Hemorrhoids (Piles)

  • Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: Bhupinder Anand, MD
Hemorrhoids Slideshow Pictures

Quick GuideHow to Get Rid of Hemorrhoids, Causes and Treatment

How to Get Rid of Hemorrhoids, Causes and Treatment

Non-surgical approaches

Grade 2 and 3 hemorrhoids are initially treated the same way, using techniques to destroy the hemorrhoid. These include injecting the hemorrhoid vein to make it sclerose or harden, using rubber bands to choke off the blood supply and make the hemorrhoidal tissue shrivel, or other procedures that cause the mucosa to shrivel and die.

Hemorrhoid surgery

Patients who have failed conservative therapy or who have grade 4 hemorrhoids are candidates for surgery to remove the swollen hemorrhoids and the larger external hemorrhoid skin tags. Options include hemorrhoid removal with laser surgery or hemorrhoidectomy (ectomy=removal) using a scalpel. Another alternative is stapled hemorrhoidectomy, where a special staple gun is positioned to remove the hemorrhoid and surround the tissue with a ring of staples to close the area as well as controlling the bleeding.

A thrombosed external hemorrhoid indicates that a clot has formed in the hemorrhoid causing significant pain. Treatment involves cutting into the hemorrhoid to remove the clot and reduce the swelling.

What is the prognosis for hemorrhoids?

Hemorrhoids are normal tissue and only raise concern when they swell, become inflamed or bleed. Hemorrhoids will recur after non-surgical treatment about 50% of the time, while the recurrence rate after surgery is only 5%.

The goal is to control hemorrhoid inflammation by diet and hydration so that surgery is not required. In this respect, hemorrhoids are a life-long condition, to be controlled and not cured.

Medically reviewed by Martin E Zipser, MD; American Board of Surgery

REFERENCE: Tintinalli JE, et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th edition McGraw hill Professional. 2010

Medically Reviewed by a Doctor on 2/5/2015

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