Hemorrhoids are a common health condition that affect millions of people worldwide. While many cases can be managed with lifestyle changes, over-the-counter remedies, or minimally invasive procedures, some patients require surgery to achieve lasting relief. Hemorrhoid surgery is often considered when symptoms are severe, persistent, or when other treatments fail to provide improvement. Understanding what hemorrhoid surgery is, why it may be needed, and what to expect during recovery can help patients make informed decisions about their health and treatment options.
Understanding Hemorrhoids
Hemorrhoids are swollen veins in the rectum or anus, similar to varicose veins that appear in the legs. They can develop internally inside the rectum or externally under the skin around the anus. Common causes include straining during bowel movements, chronic constipation, prolonged sitting, pregnancy, or obesity. Hemorrhoids may cause discomfort, itching, bleeding, and sometimes severe pain.
For many people, lifestyle changes such as increasing fiber intake, staying hydrated, and using stool softeners can relieve symptoms. However, when hemorrhoids become large, painful, or resistant to conservative care, surgery may be the best option.
When Is Hemorrhoid Surgery Needed?
Not all hemorrhoids require surgery. Doctors usually recommend it only in specific cases where the condition interferes with quality of life or poses risks. Surgery may be considered if
- Hemorrhoids are large and prolapsed (hanging outside the anus)
- There is frequent or severe bleeding
- Pain is intense and persistent
- Non-surgical treatments have failed
- Complications develop, such as blood clots (thrombosed hemorrhoids)
Before surgery is suggested, patients usually try less invasive options like rubber band ligation, sclerotherapy, or infrared coagulation. Surgery becomes the next step if these procedures are not effective.
Types of Hemorrhoid Surgery
There are different surgical methods used to treat hemorrhoids. The choice depends on the severity of the condition, patient health, and the doctor’s recommendation. The main types include
Hemorrhoidectomy
This is the most common and traditional surgery for severe hemorrhoids. The surgeon removes the hemorrhoidal tissue, either with a scalpel, laser, or electrocautery. It is highly effective in preventing recurrence but can cause significant discomfort during recovery.
Stapled Hemorrhoidopexy
Also known as stapling, this procedure is often used for internal hemorrhoids. The surgeon uses a circular stapling device to reposition the hemorrhoids and cut off their blood supply. This technique usually results in less pain and faster recovery compared to a hemorrhoidectomy.
Hemorrhoidal Artery Ligation
This procedure, sometimes called transanal hemorrhoidal dearterialization (THD), involves tying off the blood vessels that supply the hemorrhoid. By reducing blood flow, the hemorrhoid shrinks over time. This method is less invasive and may lead to quicker healing.
Preparation for Surgery
Before undergoing hemorrhoid surgery, patients will have a consultation with their doctor to discuss the best approach. Preparations may include
- Medical evaluation and blood tests
- Stopping certain medications, especially blood thinners
- Fasting before the procedure, depending on anesthesia
- Arranging for transportation home after surgery
It is important for patients to inform their doctor about any health conditions, allergies, or ongoing treatments to ensure safety during the procedure.
The Surgical Procedure
Hemorrhoid surgery is usually performed under general anesthesia, spinal anesthesia, or local anesthesia with sedation. The duration depends on the type of surgery, but most procedures last less than an hour. After the hemorrhoids are removed or treated, the patient is monitored for a short period before going home the same day or after a brief hospital stay.
Recovery After Hemorrhoid Surgery
Recovery time varies depending on the surgical method. A traditional hemorrhoidectomy may take two to four weeks for full healing, while stapled procedures often allow patients to resume normal activities within one to two weeks. Common recovery aspects include
- Pain and discomfort, especially during bowel movements
- Swelling and mild bleeding
- Restrictions on heavy lifting or strenuous activities
- Need for pain medications and stool softeners
Doctors usually recommend a high-fiber diet, plenty of fluids, and regular gentle exercise to support healing and prevent constipation. Sitz baths, which involve soaking the anal area in warm water, can also provide relief.
Possible Risks and Complications
Like any surgery, hemorrhoid surgery carries some risks. Although most patients recover without serious problems, potential complications include
- Infection at the surgical site
- Excessive bleeding
- Difficulty urinating temporarily
- Anal narrowing or scarring (rare)
- Recurrence of hemorrhoids in some cases
Following the doctor’s instructions carefully during recovery can greatly reduce these risks.
Benefits of Hemorrhoid Surgery
Despite the potential discomfort, hemorrhoid surgery can significantly improve quality of life for those who suffer from severe symptoms. The main benefits include
- Permanent removal of problematic hemorrhoids
- Relief from chronic pain and bleeding
- Reduced risk of complications associated with untreated hemorrhoids
- Improved comfort and daily functioning
Lifestyle After Surgery
To prevent new hemorrhoids from developing, patients are encouraged to adopt long-term healthy habits. Key lifestyle changes include
- Eating a high-fiber diet with fruits, vegetables, and whole grains
- Staying well-hydrated with water
- Exercising regularly to support digestion
- Avoiding prolonged sitting, especially on the toilet
- Not delaying bowel movements when the urge arises
These practices help maintain digestive health and reduce the risk of future hemorrhoid problems.
Who Should Consider Hemorrhoid Surgery?
Hemorrhoid surgery is typically reserved for patients with severe or chronic symptoms. It is most appropriate for
- Individuals with large prolapsed hemorrhoids
- Patients who experience frequent bleeding despite treatment
- People with thrombosed hemorrhoids causing intense pain
- Those who have tried other treatments without success
Because surgery carries some risks, it is important to carefully evaluate the benefits compared to non-surgical options.
Hemorrhoid surgery is an effective treatment for severe cases when other approaches fail. By removing or reducing the swollen veins, surgery can provide lasting relief from pain, bleeding, and discomfort. Recovery requires patience, proper care, and lifestyle adjustments, but the long-term benefits are often life-changing for those who suffer from persistent hemorrhoid symptoms. Understanding the types of hemorrhoid surgery, the recovery process, and preventive measures helps patients feel more confident in making the right choice for their health.