Can Hemorrhoids Be Cured? Treatment Options and Management

Hemorrhoids cannot be completely cured?

Hi Doctor, I am a male with hemorrhoids.
I started experiencing symptoms of internal hemorrhoids in November of last year, including pain during bowel movements, bleeding, and anal itching.
I was diagnosed with internal hemorrhoids at the beginning of this year.
Initially, the pain was severe, but I didn't feel any foreign body sensation, and using suppositories helped a lot.
Once I felt better, I stopped using them.
The first doctor kept telling me to adjust my lifestyle and diet.
I have made significant changes, such as not staying up late, avoiding junk food, and establishing an exercise routine.
However, I still experience mild pain during bowel movements, persistent anal itching, and some discharge, but it does not affect my daily life (the pain is not as severe as it was before my first visit).
Since the medication did not improve my condition, I stopped using the suppositories.
Three months ago, for no apparent reason, the pain returned severely.
I visited another hospital, and the doctor repeatedly told me that I had nothing serious, just mild internal hemorrhoids, but there was a wound in the anal area, possibly from scratching.
The second doctor told me that if the medication does not cure the condition, I would have to coexist with hemorrhoids for the rest of my life.
Thank you for reading this.
Here are my questions:
Q1: Currently, I experience occasional bleeding during bowel movements, but it is not very painful.
However, I am still startled every time I wipe, and the itching persists.
Given that the last time I was in severe pain, the doctor said medication would resolve it and that a complete cure is unlikely, can hemorrhoids really not be cured? If surgery is an option, can it provide a cure? (I am not considering poor lifestyle habits since I have made adjustments.)
Q2: Is there something wrong with my medication habits? I initially used one suppository twice daily, but after the pain subsided, I stopped using it (as advised by the first doctor).
However, I still experience bleeding occasionally when I strain too much, so I take another one.
Do you have any other suggestions?
Q3: Could the anal itching be caused by the wound, or is it possible that the itching is not due to hemorrhoids but rather the result of the anal wound? Is there a possibility of misdiagnosis that would require long-term observation or further diagnosis? During my second visit, I went to a large hospital, and it felt like the doctor did not want to address my mild symptoms, which left me feeling uneasy.

P.S.: My stomach is fine, I rarely experience constipation, and I have regular bowel movements.

You Zhi Nan Sheng, 20~29 year old female. Ask Date: 2018/09/14

Dr. Ke Fangxu reply Surgery

1.
If the bleeding is occasional and not significant, there is no need for excessive concern.
For itching, there are both oral and topical medications available, and surgery is not necessarily required.

2.
It is advised not to use suppositories unless there is significant bleeding; instead, the focus should be on avoiding straining during bowel movements.
If needed, stool softeners can be used.

3.
Anal itching may be caused by excessive wiping.
In addition to medication, three important points should be noted: avoid scratching to prevent wound infection, temporarily refrain from consuming spicy foods to prevent capsaicin from irritating the skin, and avoid using soap or body wash to clean the anal area to prevent excessive removal of the skin's natural oils.
If these points are followed, improvement can generally be seen within about a week.

Reply Date: 2018/09/14

More Info

Hemorrhoids, or piles, are a common condition that can cause discomfort, pain, and bleeding during bowel movements. They can be classified into two types: internal hemorrhoids, which occur inside the rectum, and external hemorrhoids, which develop under the skin around the anus. While many people experience symptoms of hemorrhoids at some point in their lives, the question of whether they can be cured is complex and depends on various factors, including the severity of the condition and the treatment options pursued.

Q1: Can Hemorrhoids Be Cured?
The short answer is that while hemorrhoids can often be effectively managed and their symptoms alleviated, they may not always be "cured" in the traditional sense. Many individuals find that lifestyle changes, such as increasing fiber intake, staying hydrated, and exercising regularly, can significantly reduce symptoms and prevent recurrence. However, for some, especially those with more severe or persistent symptoms, medical intervention may be necessary.

Surgical options, such as hemorrhoidectomy (removal of hemorrhoids) or rubber band ligation (a procedure that cuts off blood supply to the hemorrhoid), can provide a more definitive solution. These procedures can effectively eliminate the hemorrhoids and alleviate symptoms, but they come with their own risks and recovery times. It’s important to discuss these options with a healthcare provider to determine the best course of action based on individual circumstances.

Q2: Medication Usage and Management
Your approach to using medication, such as suppositories, is not uncommon. Many patients start with topical treatments or suppositories to manage symptoms. However, it’s essential to follow the guidance of a healthcare professional regarding the duration and frequency of use. If you find that symptoms recur, it may be beneficial to consult with a specialist who can provide a tailored treatment plan.

In addition to medication, consider incorporating dietary changes to ensure regular bowel movements. High-fiber foods, such as fruits, vegetables, and whole grains, can help prevent straining during bowel movements, which is a common trigger for hemorrhoid flare-ups. Over-the-counter stool softeners may also be helpful if you experience occasional constipation.

Q3: Anal Itching and Potential Misdiagnosis
Anal itching can be caused by various factors, including hemorrhoids, skin irritation, or even infections. If you have a wound or irritation around the anal area, it could contribute to itching. It’s essential to maintain good hygiene and avoid excessive wiping, which can exacerbate irritation. If the itching persists despite good hygiene practices, it may warrant further evaluation by a healthcare provider.

Regarding the possibility of misdiagnosis, while it’s less common for experienced healthcare providers to misdiagnose hemorrhoids, it’s not impossible. If you feel uncertain about your diagnosis or treatment plan, seeking a second opinion from a colorectal specialist may provide clarity and reassurance. They can conduct a thorough examination and possibly recommend additional diagnostic tests if necessary.

Conclusion
In summary, while hemorrhoids can often be managed effectively, they may not always be completely cured, especially if lifestyle factors are not adequately addressed. Surgical options are available for more severe cases, and it’s crucial to follow a healthcare provider's recommendations regarding medication and lifestyle changes. If symptoms persist or worsen, seeking further evaluation is advisable to ensure appropriate treatment and management. Remember, open communication with your healthcare provider is key to finding the best approach for your situation.

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