There’s nothing more unnerving and distressing than having to endure all the signs and symptoms of hemorrhoids every single day. Worst, there’s no greater embarrassment than to have a hemorrhoid sticking out of your anus. It is definitely a physical and psychological torture!

Out of desperation, maybe you have considered to have a surgical procedure for their removal. Though it is a good option, the removal of hemorrhoids is usually the last resort to resolve the hemorrhoids.

Most hemorrhoids, usually the milder types, heal on their own. Moreover, some procedures that remove hemorrhoids, such as hemorrhoidectomy, are associated with significant pain. And for these reasons, conservative management is initially done to make the hemorrhoids go away. But if all else fails, hemorrhoid removal through surgical means could be the only feasible option for you. Before deciding on whether to have a hemorrhoid removal or not, it is important to know more about these so that you are able to make the possible preparations and readjustments in your lifestyle.

There are various ways on how to remove the hemorrhoid.

Hemorrhoid removal through the process of hemorrhoidectomy is usually indicated for individuals with internal hemorrhoids that bulge out from the anus during bowel movements and/or with hemorrhoids that seem to protrude out of the rectum at all times. Hemorrhoidectomy is also recommended to patients who have failed every nonoperative or conservative therapy that was prescribed and in those who display significant manifestations from external hemorrhoids, such as the formation of clots, or skin tags.

Chronic bleeding and anemia and painful external thrombosed hemorrhoids are also recommended for removal. The hemorrhoid is excised using a scalpel, a cautery or a laser. The latter uses an infrared beam to cauterize the tissues. Using a traditional scalpel, the removal of hemorrhoids is achieved by surgically excising the hemorrhoid tissue. The tissues are clamped, tied off and removed. A newer method called the stapled hemorrhoidectomy attempts to remove the hemorrhoid by excising a band of prolapsed anal tissue through the using of a stapling device. The band is pulled into the device, removing the excess tissue, as the remaining tissue is stapled back to its correct location.

Sclerotherapy is a technique that involves the injection of chemical irritants into the blood vessels surrounding the hemorrhoids to induce inflammation, formation of excess tissues and scarring. The entire technique results in the shrinkage and falling off the hemorrhoid.

Hemorrhoidolysis or Galvanic Electrotherapy causes the shrinkage of a hemorrhoid tissue by the application of a small probe of electrodes. The resulting electrolysis results in complete and shriveling and drying up of the hemorrhoids.

Rubber band ligation is the most commonly used technique used in the United States as it involves lesser pain and risks with a 60 to 80% success rate. This procedure removes the hemorrhoid by tying up a small elastic band around the internal hemorrhoid, cutting off its blood supply. The hemorrhoid dries up, shrinks and falls off a few days after the procedure, in about a week. Bleeding ensues after the hemorrhoid falls off but it spontaneously resolves by itself. Only one or two hemorrhoids are removed at a time but the banding can be redone after 4 to 6 weeks.

Hemorrhoidectomy is appropriate when you have the following:

• very large internal hemorrhoids, internal hemorrhoids that still cause problems after fixative procedures
• large external hemorrhoids that cause significant discomfort and pain
• both internal and external hemorrhoids
• had other treatments for hemorrhoids that have failed

Like any other surgical procedure, hemorrhoidectomy has its own risks. Pain, bleeding, and urinary retention are the most common side effects. The least common risks are divided into early problems or abnormalities that occur a few days after the surgery and late problems – those that occur months after the surgery.

Early problems are as follows:

• bleeding from the anal area
• hematoma or collection of blood in the surgical area
• incontinence or inability to control bladder or bowel
• infection of the surgical area
• fecal impaction or stool trapped in the anal canal

Late problems include:

• narrowing or stenosis of the anal canal
• recurrence of hemorrhoids
• fistula – which is the abnormal passage that forms between the anal or rectal canal
• rectal prolapsed – which happens when the rectal lining protrudes out of the anal opening like a protruding hemorrhoid.

There is a special preparation done before hemorrhoidectomy is performed. A day before the surgery, the nurse will give you an enema to cleanse your colon. Special preparations are mainly done to prevent the occurrence of infections after your surgery.

Keep in mind that the gastrointestinal tract consisting of the large intestine to the anus is inhabited by many bacteria. In this area, they are the harmless non-visible organisms that merely feed on food scraps to survive, but once they gain access to the other parts of your body, they turn into the most aggressive infection-causing machines overnight.

Before the hemorrhoid operation, you will either be given a general or spinal anesthesia so that you will not feel any pain. In a general anesthesia, you are asleep during the entire procedure, while in spinal anesthesia, you are numb form waist down to your toes. You are conscious and able to talk the whole time during the procedure.

The procedure involves making an incision on the tissue surrounding the hemorrhoid. Before hemorrhoid removal can take place, the swollen veins inside it are tied up to prevent bleeding. The incised area may be sewn or left open. Medicated gauze is used then placed over the incised wound. The incision can be done using either a knife, cautery pencil, or a laser. Lasersare often advertised as they are less painful and encourage faster healing, but these claims have not been proven. What is known is that lasers are more expensive than the traditional technique, takes longer to perform and can cause deep tissue injury.

After the surgery, you can expect some pain. Some bleeding is normal, especially on the first defecation. Straining is still avoided up to this point to prevent hemorrhoids from coming back.

For this, conservative management is applied at home. Follow up exams with your surgeon are done 2 to 3 weeks after surgery to check for your progress and complications.

Hemorrhoidectomy may provide better long-term results than fixative procedures that basically use the principle of cutting off blood flow to the hemorrhoid. However, surgery is more expensive, has greater risk of complications, and usually is more painful.

Read more about hemorrhoid prevention

The most important thing to remember and do is to avoid straining. This is just about the best way to get rid of hemorrhoids and shrink them.

Remember, a warm sitz bath can help to ease your hemorrhoid symptoms and fairly rapidly too. It really is very easy to do and costs nothing.

Want to be more proactive? Read my personal review of Venapro

Medicines can help relieve the symptoms of hemorrhoids. You might want to try one or more of the following medications…

To reduce inflammation and bleeding, you have the option to choose from a wide variety of ointments with or without hydrocortisone that are out in the market, or salicylate containing suppositories for internal hemorrhoids to lubricate the anal canal during bowel movements.

Hydrocortisone, a type or steroid, can also relieve itching. However, this should not be used for more than two weeks because hydrocortisone can thin out the skin.

There are also ointments that protect the skin such as zinc oxide or petroleum jelly. Ointments also can prevent further injury and reduce itching by forming a barrier over hemorrhoids.

For the pain, take non-prescription pain relievers. Nonsteroidal anti-inflammatory drugs or NSAIDs such as naproxen and ibuprofen can help with the pain and the swelling.

Surgery is rarely needed in hemorrhoid treatment. Surgery may be an option for you if other treatments, including home treatments, have failed. You can also consider surgery if your hemorrhoid creates a medical emergency, such as uncontrolled bleeding and pus at the anus along with severe rectal pain.

The most common surgical procedure done is called hemorrhoidectomy. This is done for severe cases of piles such as those that are large and or prolapsed. Basically, this is done under general or spinal anesthesia. Then hemorrhoid removal is possible.

Usually, the wounds heal up within a week or two. In most cases, one can resume normal activities after a few days and be fit for work. The first bowel motion usually happens on the second day and should not cause any great discomfort.

Other surgical procedures include:

• injection sclerotherapy
• infrared coagulation
• photocoagulation
• diathermy
• electrotherapy
• hemorrhoidal artery ligation

Aside from surgery, there are nonsurgical procedures called fixative procedures to choose from to treat your haemorrhoid. The goal of fixative procedures is to reduce the blood supply to the hemorrhoid so it shrinks or goes away. A scar tissue is left in place. Consequently, this scar tissue helps support the anal tissue and helps prevent more hemorrhoids from developing. Fixative procedures include:

• rubber band ligation
• heat
• lasers
• electric current

All the above procedures help to create beneficial scar tissue.

In most cases, external hemorrhoids are usually not removed via surgery except if they are very large and uncomfortable or if you are having surgery on the anal area for another reason such as internal hemorrhoids or a tear. While for internal hemorrhoids that are small, surgery is the last resort, but for large ones, it is considered the most successful way to treat them. This is especially true for those that are still a problem after fixative procedures have been tried but failed.

Hemorrhoid treatment need not be daunting. As you can see, there are many options and solutions.