In the case of thrombosed external hemorrhoids, if the thrombosis is very large and painful excising the clot may be necessary and can be performed in the office. Mild symptomatic internal hemorrhoids can resolve with dietary and lifestyle changes. If constipation is the primary cause then a high fiber diet and more fluids can help. If diarrhea is the culprit, it is important to find the cause of the diarrhea and treat accordingly. Eliminating straining and sitting on the toilet for long periods of time often helps to prevent symptoms. Topical creams and ointments such as hydrocortisone may help alleviate symptoms. If these conservative interventions fail to improve symptoms, a formal evaluation and treatment of hemorrhoids by a colon and rectal surgeon either in the office or the operating room may be warranted.
These are often simple and painless techniques that are administered via an anoscope
A chemical solution such as phenol is injected into the hemorrhoid to help shrink and fix the hemorrhoid back to where it anatomically belongs.
The infra-red coagulation light penetrates the hemorrhoidal tissue and converts to heat to reduce the hemorrhoids.
A small rubber band is place around the excess hemorrhoidal tissue. The blood vessels constrict causing the hemorrhoid to shrink and slough in a few days.
There are some novel techniques in treating hemorrhoids that are much less painful than traditional surgery with a quicker recovery.
Transanal Hemorrhoidal Dearterialization (THD)
THD is a less traumatic and less invasive surgical treatment for hemorrhoids that has been shown to cause less pain and discomfort. It has been called “excision-less hemorrhoid surgery”. The THD technique is based on the closure of the hemorrhoidal blood flow through Doppler guidance as well as a suture pexy of the hemorrhoidal tissue back to its normal anatomical position.
Procedure for Prolapsing Hemorrhoids (PPH)
This procedure uses a special stapling device the removes a circular sleeve of excess hemorrhoidal tissue and fixates the remaining tissue back to its normal anatomical position.
This is the classically described operation for the treatment of hemorrhoids. It involves removal of one or more columns of external and internal hemorrhoidal tissue.