Hemorrhoids: When to Consider Surgery and Treatment Options - Surgery

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Hemorrhoids, commonly known as piles, are swollen veins in the lower rectum and anus that can cause discomfort, pain, and bleeding. They can be classified into two main types: internal hemorrhoids, which occur inside the rectum, and external hemorrhoids, which develop under the skin around the anus. The severity of hemorrhoids is often classified into four stages, with stage III indicating that the hemorrhoids protrude outside the anal canal and require manual reduction.

In your case, it seems you are experiencing stage III hemorrhoids, which can lead to significant discomfort and complications if left untreated. The recommendation from your doctor to consider surgery is based on the severity of your condition and the potential for worsening symptoms. While conservative treatments, such as topical medications and lifestyle modifications, can be effective for early-stage hemorrhoids, they may not provide sufficient relief for more advanced cases.


When to Consider Surgery
Surgery for hemorrhoids is typically considered when:
1. Severe Symptoms: If you experience persistent pain, bleeding, or discomfort that does not improve with conservative treatments, surgery may be necessary.

2. Prolapse: If the hemorrhoids protrude outside the anus and cannot be manually pushed back in, surgical intervention is often recommended.

3. Recurrent Issues: If you have frequent flare-ups or complications such as thrombosis (blood clots in external hemorrhoids), surgery may be the best option to prevent future occurrences.


Treatment Options
1. Conservative Management: This includes dietary changes (increasing fiber intake), hydration, and the use of topical treatments like creams or suppositories. Warm sitz baths can also provide relief by reducing inflammation and discomfort.


2. Minimally Invasive Procedures: Options such as rubber band ligation, sclerotherapy, or infrared coagulation can be effective for treating internal hemorrhoids without the need for major surgery. These procedures are typically less painful and have shorter recovery times.

3. Surgical Options: If your doctor recommends surgery, it may involve procedures such as hemorrhoidectomy (removal of hemorrhoids) or stapled hemorrhoidopexy (stapling the hemorrhoids back into place). These surgeries are generally safe and effective, but they do come with risks such as infection, bleeding, and pain.


Concerns About Medication and Treatment
You mentioned using a topical medication (喜療痣) that may cause itching. Some topical treatments can indeed cause irritation or allergic reactions in sensitive individuals. If you experience significant discomfort, it’s important to discuss this with your doctor, who may recommend alternative treatments.

Regarding the use of an ultrasound knife (超音波刀), this is a newer technique that can minimize pain and recovery time compared to traditional surgical methods. It’s essential to discuss the benefits and risks of this approach with your healthcare provider to determine if it’s suitable for your situation.


Conclusion
Ultimately, the decision to proceed with surgery should be based on a thorough evaluation of your symptoms, the effectiveness of conservative treatments, and your overall health. If you are hesitant about surgery, consider seeking a second opinion from another specialist. Remember, untreated hemorrhoids can lead to complications, so it’s crucial to address your concerns proactively. Regular follow-ups with your healthcare provider will ensure that you receive the best possible care tailored to your needs.