Hemorrhoids Treatments and Procedures

Office Treatment

Simple treatment measures done in the surgeon’s office can be used to manage most cases of symptomatic hemorrhoids. There are several procedures that can be performed depending on the type of hemorrhoids and their location. These treatments include:

  • Rubber Band Ligation: This procedure is used with internal hemorrhoids. An elastic band is applied to the hemorrhoid in order to cut off its blood supply. After about a week the hemorrhoid will fall off. The cure rate for this procedure is almost 90%.
  • Sclerotherapy: This involves injecting a medicine into the hemorrhoid, which makes it shrink and shrivel up. The success rate is 70% with this treatment.
  • Cauterization: There are several cautery methods including:
    • Infrared Coagulation – The surgeon uses a device that creates an intense beam of light, which cuts off the blood supply to the hemorrhoid. The hemorrhoid dies and a scar remains.
    • Laser Surgery –The surgeon uses a laser light with pinpoint accuracy that vaporizes the hemorrhoid.
    • Electrocautery – A metal probe that is heated by electricity is used to destroy the hemorrhoid.
Traditional Surgical Treatment

Often medically managing hemorrhoids will give you relief and there are several non-surgical treatments also available (mentioned above). However, sometime it’s necessary to perform surgery. The type of surgery performed is called a hemorrhoidectomy, which means excising (cutting) the hemorrhoid and removing it. This can be done using a local anesthetic, which means the area to be operated on is numbed so you won’t feel any pain, but you are awake during the procedure or it can be done using general anesthesia and you are asleep during the entire procedure. Frequently this is done on an outpatient basis, and you can go home the same day you have the surgery. Usually surgery provides relief for the pain and swelling, but since stitches may be required, that area will be painful and sensitive until healing occurs. Pain medication, Sitz baths, and taking stool softeners will help you manage the pain as you recover. However, don’t take any pain medication without your surgeon’s approval. Recovery time may be from two to six weeks.

Procedure for Prolapsing Hemorrhoids (PPH)

Sometimes hemorrhoids will prolapse. Prolapse means “to fall out.” These are internal hemorrhoids that have become so stretched that they protrude outside the anus. When this occurs, a procedure called PPH (Procedure for Prolapsing Hemorrhoids) is usually performed. Excess tissue is removed and the remaining hemorrhoidal tissue is stapled, which restores the hemorrhoids back to their original position and cuts off their blood supply. Without a supply of blood, the hemorrhoids shrivel up and die.