Hemorrhoids are nearly always a transient condition. However, if severe hemorrhoids persist or are recurrent in spite of good hygiene practices, home care remedies, a healthy diet, and regular exercise, hemorrhoid surgery as a last resort may be necessary for enduring relief.
Surgery, or a hemorrhoidectomy, is required in less than one percent of cases and should be considered only when all other treatments have failed.
Depending on the location and severity of the offending hemorrhoids, minimally invasive procedures can be performed with local anesthesia in a surgeon’s office or on an outpatient basis.
While still unpleasant and painful, the aftercare and recovery time associated with these procedures are significantly less than with major surgery. Less invasive techniques block the blood supply to the hemorrhoid causing it to die and slough off.
One such procedure is rubber band ligation (RBL), whereby a physician places a band around the base of the hemorrhoid, strangulating the blood flow. Similarly, stapling devices also interrupt circulation to hemorrhoids and tend to be less painful than RBL.
Laser coagulation and heat coagulation create a blockage by forming a clot in the blood vessel. Another method, sclerotherapy, uses a hardening solution injected into the hemorrhoid causing it to shrivel and eventually fall off.
Treatment with major surgery is necessary to remove large, severe, often prolapsed, internal hemorrhoids. The same risks and post-operative care, along with a longer recovery time, inherent with any major surgery can be expected.
This type of hemorrhoidectomy involves removal through surgical incisions made around the base of the hemorrhoid to excise it completely.
Recovery time from a major hemorrhoidectomy is about 3 weeks. Bleeding is normal and antibiotics are often prescribed to prevent infection.
Ice packs may be used in addition to the prescribed and over-the counter medication to numb the pain from the incisions. Frequent soaks in warm sitz baths are recommended to ease discomfort and muscle spasms.
While treatment through major surgery is the most painful and difficult to recover from, it is also the treatment least likely to see a recurrence of hemorrhoids.
But because of its radical nature and lingering effects, surgery is impractical for most sufferers of hemorrhoids. Unless hemorrhoids are chronic and severe, treatment with surgery is more unpleasant and painful than the hemorrhoids themselves.
Following recovery from surgery, major or minor, your mind must be set on preventing a relapse of hemorrhoids. The conditions that caused the hemorrhoids in the first place must be changed and counteracted.
Healthy lifestyle elements, especially a diet rich in fiber, exercise, and good hygiene practices must be put into place to avoid relapse.