The SURGERY “TO BE OR NOT TO BE? ” Question
Odd as this might sound, it’s not always a good idea to remove hemorrhoids. Many cases of hemorrhoids aren’t really serious enough or symptomatic enough to justify the risks of removing them surgically. Of course, you’re the only one who can ever make that sort of decision. However, if your hemorrhoids cause no trouble at all and aren’t getting any bigger, then they’ll probably go away on their own with a bit of lifestyle changes.
Hemorrhoid surgery is not an easy decision, so work through it and don’t jump in.
When not to remove hemorrhoids, unless your doctor or surgeon believes it necessary
- When pregnant it is normally safer for the baby if you suffer with the hemorrhoids rather than try and remove them.
- You suffer from portal hypertension (high blood pressure in your hemorrhoidal area), as some heavy bleeding may result.
- You suffer from leukemia, as this makes it difficult for your body to heal.
- You suffer from inflamatory bowel disease AND you haven’t actively managed the condition leading up to the operation – poor wound healing may result.
- You suffer from a bleeding disease or are on medication (mostly nonsteroidal anti-inflammatories, such as aspirin) that causes easier bleeding
When To Remove Hemorrhoids
It becomes more important to remove hemorrhoids when they start causing serious impact on your life overall:
- When hemorrhoid symptoms get bad enough that they start interfering with your day to day life, then it’s time to look at removing them.
- If you just keep getting hemorrhoids over and over again, it means that the hemorrhoidal tissue has weakened, so you need to think about developing a plan to remove the hemorrhoids and strengthen the tissues so they don’t come back.
- When hemorrhoids get thrombosed or strangulated or start prolapsing outside the body (the latter in the case of internal hemorrhoids only, of course) then removing the hemorrhoids moves to the top of your priority list.
One of the biggest things you need to do when coming up with your plan to remove hemorrhoids is to figure out exactly what kind of hemorrhoids you’ve got. If you cant figure out what type of hemorrhoid you have, then you may want to use a mirror and compare yours to those in these hemorrhoid photos. If you’re suffering from an external hemorrhoid that’s thrombosed, then how you remove the hemorrhoids will be different than if you were suffering from an internal hemorrhoid that was bleeding all over the place.
There are different techniques used to remove hemorrhoids, and the choice of one technique over another depends on:
- the hemorrhoids location
- the hemorrhoids current level of severity
- and your current health condition and history.
The Ways To Remove Hemorrhoids
The best way to remove hemorrhoids is usually at home if at all possible.
There are quite a few options to remove hemorrhoids at home, including home remedies in concert with herbal treatments. Most of the hemorrhoid creams you can find at the grocery store today are meant for external hemorrhoid symptom relief only, but there are quite a few online hemorrhoid treatments that can remove hemorrhoids quite efficiently by absorbing them back into the body and strenghtening the surrounding tissue. In addition, a herbal remedy to remove hemorrhoids can occasionally work in conjunction with a lesser surgical procedure to keep from having to have a more invasive surgery. Most of the hemorrhoid remedies you find around the house can’t remove hemorrhoids all by themselves, but do work wonders when paired up with alternative hemorrhoid remedies.
Unfortunately, some hemorrhoids get so severe that they just cannot be treated successfully at home. When that happens, then most people start considering surgical intervention to remove hemorrhoids. Of course, there are a few different options to remove hemorrhoids surgically as well. The most invasive method commonly used to remove hemorrhoids is a full hemorrhoidectomy. The least invasive methods used to surgically remove hemorrhoids are infrared coagulation and latex banding, both of which remove hemorrhoids by cutting off the blood supply to the hemorrhoid. In between these two extremes to surgically remove hemorrhoids there is a whole spectrum of possibilities, each with its own good points and bad points.
Some things a surgeon looks at before deciding to remove hemorrhoids
Surgeons and doctors will normally agree to operate and remove hemorrhoids if you fall into one of two categories:
The hemorrhoid has developed a thrombosis – PAIN
See thrombosed hemorrhoids if internal hemorrhoids are involved and if external hemorrhoids see thrombosed external hemorrhoids. A thrombosed hemorrhoid is treated by surgery if it is big enough and in an acute stage of severe pain or poses a health risk – for example, gangrene of the hemorrhoid might set in.
Internal hemorrhoids do not cause pain unless a thrombosis has occurred – the thrombosis is normally caused by strangulation of a prolapsed internal hemorrhoid and these wont normally resolve on their own unless they can go back inside. Thrombosed external hemorrhoids mostly can resolve on their own within a few days – pain wise at least.
Hemorrhoid symptoms are troublesome
The hemorrhoid symptoms surgeons and doctors consider when thinking about an operation are:
1.. Bleeding if it wont improve or only gets worse, even with diet and life style changes.
2.. Prolapse – if the internal hemorrhoid produces symptoms such as bleeding, discomfort, mucus discharge, or itching (pruritis)
3.. Mucus and Pruritis – Excess mucus comes from a chronic prolapsed hemorrhoid that is constantly irritated. The itching (and burning) comes from the mucus irritating the skin. These symptoms may also be caused by weak anal muscles that don’t hold everything inside that should be, such as the mucus. If large skin tags are present the area may be difficult to clean after a bowel motion and some fecal matter (poo) may be left behind, which then irritate the area as well.
4.. Fecal seepage – Can be due to large internal hemorrhoids that prevent the anal canal from tightly closing shut.
5.. Anemia – rare symptom for hemorrhoids to cause – lots of bleeding leading to iron defiency.
The operations the surgeon choose from to remove internal hemorrhoids:
The operations the surgeon is likely to suggest will be infrared coagulation or sclerotherapy if the bleeding is from small internal hemorrhoids. If the internal hemorrhoids are sometimes prolapsing out (falling outside) but then going back in unaided, the surgeon will consider hemorrhoid rubber band ligation. If the internal hemorrhoids are bigger still, only going back in if you push them back in, then the surgeon will likely suggest mulitple surgeries with banding, or multiple ultrasound directed suture ligation (suture the blood supply off from them so the hemorrhoids die), or the Procedure for Prolapse and Hemorrhoids (PPH). If the internal hemorrhoids cannot be pushed back in, then the surgeon will likely suggest a hemorrhoidectomy (hemorrhoid cut away). A hemorrhoidectomy may also be considered if large skin tags are causing some of the symptoms, in this scenario, the hemorrhoids and skin tags will be cut out at the same time.
For external hemorrhoids the surgeon will remove your hemorrhoids by:
Hemorrhoidectomy. It’s the only operation available for external hemorrhoids.
How to Safely Remove Hemorrhoids
Medications can always cause allergic reactions or bad side effects, while surgery to remove hemorrhoids always carries a bit of risk. Of course, all life is a series of considered risks, but the name of the game when trying to remove hemorrhoids is to maximize the benefits and reduce the risk factors as much as possible.
If you’re planning on taking an herbal, alternative, or medication based method to remove hemorrhoids, always read the possible side effects carefully.
If the hemorrhoids remedy in question claims to have no side effects at all, be very careful. There is no such thing as a medication to remove hemorrhoids that has no possible side effects.
In addition, do remember to read the entire active and inactive ingredient lists to see if there’s anything you might be allergic to.
If you start developing problems while you’re taking the medication to remove the hemorrhoids, or if the medication doesn’t seem to remove the hemorrhoids in a reasonable time period, then stop the medication. The medication should start to healing hemorrhoids within two weeks, and any plan to remove hemorrhoids without surgery should work within about six months.
Of course, if you’re looking to surgery to remove the hemorrhoids, then you should carefully consider those risks as well.
Removing hemorrhoids by surgical intervention can cause:
- muscle damage
- nerve damage
- and fecal incontinence.
Of course, some of these risks are short term while others will last for a while. Shock, bleeding, and infection tend to be the short term risks of the surgery. Serious pain is both a short and a long term risk. Muscle damage, nerve damage, and fecal incontinence are all possible long term risks of having surgery to remove hemorrhoids. Needless to say, the risks of surgery rise quickly when you’ve got an incompetent surgeon, so do take the time to research the best possible surgeon in your area.
Ironically, hemorrhoidectomy carries the worst possible side effects, including incontinence, but has the best outcomes for removing hemorrhoids. Banding has only minor side effects for the most part, but carries the greatest risk of all operations for being life threatening (though it is still very very rare for anyone to die from its complications)
Removing Hemorrhoids For Good
One of the biggest points to consider when planning to remove hemorrhoids from your life permanently is to seek out all possiblecauses of hemorrhoids and eliminate them.
The most common causes of hemorrhoids are poor health and lifestyle choices. Therefore if you never want to have to remove hemorrhoids again, you should take a good long look at your current lifestyle choices and think about how you could improve them. Creating a hemorrhoids diet , avoiding foods that cause and or aggravate hemorrhoids, and suitable exercise plan are important in ending hemorrhoids from your life forever.
Two health conditions that deserve special mention when it comes to planning to remove hemorrhoids are obesity and high blood pressure.
Considering that hemorrhoids are caused by excessive downward pressure on the hemorrhoidal veins, both obesity and high blood pressure contribute significantly to these sorts of problems. A good hemorrhoids diet and exercise plan will probably help with both of these health issues.
Of course, high blood pressure and obesity are not the only two obstacles to removing hemorrhoids permanently. There are a number of other health conditions that can cause hemorrhoid problems. Crohn’s disease, irritable bowel syndrome, pregnancy, and diabetes are just a few of the health conditions that can cause or contribute to hemorrhoids. These health conditions might not be curable, but controlling these conditions as much as you can can help immensely.
Recap On Removing Hemorrhoids
The goal to remove hemorrhoids is obviously within reach with the right thought, research, and planning. First, find out what sort of hemorrhoids you’ve got. Then, find out what options exist to remove hemorrhoids of that particular type. Pick the method or methods to remove hemorrhoids that you find most acceptable in terms of risk and benefit. Then, once you’ve gotten rid of your current case of hemorrhoids, plan to remove hemorrhoids from your life forever with a good, overarching hemorrhoid prevention plan – eg diet and exercise.
Of course if removing hemorrhoids pose too greater risk in any way, then you may decide to just stay with the hemorrhoid relief option. You don’t have to remove hemorrhoids just becuase you have them.
References used to compile this article on Removing Hemorrhoids
Banov L, Knoepp LF, Erdman LH, Alia RT (1985). “Management of hemorrhoidal disease”. J S C Med Assoc 81 (7): 398–401.
Chen, Herbert (present). Illustrative Handbook of General Surgery. Berlin: Springer. pp. 217.
Khubchandani, I., ed., et al., Surgical treatment of hemorrhoids, Springer-Verlag London Ltd., 2009.
Lorenzo-Rivero S (August 2009). “Hemorrhoids: diagnosis and current management”. Am Surg 75 (8): 635–42.
Research and main write by Loni L. Ice, quality control, editing and additional writing by D. S. Urquhart.