While there are homemade treatment protocols that patients with hemorrhoids can follow, there are cases that persist despite being treated. If you notice that the hemorrhoids become quite large, bleed a lot, cause excessive pain, interfere with bowel movements or become swollen and hard, surgery might be necessary.1,2,3
Before having surgery for hemorrhoids, consult a physician or surgeon first to determine the procedure that’s right for you, or if there are other homemade solutions that you haven’t tried yet that could help with your case. There are three different surgical treatments for hemorrhoids:
• Hemorrhoidectomy: in this procedure, the surgeon cuts out the large hemorrhoids.4,5,6
Prior to the operation, you and your surgeon will choose from three types of anesthesia: general (sends you into a deep sleep throughout the operation), regional (delivered via a shot on your back and numbs your body from the waist down) or local (numbs your anus or rectum).
While hemorrhoidectomy is effective at treating recurrent hemorrhoid cases and lowering the risk of the hemorrhoids returning, there are potential and painful complications.
Bleeding, urinary tract infections and temporary difficulty in emptying bladder and stools are common problems after this procedure. Plus, recovery time can take up to a week, and even you still might experience post-surgery pain.
• Hemorrhoid stapling or hemorrhoidopexy: this is often performed on prolapsed hemorrhoids because of its effectivity. Just like hemorrhoidectomy, you and your surgeon will decide first whether to use general, regional or local anesthesia.
This process uses a surgical staple to fix the prolapsed hemorrhoid and return it into its place inside your rectum. This blocks blood supply, causing the tissue to shrink and be reabsorbed. Compared to hemorrhoidectomy, hemorrhoid stapling is less painful and involves a shorter recovery period.
However, there is a chance that hemorrhoids will still return post-surgery. There is also a risk for rectal prolapse, wherein a part of your rectum may stick out from your anus. In some cases, the surgery might result in a blockage or hole in your anus or rectum, or even an infection in these areas.
• Hemorrhoidal artery ligation: also called a hemorrhoid artery ligation operation or HALO, the procedure uses an instrument called a modified proctoscope containing a Doppler probe. This will be placed in your anus, allowing your surgeon to have a good view of the hemorrhoids. The Doppler probe will then locate the blood vessels that cause the hemorrhoids.7,8
Once these blood vessels are located, a small window inside the proctoscope allows your surgeon to place a suture or stitch around the artery. This cuts off the blood supply to your hemorrhoids and causes them to shrink. Hemorrhoidal artery ligation also brings the hemorrhoids higher up the anal canal.9
Hemorrhoidal artery ligation is effective for patients with bleeding and/or prolapsing hemorrhoids. The procedure also causes less pain post-surgery, although there might be slight discomfort in the process. Unfortunately, there is a possibility that the hemorrhoids will return and you might experience difficulty or inability urinating. Having open bowels may also result in pain.10