go away with home care and natural home remedies. Simple changes can help:
Read article: Hemorrhoids explained symptoms causes simple home remedies.
If these changes don’t help and you're still dealing with pain, bleeding, or swelling, your doctor might suggest surgery as a more permanent solution.
Read also: Top 7 hemorrhoid related products that work.
Is Hemorrhoid Surgery Painful
Yes, but modern pain management techniques have significantly reduced discomfort.
The most painful period is during bowel movements and wound care within the first 7-10 days post-surgery.
However, in between, pain is usually mild or absent with proper medication.
Minimally invasive techniques result in less pain and allow patients to resume daily activities within a few days.
Possible Complications of Hemorrhoid Surgery
- Common Side Effects: Bleeding, urgency to defecate, and mild pain.
- Rare but Severe Complications: Difficulty urinating, anal stenosis (narrowing of the anal canal), or incontinence.
- Laser and Radiofrequency Complications: These are minimal and infrequent, but the long-term effectiveness of these methods is still being evaluated.
Do Hemorrhoids Return After Surgery
Surgery does not permanently eliminate the risk of hemorrhoids. The key to a successful procedure is preserving enough hemorrhoidal tissue, as it plays a role in fine anal continence.
Some patients may experience minor recurrences, such as occasional bleeding or mild protrusions, but these symptoms are usually less severe and less frequent than before surgery. Most patients recommend surgery and regret not having done it sooner.
What Are the Risks of a hemorrhoid surgery
Like any surgery, hemorrhoid surgery comes with some risks. These may include:
- Reactions to anesthesia (such as breathing issues or allergic reactions)
- Bleeding or infection
- Blood clots
- Difficulty urinating due to pain after surgery
- Mild leakage of stool (though this is rare and usually temporary)
Most people recover well, especially when they follow their doctor’s instructions after the procedure.
Conclusion
Hemorrhoid surgery can provide lasting relief when other treatments fail. If you're struggling with constant pain or bleeding from hemorrhoids, talk to your healthcare provider about whether surgery is right for you.
With today’s medical options, many procedures are quick and done on the same day—with minimal downtime.
For long-term relief, focus on healthy habits like eating more fiber foods, staying hydrated, and avoiding straining in the bathroom.
📚 Medical Sources
- Lohsiriwat V. Hemorrhoids: From basic pathophysiology to clinical management. World J Gastroenterol. 2012;18(17):2009–2017.
- Simillis C, et al. A meta-analysis comparing conventional hemorrhoidectomy with other minimally invasive procedures. Dis Colon Rectum. 2008;51(12):1701–1715.
- Shanmugam V, et al. Rubber band ligation versus excisional haemorrhoidectomy for haemorrhoids. Cochrane Database Syst Rev. 2005;(3):CD005034.
- Tjandra JJ, Chan MK. Systematic review on the procedure for prolapse and hemorrhoids. Dis Colon Rectum. 2007;50(6):878–892.
- Macrae HM, McLeod RS. Comparison of hemorrhoidal treatments: a meta-analysis. Can J Surg. 1995;38(6):687–694.
- Mounsey AL, et al. Hemorrhoids. Am Fam Physician. 2011;84(2):204–210.
