Can Hemorrhoids Be Treated Without Surgery? Exploring Non-Surgical Options

Can hemorrhoids be treated without surgery?

Hello, doctor.
I visited a gastroenterology clinic at the beginning of November, and I’m not sure what kind of examination was performed; I was just asked to lie on my side, and it seemed like the doctor examined my rectum manually.
The doctor diagnosed me with hemorrhoids and prescribed a topical hemorrhoid suppository and some anti-inflammatory medication.
After two visits, I didn’t return for follow-up.
I feel that the suppository has been somewhat effective, but the oral medication hasn’t shown much effect.
Recently, I’ve developed a daily bowel movement routine due to the hemorrhoids, relying on exercise and increased vegetable intake to see if it can improve my condition.
I also bought a hemorrhoid cream to apply, but sometimes in the morning, my bowel movements are very smooth, and I don’t feel any hemorrhoids.
Other times, I experience a sharp pain at the beginning of the bowel movement, followed by itching and some blood on the toilet paper.
Occasionally, I feel a sensation of something foreign in my rectum while walking, but sometimes I don’t.
I would like to ask if I should see a doctor again.
If I do, should I choose a proctology clinic instead? I found some proctology clinics online.

Nìmíng, 30~39 year old female. Ask Date: 2016/11/18

Dr. Ke Fangxu reply Surgery

My personal principle is to recommend surgery only for hemorrhoids that are accompanied by persistent bleeding, severe pain, or significant prolapse.
Otherwise, conservative treatment targeting the symptoms can be pursued first.
As long as there are no uncomfortable symptoms, there is no need for concern.
During this period, it is advisable to avoid constipation and shorten the time spent on bowel movements.
Warm sitz baths should also help alleviate symptoms.
Over-the-counter hemorrhoid suppositories can be used, but it is best not to take stool softeners indiscriminately.
At this age, increasing the intake of dietary fiber and fluids should be sufficient.
If bleeding persists, it is best to consult a physician for evaluation.

Reply Date: 2016/11/18

More Info

Hemorrhoids, also known as piles, are swollen veins in the lower rectum and anus that can cause discomfort, pain, and bleeding. They are a common condition, and many people experience them at some point in their lives. The good news is that there are several non-surgical treatment options available for managing hemorrhoids, which can be effective in alleviating symptoms and improving quality of life.

Non-Surgical Treatment Options for Hemorrhoids
1. Dietary Changes: One of the most effective ways to manage hemorrhoids is through dietary modifications. Increasing fiber intake can help soften stools and reduce straining during bowel movements, which is a significant contributor to hemorrhoid formation. Foods rich in fiber include fruits, vegetables, whole grains, and legumes. Additionally, staying well-hydrated by drinking plenty of water can also aid in digestion and prevent constipation.

2. Over-the-Counter Medications: Topical treatments, such as hemorrhoid creams or ointments, can provide temporary relief from itching, pain, and inflammation. These products often contain ingredients like hydrocortisone or witch hazel, which can soothe the affected area. Oral pain relievers, such as acetaminophen or ibuprofen, can also help manage discomfort.

3. Sitz Baths: Taking warm sitz baths several times a day, especially after bowel movements, can help relieve pain and reduce swelling. A sitz bath involves sitting in a few inches of warm water, which can promote relaxation and healing in the anal area.

4. Lifestyle Modifications: Regular exercise can improve bowel function and help prevent constipation. Additionally, avoiding prolonged sitting or standing, as well as practicing good bathroom habits (such as not straining during bowel movements), can help reduce the risk of hemorrhoid flare-ups.

5. Minimally Invasive Procedures: If conservative measures do not provide sufficient relief, there are minimally invasive procedures that can be performed in a doctor's office. These include rubber band ligation, sclerotherapy, and infrared coagulation. These procedures aim to reduce the size of hemorrhoids without the need for traditional surgery.

When to See a Doctor
Given your symptoms, it may be beneficial to consult with a healthcare professional again, especially if you are experiencing persistent pain, bleeding, or a sensation of fullness in the rectal area. While your current treatment regimen may have provided some relief, it’s important to ensure that there are no complications or other underlying conditions.

You mentioned that you were initially seen by a gastroenterologist. If you decide to seek further evaluation, a colorectal surgeon or a specialist in proctology may be more appropriate, as they have specific expertise in treating conditions related to the rectum and anus.

Conclusion
In summary, hemorrhoids can often be managed effectively without surgery through a combination of dietary changes, over-the-counter medications, lifestyle modifications, and minimally invasive procedures. If your symptoms persist or worsen, it is advisable to seek further medical evaluation to explore additional treatment options. Remember, early intervention can help prevent complications and improve your overall comfort and health.

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