Hemorrhoids Are Common — But You Don't Have to Live With Them

Hemorrhoids are normal vascular structures located in the anal canal. However, when they become enlarged, irritated, swollen, or prolapsed, they can cause significant physical discomfort and daily disruption. Many people delay treatment because they are embarrassed to talk about hemorrhoids. There is no reason to suffer in silence. A proper evaluation can determine whether your symptoms are truly caused by hemorrhoids and which treatment is most appropriate.

What Do Hemorrhoids Feel Like?

Internal Hemorrhoids

• Bright-red rectal bleeding during bowel movements

• Tissue protruding or prolapsing from the anus

• Mucus discharge or mild skin irritation

• Sensations of fullness, pressure, or incomplete evacuation

• Note: Internal hemorrhoids are rarely painful unless prolapsed or strangulated.

External Hemorrhoids

• Localized pain, itching, or soreness around the anus

• Swelling or a visible firm bump near the anal opening

• Difficulty maintaining cleanliness after bowel movements

• Intermittent bleeding when wiped or irritated

Thrombosed Hemorrhoids

• A blood clot forming within an external hemorrhoid

• Sudden, severe, or throbbing anal pain

• A firm, bluish, or highly tender lump near the anus

• Difficulty sitting or walking comfortably

When Should You See a Doctor?

Rectal bleeding should never be automatically assumed to be hemorrhoids. A medical evaluation is essential to rule out other gastrointestinal conditions, including colorectal cancer or inflammatory bowel disease. You should consult a physician promptly if you experience:

• Persistent or recurrent rectal bleeding

• A noticeable change in bowel habits or stool shape

• Unexplained weight loss or fatigue

• Persistent abdominal or severe rectal pain

• Symptoms of anemia (dizziness, weakness, or lightheadedness)

• A new, firm, or rapidly expanding anal lump

• Heavy bleeding or symptoms that do not improve with conservative home care

Why Do Hemorrhoids Happen?

Hemorrhoids develop due to increased pressure in the lower rectum and pelvic tissue. Common contributing factors include:

• Chronic constipation or straining during bowel movements

• Prolonged sitting on the toilet

• Low-fiber dietary habits

• Chronic diarrhea or frequent loose stools

• Pregnancy and pelvic pressure during childbirth

Effective care focuses not only on removing hemorrhoidal tissue but also on addressing the underlying bowel habits and lifestyle factors that cause recurrence.

Treatment Starts With the Basics: Step 1

Many mild to moderate hemorrhoids improve significantly with conservative home care and dietary adjustments:

• Fiber Optimization: Increase dietary fiber through whole foods or daily supplements (such as psyllium or methylcellulose) to soften and bulk stool, minimizing straining.

• Hydration: Maintain adequate daily water intake to assist dietary fiber in keeping stools soft.

• Avoid Straining: Never force bowel movements or hold your breath while straining.

• Limit Toilet Time: Avoid sitting on the toilet for extended periods (such as reading or using phones).

• Physical Activity: Engage in regular moderate exercise to encourage healthy gut motility.

Medications & At-Home Relief

For temporary symptom control during flare-ups:

• Warm sitz baths (soaking the pelvic area in plain warm water for 15–20 minutes)

• Topical over-the-counter creams containing lidocaine or witch hazel

• Short-term topical hydrocortisone preparations to reduce itching and swelling

Safety Warning: Do not use steroid-containing hemorrhoid creams for extended periods without explicit medical guidance, as prolonged use can cause skin thinning and local tissue damage.

When Symptoms Keep Coming Back, It's Time to Consider a Procedure

When conservative treatment is insufficient, procedurally directed interventions are considered based on hemorrhoid type, size, and severity:

Office-Based Treatments

Best for select internal hemorrhoids. Options include rubber band ligation, sclerotherapy injections, or infrared coagulation to restrict blood supply and shrink internal tissue.

Minimally Invasive Surgery

Procedures such as THD (Transanal Hemorrhoidal Dearterialization) offer precise arterial ligation and tissue repositioning without extensive surgical cutting.

Traditional Surgery

Excisional Hemorrhoidectomy involves complete surgical removal of diseased tissue, ideal for advanced, complicated, or combined internal/external disease.

THD: A Minimally Invasive Approach to Internal Hemorrhoids

Treat the source of the problem while preserving the surrounding tissue.

THD stands for Transanal Hemorrhoidal Dearterialization. Using a specialized Doppler-guided ultrasound device, the surgeon precisely locates the terminal branches of the superior rectal arteries supplying the hemorrhoids. Precise sutures are placed to reduce blood flow, causing internal tissue to shrink over time. When internal tissue prolapse is present, a mucopexy technique is added to lift and secure prolapsed tissue back into its anatomical position.

Note: THD is designed primarily for internal hemorrhoidal disease.

Why Patients May Choose THD

• No Tissue Removal: Avoids routine surgical excision of anal mucosa.

• Reduced Postoperative Pain: Operates above the pain line in the lower rectum, resulting in lower pain scores than excisional surgery.

• Faster Recovery: Most patients return to daily routines and work significantly faster.

• Addresses Bleeding & Prolapse: Restricts arterial blood supply and restores tissue position.

• Same-Day Outpatient Procedure: Performed under general or regional anesthesia with same-day discharge.

• Preserves Natural Anatomy: Maintains the physiological cushions of the anal canal.

Recovery After Hemorrhoid Treatment

Recovery times vary based on the procedure chosen:

• Following THD: Patients often experience mild pressure, fullness, or urgency for 24–48 hours. Most resume regular non-strenuous daily activities within a few days.

• Following Hemorrhoidectomy: Postoperative pain management, sitz baths, stool softeners, and adequate rest are crucial. Full healing generally takes several weeks.

How to Prevent Hemorrhoids From Coming Back

• ✓ Maintain high dietary fiber intake (25–35g daily)

• ✓ Drink plenty of fluids daily

• ✓ Avoid delay or straining during bowel movements

• ✓ Keep toilet visits under 5 minutes

• ✓ Stay active and avoid prolonged sitting

• ✓ Address chronic diarrhea or constipation promptly

Frequently Asked Questions

Are hemorrhoids dangerous?

Hemorrhoids themselves are benign, but their primary symptom—rectal bleeding—can mimic serious conditions like colorectal cancer. Professional evaluation is always recommended.

Can hemorrhoids go away without surgery?

Yes. Mild internal and external hemorrhoids often improve with dietary changes, increased fiber, and improved bowel habits.

What is THD?

THD (Transanal Hemorrhoidal Dearterialization) is a minimally invasive surgical procedure that uses Doppler ultrasound to tie off hemorrhoidal arteries and lift prolapsed tissue without cutting.

Is THD painful?

Because THD works above the dentate line (where sensory pain nerves are sparse), postoperative pain is generally far lower than traditional excisional surgery.